Skip to main content

Advertisement

Log in

Role of endocortical contouring methods on precision of HR-pQCT-derived cortical micro-architecture in postmenopausal women and young adults

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Precision errors of cortical bone micro-architecture from high-resolution peripheral quantitative computed tomography (pQCT) ranged from 1 to 16 % and did not differ between automatic or manually modified endocortical contour methods in postmenopausal women or young adults. In postmenopausal women, manually modified contours led to generally higher cortical bone properties when compared to the automated method.

Introduction

First, the objective of the study was to define in vivo precision errors (coefficient of variation root mean square (CV%RMS)) and least significant change (LSC) for cortical bone micro-architecture using two endocortical contouring methods: automatic (AUTO) and manually modified (MOD) in two groups (postmenopausal women and young adults) from high-resolution pQCT (HR-pQCT) scans. Second, it was to compare precision errors and bone outcomes obtained with both methods within and between groups.

Methods

Using HR-pQCT, we scanned twice the distal radius and tibia of 34 postmenopausal women (mean age ± SD 74 ± 7 years) and 30 young adults (27 ± 9 years). Cortical micro-architecture was determined using AUTO and MOD contour methods. CV%RMS and LSC were calculated. Repeated measures and multivariate ANOVA were used to compare mean CV% and bone outcomes between the methods within and between the groups. Significance was accepted at P < 0.05.

Results

CV%RMS ranged from 0.9 to 16.3 %. Within-group precision did not differ between evaluation methods. Compared to young adults, postmenopausal women had better precision for radial cortical porosity (precision difference 9.3 %) and pore volume (7.5 %) with MOD. Young adults had better precision for cortical thickness (0.8 %, MOD) and tibial cortical density (0.2 %, AUTO). In postmenopausal women, MOD resulted in 0.2–54 % higher values for most cortical outcomes, as well as 6–8 % lower radial and tibial cortical BMD and 2 % lower tibial cortical thickness.

Conclusions

Results suggest that AUTO and MOD endocortical contour methods provide comparable repeatability. In postmenopausal women, manual modification of endocortical contours led to generally higher cortical bone properties when compared to the automated method, while no between-method differences were observed in young adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475

    Article  PubMed  Google Scholar 

  2. Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5):505S–511S

    Article  CAS  PubMed  Google Scholar 

  3. Bouillon R, Burckhardt P, Christiansen C, Fleisch H, Fujita T, Gennari C, Martin TJ, Mazzuoli G, Melton LJ, Ringe JD, Riis B, Peck WA, Samsioe G, Shulman LE (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int 1:114–117

    Article  Google Scholar 

  4. Mueller TL, van Lenthe GH, Stauber M, Gratzke C, Eckstein F, Muller R (2009) Regional, age and gender differences in architectural measures of bone quality and their correlation to bone mechanical competence in the human radius of an elderly population. Bone 45(5):882–891

    Article  PubMed  Google Scholar 

  5. Spadaro JA, Werner FW, Brenner RA, Fortino MD, Fay LA, Edwards WT (1994) Cortical and trabecular bone contribute strength to the osteopenic distal radius. J Orthop Res 12(2):211–218

    Article  CAS  PubMed  Google Scholar 

  6. Alffram P-A, Bauer GCH (1962) Epidemiology of fractures of the forearm: a biomechanical investigation of bone strength. J Bone Joint Surg 44A(1):105–114

    Google Scholar 

  7. Owen RA, Melton L Jr, Johnson KA, Ilstrup DM, Riggs BL (1982) Incidence of Colles’ fracture in a North American community. Am J Public Health 72(6):605–607

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Augat P, Claes LE (1996) Prediction of fracture load at differenet skeletal sites by geometric properties of the cortical shell. J Bone Miner Res 11(9):1356–1363

    Article  CAS  PubMed  Google Scholar 

  9. MacNeil JA, Boyd SK (2007) Load distribution and the predictive power of morphological indices in the distal radius and tibia by high resolution peripheral quantitative computed tomography. Bone 41(1):129–137

    Article  PubMed  Google Scholar 

  10. Augat P, Schorlemmer S (2006) The role of cortical bone and its microstructure in bone strength. Age Ageing 35(Suppl 2):ii27–ii31

    PubMed  Google Scholar 

  11. Currey JD (1979) Changes in the impact energy absorption of bone with age. J Biomech 12:459–469

    Article  CAS  PubMed  Google Scholar 

  12. Currey JD (1988) The effect of porosity and mineral content on the Young’s modulus of elasticity of compact bone. J Biomech 21(2):131–139

    Article  CAS  PubMed  Google Scholar 

  13. Currey J (2004) Incompatible mechanical properties in compact bone. J Theor Biol 231(4):569–580

    Article  PubMed  Google Scholar 

  14. McCalden RW, McGeough JA, Barker MB, Court-Brown CM (1993) Age related changes in the tensile properties of cortical bone. J Bone Joint Surg 75A(8):1193–1205

    Google Scholar 

  15. Patsch JM, Burghardt AJ, Yap SP, Baum T, Schwartz AV, Joseph GB, Link TM (2013) Increased cortical porosity in type 2 diabetic postmenopausal women with fragility fractures. J Bone Miner Res 28(2):313–324

    Article  PubMed Central  PubMed  Google Scholar 

  16. Bell KL, Loveridge N, Jordan GR, Power CR (2000) A novel mechanism for induction of increased cortical porosity in cases of intracapsular hip fracture. Bone 26:305–313

    Article  PubMed  Google Scholar 

  17. Bala Y, Zebaze R, Ghasem-Zadeh A, Atkinson EJ, Iuliano S, Peterson JM, Amin S, Bjornerem A, Melton LJ 3rd, Johansson H, Kanis JA, Khosla S, Seeman E (2014) Cortical porosity identifies women with osteopenia at increased risk for forearm fractures. J Bone Miner Res 29(6):1356–1362

