Abstract
Purpose
To determine inter-scan, inter-reader and intra-reader variability of trabecular structure analysis using flat-panel volume computed tomography (fp-VCT) in cadaver knee specimens.
Methods
Five explanted knee specimens were imaged at three different time points using fp-VCT. Four parameters that quantify trabecular bone structure of the proximal tibia were measured by two observers at two different time points. Bland–Altman analysis was used to compute the inter-scan, inter-observer and intra-observer variability.
Results
Inter-scan variability was low, with a mean difference of 0% and a standard deviation less than 8.4% for each of the four parameters. The inter-observer and intra-observer variability was less than 2.8% ± 8.5%.
Conclusion
Fp-VCT is a method for assessing trabecular structure parameters with low inter-scan, inter-reader and intra-reader variability.
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References
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285: 785–795.
Kleerekoper M, Villanueva AR, Stanciu J, Rao DS, Parfitt AM. The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures. Calcif Tissue Int. 1985; 37: 594–597.
Ladinsky GA, Wehrli FW. Noninvasive assessment of bone microarchitecture by MRI. Curr Osteoporos Rep 2006; 4: 140–147.
Laib A, Hildebrand T, Hauselmann HJ, Ruegsegger P. Ridge number density: a new parameter for in vivo bone structure analysis. Bone 1997; 21: 541–546.
Link TM, Bauer J, Kollstedt A, et al. Trabecular bone structure of the distal radius, the calcaneus, and the spine: which site predicts fracture status of the spine best? Invest Radiol 2004; 39: 487–497.
Milos G, Spindler A, Ruegsegger P, et al. Cortical and trabecular bone density and structure in anorexia nervosa. Osteoporos Int 2005; 16: 783–790.
Newitt DC, Majumdar S, van Rietbergen B, et al. In vivo assessment of architecture and micro-finite element analysis derived indices of mechanical properties of trabecular bone in the radius. Osteoporos Int 2002; 13: 6–17.
Patel PV, Prevrhal S, Bauer JS, et al. Trabecular bone structure obtained from multislice spiral computed tomography of the calcaneus predicts osteoporotic vertebral deformities. J Comput Assist Tomogr 2005; 29: 246–253.
Wehrli FW, Song HK, Saha PK, Wright AC. Quantitative MRI for the assessment of bone structure and function. NMR Biomed 2006; 19: 731–764.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 2005; 90: 6508–6515.
Gomberg BR, Wehrli FW, Vasilic B, et al. Reproducibility and error sources of micro-MRI-based trabecular bone structural parameters of the distal radius and tibia. Bone 2004; 35: 266–276.
Damilakis J, Maris TG, Karantanas AH. An update on the assessment of osteoporosis using radiologic techniques. Eur Radiol 2007; 17: 1591–1602.
Kalender WA. The use of flat-panel detectors for CT imaging. Radiologe 2003; 43: 379–387.
Gupta R, Grasruck M, Suess C, et al. Ultra-high resolution flat-panel volume CT: fundamental principles, design architecture, and system characterization. Eur Radiol 2006; 16: 1191–1205.
Parfitt AM. Bone histomorphometry: standardization of nomenclature, symbols and units. Summary of proposed system. Bone Miner 1988; 4: 1–5.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.
Link TM, Saborowski S, Kisters K, et al. Changes in calcaneal trabecular bone structure assessed with high-resolution MR imaging in patients with kidney transplantation. Osteoporos Int 2002; 13: 119–129.
Ross PD, Wasnich RD, Davis JW. Fracture prediction models for osteoporosis prevention. Bone 1990; 11: 327–331.
Benhamou CL. Effects of osteoporosis medications on bone quality. Joint Bone Spine 2007; 74: 39–47.
Chen P, Miller PD, Recker R, et al. Increases in BMD correlate with improvements in bone microarchitecture with teriparatide treatment in postmenopausal women with osteoporosis. J Bone Miner Res 2007; 22: 1173–1180.
Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 1995; 332: 767–773.
Link TM, Majumdar S. Current diagnostic techniques in the evaluation of bone architecture. Curr Osteoporos Rep 2004; 2: 47–52.
Parisien MV, McMahon D, Pushparaj N, Dempster DW. Trabecular architecture in iliac crest bone biopsies: infra-individual variability in structural parameters and changes with age. Bone 1988; 9: 289–295.
Bredella MA, Misra M, Miller KK, et al. Distal radius in adolescent girls with anorexia nervosa: trabecular structure analysis with high-resolution flat-panel volume CT. Radiology 2008; 249: 938–946.
Thomsen JS, Ebbesen EN, Mosekilde L. Predicting human vertebral bone strength by vertebral static histomorphometry. Bone 2002; 30: 502–508.
Phan CM, Matsuura M, Bauer JS, et al. Trabecular bone structure of the calcaneus: comparison of MR imaging at 3.0 and 1.5 T with micro-CT as the standard of reference. Radiology 2006; 239: 488–496.
Link TM, Vieth V, Stehling C, et al. High-resolution MRI vs multislice spiral CT: which technique depicts the trabecular bone structure best? Eur Radiol 2003; 13: 663–671.
Reichardt B, Sarwar A, Bartling SH, et al. Musculoskeletal applications of flat-panel volume CT. Skeletal Radiol 2008; 37: 1069–1076.
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Cheung, A.C., Bredella, M.A., Al Khalaf, M. et al. Reproducibility of trabecular structure analysis using flat-panel volume computed tomography. Skeletal Radiol 38, 1003–1008 (2009). https://doi.org/10.1007/s00256-009-0707-9
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DOI: https://doi.org/10.1007/s00256-009-0707-9