Spine Bone Texture and the Trabecular Bone Score (TBS)
Trabecular bone score (TBS) is a gray-level texture measure that can be extracted from two-dimensional lumbar spine dual-energy X-ray absorptiometry (DXA) images and provides skeletal information beyond standard bone mineral density (BMD) measurement. This chapter reviews scientific and clinical evidence on the development, validation, and clinical application of lumbar spine TBS. TBS should not be used alone to determine treatment recommendations, but can be used in association with the World Health Organization fracture risk assessment tool (FRAX) to adjust FRAX probability of fracture in postmenopausal women and older men and additionally guide decisions regarding treatment initiation.
KeywordsOsteoporosis Fracture Trabecular bone score Bone texture Dual-Energy X-ray Absorptiometry
- Amstrup AK, Jakobsen NF, Moser E, et al. Association between bone indices assessed by DXA, HR-pQCT and QCT scans in post-menopausal women. J Bone Miner Metab. 2015; [Epub ahead of print]Google Scholar
- Hans D, Barthe N, Boutroy S, 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. 2011a;14:302–12.CrossRefPubMedGoogle Scholar
- Iki M, Tamaki J, Kadowaki E, et al. Trabecular bone score (TBS) predicts vertebral fractures in Japanese women over 10 years independently of bone density and prevalent vertebral deformity: the Japanese Population-Based Osteoporosis (JPOS) cohort study. J Bone Miner Res. 2014;29:399–407.CrossRefPubMedGoogle Scholar
- Kalder M, Kyvernitakis I, Albert US, et al. Effects of zoledronic acid versus placebo on bone mineral density and bone texture analysis assessed by the trabecular bone score in premenopausal women with breast cancer treatment-induced bone loss: results of the ProBONE II substudy. Osteoporos Int. 2015;26:353–60.CrossRefPubMedGoogle Scholar
- Kanis JA, on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. Accessible at http://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf. 2007; Last Accessed 8 Mar 2016.
- Leslie WD, Johanson H, Oden A, et al. Improved risk assessment using lumbar spine trabecular bone score (TBS) to adjust fracture probability: the Manitoba BMD Cohort [abstract]. J Bone Miner Res. 2015;29:103.Google Scholar
- Leslie WD, Winzenrieth R, Majumdar SR, et al. Clinical performance of an updated version of trabecular bone score in men and women: the Manitoba BMD Cohort [abstract]. J Bone Miner Res. 2014d;28:97.Google Scholar
- McCloskey EV, Oden A, Harvey NC, et al. A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res. 2016;31(5):940–8. [epub ahead of print].Google Scholar
- Popp AW, Meer S, Krieg MA, et al. Bone mineral density (BMD) and vertebral trabecular bone score (TBS) for the identification of elderly women at high risk for fracture: the SEMOF cohort study. Eur Spine J. 2015; [Epub ahead of print]Google Scholar
- Rabier B, Heraud A, Grand-Lenoir C, et al. A multicentre, retrospective case–control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): analysing the odds of vertebral fracture. Bone. 2010;46:176–81.CrossRefPubMedGoogle Scholar
- Schousboe JT, Vo T, Taylor BC, et al. Prediction of Incident Major Osteoporotic and Hip Fractures by Trabecular Bone Score (TBS) and Prevalent Radiographic Vertebral Fracture in Older Men. J Bone Miner Res 2016;31(3):690–7.Google Scholar
- Sritara C, Thakkinstian A, Ongphiphadhanakul B, et al. Age-adjusted dual X-ray absorptiometry-derived trabecular bone score curve for the lumbar spine in thai females and males. J Clin Densitom. 2015; [Epub ahead of print]Google Scholar