Measuring bone structure could improve prediction of bone strength, but the clinical feasibility of available imaging technologies is limited. The trabecular bone score—a dual-energy X-ray absorptiometry texture algorithm—has shown promise in fracture prediction in a large cohort study, and might provide a practical means of assessing bone quality.
References
Hans, D., Goertzen, A. L., Krieg, M. A. & Leslie, W. D. Bone micro-architecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J. Bone Miner. Res. 26, 2762–2769 (2011).
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 285, 785–795 (2001).
Sornay-Rendu, E., Boutroy, S., Munoz, F. & Bouxsein, M. L. Cortical and trabecular architecture are altered in postmenopausal women with fractures. Osteoporos. Int. 20, 1291–1297 (2009).
Techawiboonwong, A., Song, H. K., Leonard, M. B. & Wehrli, F. W. Cortical bone water: in vivo quantification with ultrashort echo-time MR imaging. Radiology 248, 824–833 (2008).
Li, X. et al. Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis. J. Magn. Reson. Imaging 33, 974–979 (2011).
Guglielmi, G., Adams, J. & Link, T. M. Quantitative ultrasound in the assessment of skeletal status. Eur. Radiol. 19, 1837–1848 (2009).
Lespessailles, E., Chappard, C., Bonnet, N. & Benhamou, C. L. Imaging techniques for evaluating bone microarchitecture. Joint Bone Spine 73, 254–261 (2006).
Boehm, H. F. et al. Local topological analysis of densitometer-generated scan images of the proximal femur for differentiation between patients with hip fracture and age-matched controls. Osteoporos. Int. 20, 617–624 (2009).
Hans, D. et al. Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J. Clin. Densitom. 14, 302–312 (2011).
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Link, T. Assessing bone structure in the prediction of osteoporotic fractures. Nat Rev Rheumatol 8, 6–8 (2012). https://doi.org/10.1038/nrrheum.2011.174
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DOI: https://doi.org/10.1038/nrrheum.2011.174
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