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Increasing soft tissue thickness does not affect trabecular bone score reproducibility: a phantom study

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Abstract

Purpose

Trabecular Bone Score (TBS) provides an indirect score of trabecular microarchitecture from lumbar spine (LS) dual energy X-ray absorptiometry. Increasing soft tissue thickness artifactually reduces TBS values; we evaluated the effect of a fictitious increase of soft tissue thickness on TBS and bone mineral density (BMD) reproducibility on a phantom model.

Methods

A Hologic spine phantom was scanned with a QDR-Discovery W Hologic densitometer. Fresh pork rind layers of 5 mm were used to simulate the in-vivo soft tissues. For each scan mode (fast array [FA], array, high definition [HD]), 25 scans were consecutively performed without phantom repositioning, at 0 (no layers), 1 cm, 3 cm, and 6 cm of thickness. BMD and TBS reproducibility was calculated as the complement to 100% of least significant change.

Results

Both BMD and TBS reproducibility slightly decreased with increasing soft tissue; this difference was statistically significant only for BMD using HD modality (reproducibility decreased from 99.4% at baseline to 98.4% at 6-cm of thickness). TBS reproducibility was slightly lower compared to that of BMD, and ranged between 98.8% (array, 0 cm) and 97.4% (FA, 6 cm). Without taking into account manufacturer BMI optimization, we found a progressive decrease of TBS mean values with increasing soft tissue thickness. The highest TBS difference between baseline scan and 6 cm was −0.179 (−14.27%) using HD.

Conclusions

Despite being slightly lower than that of BMD, TBS reproducibility was not affected up to 6 cm of increasing soft tissue thickness, and was even less influenced by fat than BMD reproducibility.

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Authors and Affiliations

  1. Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Carmelo Messina & Luca Maria Sconfienza

  2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy

    Carmelo Messina & Luca Maria Sconfienza

  3. Reparto di Radiologia, ASST Bergamo Est Ospedale Bolognini, Via Paderno 21, 24068, Seriate, Italy

    Alessandro Poloni

  4. Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Via Panzini 5, Napoli, Italy

    Vito Chianca

  5. Sezione di Scienze Radiologiche, Di.Bi.Med., Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Domenico Albano

  6. Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Luca Petruccio Piodi

  7. Bone Metabolic Unit, Nuclear Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Fabio Massimo Ulivieri

Authors
  1. Carmelo Messina
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  2. Alessandro Poloni
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  3. Vito Chianca
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  4. Domenico Albano
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  5. Luca Petruccio Piodi
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  6. Fabio Massimo Ulivieri
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  7. Luca Maria Sconfienza
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Corresponding author

Correspondence to Carmelo Messina.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors. Institutional Review Board approval was not needed, as no patients are involved.

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Messina, C., Poloni, A., Chianca, V. et al. Increasing soft tissue thickness does not affect trabecular bone score reproducibility: a phantom study. Endocrine 61, 336–342 (2018). https://doi.org/10.1007/s12020-018-1647-8

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  • DOI: https://doi.org/10.1007/s12020-018-1647-8

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