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Influence of angulation on metacarpal bone mineral density measurements using digital X-ray radiogrammetry

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Objective

Digital X-ray radiogrammetry (DXR) is a computer-assisted technique used to quantify cortical bone density of the metacarpals. The influence of metacarpal bone rotation and type of cast material on bone mineral density (BMD) measurements using the DXR technique was tested.

Methods

The bone mineral density of the hand was measured by DXR, and rotation error (DXR–RE) as coefficients of variation were calculated, to verify reliability and reproducibility of this radiogeometric technique to assess in particular minor disease-related changes in the metacarpal bone mass. The reproducibility of the DXR measurements was also investigated using different cast materials (mull, elastic, and plastic).

Results

There were no significant changes in absolute values of DXR–BMD observed between 0 to \(19^\circ \) angulation. The relative DXR–RE ranged between 0 % (degree 1) and 0.70 % (degrees 15 and 19) for DXR–BMD. Regarding the different cast materials, DXR–BMD revealed a coefficient of variation with 0.41 % (mull cast) and 0.21 % (elastic cast). For the plastic cast, the DXR technique was not able to perform an analysis of DXR–BMD.

Conclusion

The study revealed no significant influence of metacarpal rotation on the measurements of metacarpal bone mineral density as estimated by DXR. DXR measurements are not optimal when cast material is used. DXR can accurately quantify periarticular cortical bone mass. This is significant especially for rheumatoid arthritis and related conditions where X-ray imaging of arthritic hands with varying degrees of deformity is performed.

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Abbreviations

BMD:

Bone mineral density (g/cm\(^{2}\))

CAD:

Computer-assisted detection

CT:

Cortical thickness (cm)

CV:

Coefficient of variation in %

DXR:

Digital X-ray radiogrammetry

MCI:

Metacarpal index

RE:

Rotation error

W:

Metacarpal bone width (cm)

RA:

Rheumatoid arthritis

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Acknowledgments

The authors thank Monika Arens (managing director, Arewus GmbH) and Jacob Algulin (managing director, Sectra, Sweden) for use of the digital X-ray radiogrammetry equipment. Also, many thanks to Günter Ditze (Forschungswerkstatt Friedrich—Schiller—University Jena) for the planning and construction of the phantom equipment and to Rüdiger Vollandt (PhD) for the statistical advice.

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Authors and Affiliations

  1. Department of Internal Medicine III, Jena University Hospital – Friedrich Schiller University Jena, Erlanger Allee 101, 07747 , Jena, Germany

    Alexander Pfeil, Gabriele Lehmann & Gunter Wolf

  2. Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 , Berlin, Germany

    Diane M. Renz & Julia Sommerfeld

  3. Institute of Anatomy I, Jena University Hospital – Friedrich Schiller University Jena, Teichgraben 7, 07740 , Jena, Germany

    Rosemarie Fröber

  4. Institute of Diagnostic and Interventional Radiology, Heinrich – Braun – Clinic Zwickau, Karl-Kreil-Straße 35, 08060 , Zwickau, Germany

    Andreas Hansch

  5. Department of Radiology, Suedharz Clinic Nordhausen, Dr.Robert-Koch Str. 39, 99734 , Nordhausen, Germany

    Ansgar Malich

  6. Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548 , Gera, Germany

    Joachim Böttcher

Authors
  1. Alexander Pfeil
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  2. Diane M. Renz
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  4. Andreas Hansch
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  9. Joachim Böttcher
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Correspondence to Alexander Pfeil.

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Pfeil, A., Renz, D.M., Fröber, R. et al. Influence of angulation on metacarpal bone mineral density measurements using digital X-ray radiogrammetry. Int J CARS 10, 587–592 (2015). https://doi.org/10.1007/s11548-014-1076-y

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  • DOI: https://doi.org/10.1007/s11548-014-1076-y

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