Abstract
Objective
The trabecular bone score (TBS) accounts for the bone microarchitecture and is calculated on dual-energy X-ray absorptiometry (DXA). We estimated the reproducibility of the TBS using different scan modes compared to the reproducibility bone mineral density (BMD).
Materials and methods
A spine phantom was used with a Hologic QDR-Discovery A densitometer. For each scan mode [fast array, array, high definition (HD)], 25 scans were automatically performed without phantom repositioning; a further 25 scans were performed with phantom repositioning. For each scan, the TBS was obtained. The coefficient of variation (CoV) was calculated as the ratio between standard deviation and mean; percent least significant change (LSC%) as 2.8×CoV; reproducibility as the complement to 100 % of LSC%. Differences among scan modes were assessed using ANOVA.
Results
Without phantom repositioning, the mean TBS (mm−1) was: 1.352 (fast array), 1.321 (array), and 1.360 (HD); with phantom repositioning, it was 1.345, 1.332, and 1.362, respectively. Reproducibility of the TBS without phantom repositioning was 97.7 % (fast array), 98.3 % (array), and 98.2 % (HD); with phantom repositioning, it was 97.9 %, 98.7 %, and 98.4 %, respectively. LSC% was ≤2.26 %. Differences among scan modes were all statistically significant (p ≤ 0.019). Reproducibility of BMD was 99.1 % with all scan modes, while LSC% was from 0.86 % to 0.91 %.
Conclusion
Reproducibility error of the TBS was 2–3-fold higher than that of BMD. Although statistically significant, differences in TBS among scan modes were within the highest LSC%. Thus, the three scan modes can be considered interchangeable.
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References
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis and Therapy. JAMA. 2001;285:785–95.
Bouxsein ML, Seeman E. Quantifying the material and structural determinants of bone strength. Best Pract Res Clin Rheumatol. 2009;23:741–53.
Kanis JA, Borgstrom F, De Laet C, et al. Assessment of fracture risk. Osteoporos Int. 2005;16:581–9.
Brandi ML. Microarchitecture, the key to bone quality. Rheumatology. 2009;48 Suppl 4:iv3–8.
Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787–93.
Kanis JA, Hans D, Cooper C, Task Force of the FRAX Initiative, et al. Interpretation and use of FRAX in clinical practice. Osteoporos Int. 2011;22(9):2395–411. doi:10.1007/s00198-011-1713-z.
Pothuaud L, Carceller P, Hans D. Correlations between grey-level variations in 2D projection images (TBS) and 3D microarchitecture: applications in the study of human trabecular bone microarchitecture. Bone. 2008;42:775–87.
Pothuaud L. Process of interpretation of two-dimensional densitometry images for the prediction of bone mechanical strength. Lecture notes in computer science. Springer-Verlag GmbH; 2004. p. 1079–80.
Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA. Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom. 2011;14(3):302–12. doi:10.1016/j.jocd.2011.05.005.
Delnevo A, Bandirali M, Di Leo G, et al. Differences among array, fast array, and high-definition scan modes in bone mineral density measurement at dual-energy x-ray absorptiometry on a phantom. Clin Radiol. 2013;68(6):616–9. doi:10.1016/j.crad.2012.11.017.
Bousson V et al. Trabecular bone score (TBS): available knowledge, clinical relevance, and future prospects. Osteoporos Int. 2012;23:1489–501.
Lewiecki EM, Gordon CM, Baim S, et al. Special report on the 2007 adult and pediatric Position Development Conferences of the International Society for clinical densitometry. Osteoporos Int. 2008;19(10):1369–78. doi:10.1007/s00198-008-0689-9.
Blake GM, Fogelman I. Role of dual-energy X-ray absorptiometry in the diagnosis and treatment of osteoporosis. J Clin Densitom. 2007;10(1):102–10.
Bandirali M, Sconfienza LM, Aliprandi A, et al. In vivo differences among scan modes in bone mineral density measurement at dual-energy X-ray absorptiometry. Radiol Med. 2014;119(4):257–60. doi:10.1007/s11547-013-0342-3.
Bandirali M, Lanza E, Messina C et al. Dose Absorption in Lumbar and Femoral Dual Energy X-ray absorptiometry examinations using three different scan modalities: an anthropomorphic phantom study. J Clin Densitom. 2013;24. doi:10.1016/j.jocd.2013.02.005.
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Bandirali, M., Di Leo, G., Messina, C. et al. Reproducibility of trabecular bone score with different scan modes using dual-energy X-ray absorptiometry: a phantom study. Skeletal Radiol 44, 573–576 (2015). https://doi.org/10.1007/s00256-014-1980-9
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DOI: https://doi.org/10.1007/s00256-014-1980-9