The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients
- 133 Downloads
Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children.
To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion.
Materials and methods
A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed.
No significant difference between CA and BA Z-scores was detected in the overall cohort (P = 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort.
Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males.
KeywordsBone age Bone mineral density Children Quantitative computed tomography (QCT)
The authors would like to thank Dr. Chuck Sklar for review of the manuscript and insightful critique.
This work was supported by Cancer Center Support (CORE) Grant P30 CA 21765 from the National Institutes of Health and by the American Lebanese Syrian Associated Charities (ALSAC).
- 1.National Institutes of Health (2000) Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 17:1–45Google Scholar
- 8.Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer, New YorkGoogle Scholar
- 16.Greulich W, Pyle S (1969) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Palo Alto, CAGoogle Scholar
- 34.CureSearch National Childhood Cancer Foundation (2006) Long-term follow-up guidelines for survivors of childhood, adolescent and young adult cancers. Children’s Oncology Group. http://www.survivorshipguidelines.org/. Accessed 18 Aug 2008