    Article  PubMed Central  PubMed  Google Scholar 

  18. Bell KL, Loveridge N, Power J, Garrahan N, Meggitt BF, Reeve J (1999) Regional differences in cortical porosity in the fractured femoral neck. Bone 24(1):57–64

    Article  CAS  PubMed  Google Scholar 

  19. Burghardt AJ, Buie HR, Laib A, Majumdar S, Boyd SK (2010) Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT. Bone 47(3):519–528

    Article  PubMed Central  PubMed  Google Scholar 

  20. Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK (2010) Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res 25(4):882–890

    PubMed  Google Scholar 

  21. Ostertag A, Peyrin F, Fernandez S, Laredo JD, de Vernejoul MC, Chappard C (2014) Cortical measurements of the tibia from high resolution peripheral quantitative computed tomography images: a comparison with synchrotron radiation micro-computed tomography. Bone 63C:7–14

    Article  Google Scholar 

  22. Kawalilak CE, Johnston JD, Olszynski WP, Leswick D, Kontulainen SA (2014) Comparison of short term in vivo precision of bone density and micro-architecture at the distal radius and tibia between postmenopausal women and young adults. J Clin Densitom 17(4):510–517

    Article  PubMed  Google Scholar 

  23. Kreiger N, Tenehouse A, Joseph L, Mackenzie T, Poliquin S, Brown JP, Prior JC, Rittmaster RS (1999) The Canadian multicentre osteoporosis study (CaMos): background, rationale, methods. Can J Aging 18(3):376–387

    Article  Google Scholar 

  24. Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD, Scientific Advisory Council of Osteoporosis C (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. Can Med Assoc J 182(17):1864–1873

    Article  Google Scholar 

  25. Medical S (2011) Xtreme CT operations manual, Version 61st edn. SCANCO Medical Ag Fabrikweg 2 CH-8306, Bruettisellen, Switzerland

    Google Scholar 

  26. Kawalilak CE, Johnston JD, Olszynski WP, Kontulainen SA (2014) Characterizing micro-architectural changes at the distal radius and tibia in postmenopausal women using HR-pQCT. Osteoporos Int 25(8):2057–2066

    Article  CAS  PubMed  Google Scholar 

  27. Pialat JB, Burghardt AJ, Sode M, Link TM, Majumdar S (2012) Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone 50(1):111–118

    Article  CAS  PubMed  Google Scholar 

  28. Buie HR, Campbell GM, Klinck RJ, MacNeil JA, Boyd SK (2007) Automatic segmentation of cortical and trabecular compartments based on a dual threshold technique for in vivo micro-CT bone analysis. Bone 41(4):505–515

    Article  PubMed  Google Scholar 

  29. Gluer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5:262–270

    Article  CAS  PubMed  Google Scholar 

  30. Engelke K, Adams JE, Armbrecht G, Augat P, Bogado CE, Bouxsein ML, Felsenberg D, Ito M, Prevrhal S, Hans DB, Lewiecki EM (2008) Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: the 2007 ISCD Official Positions. J Clin Densitom 11(1):123–162

    Article  PubMed  Google Scholar 

  31. Gluer CC (1999) Monitoring skeletal changes by radiological techniques. J Bone Miner Res 14(11):1952–1962

    Article  CAS  PubMed  Google Scholar 

  32. Bonnick SL, Johnston CC, Kleerekoper M, Lindsay R, Miller P, Sherwood L, Siris E (2001) Importance of precision in bone density measurements. J Clin Densitom 4(2):105–110

    Article  CAS  PubMed  Google Scholar 

  33. Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. J Bone Miner Res 2(3):595–610

    CAS  PubMed  Google Scholar 

  34. Zebaze RMD, Ghasem-Zadeh A, Bohte A, Iuliano-Burns S, Mirams M, Price RI, Mackie EJ, Seeman E (2010) Intracortical remodelling and porosity in the distal radius and post-mortem femurs of women: a cross-sectional study. Lancet 375:1729–1736

    Article  PubMed  Google Scholar 

  35. Jorgenson BL, Buie HR, McErlain DD, Sandino C, Boyd SK (2015) A comparison of methods for in vivo assessment of cortical porosity in the human appendicular skeleton. Bone 73:167–175

    Article  PubMed  Google Scholar 

  36. Swinford RR, Warden SJ (2010) Factors affecting short-term precision of musculoskeletal measures using peripheral quantitative computed tomography (pQCT). Osteoporos Int 21(11):1863–1870

    Article  CAS  PubMed  Google Scholar 

  37. Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42(3):467–475

    Article  CAS  PubMed  Google Scholar 

  38. Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank all our CaMos Saskatoon cohort participants for their continued altruism and volunteering for scientific research. We thank Andrew Frank and Jola Thingvold for coordinating the study measurements. The authors also acknowledge the University of Saskatchewan and Canadian Institutes of Health Research (CIHR) for their funding support. This work was supported in part by grants from CIHR Regional Partnership Program New Investigator Award, Saskatchewan Health Research Foundation, and Canadian Foundation for Innovation (CFI 16935) and a CIHR Operating Grant (MOP98002).

Conflicts of interest

Chantal E Kawalilak, James D Johnston, Wojciech Olszynski, David ML Cooper, and Saija A Kontulainen declare that they have no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. E. Kawalilak.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kawalilak, C.E., Johnston, J.D., Cooper, D.M.L. et al. Role of endocortical contouring methods on precision of HR-pQCT-derived cortical micro-architecture in postmenopausal women and young adults. Osteoporos Int 27, 789–796 (2016). https://doi.org/10.1007/s00198-015-3262-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-015-3262-3

Keywords

Navigation