Monitoring Bone Growth Using Quantitative Ultrasound in Comparison with DXA and pQCT

Wang, Qingju; Nicholson, Patrick H.F.; Timonen, Jussi; Alen, Markku; Moilanen, Petro; Suominen, Harri; Cheng, Sulin

doi:10.1016/j.jocd.2007.10.003

« Previous Next »Journal of Clinical Densitometry
Volume 11, Issue 2 , Pages 295-301, April 2008

Monitoring Bone Growth Using Quantitative Ultrasound in Comparison with DXA and pQCT

Qingju Wang
- Endocrine Center of Excellence, Austin Health, University of Melbourne, Melbourne, Australia
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Address correspondence to: Qingju Wang, PhD, Endocrine Center of Excellence, Austin Health, University of Melbourne, Melbourne, Australia.
Patrick H.F. Nicholson
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Jussi Timonen
- Department of Physics Sciences, University of Jyväskylä, Jyväskylä, Finland
Markku Alen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Petro Moilanen
- Department of Physics Sciences, University of Jyväskylä, Jyväskylä, Finland
Harri Suominen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Sulin Cheng
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

Received 10 September 2007; received in revised form 25 October 2007; accepted 25 October 2007. published online 03 January 2008.

Abstract

Quantitative ultrasound (QUS) is a safe, inexpensive, and nonradiation method for bone density assessment. QUS correlates with, and predicts fragility fractures comparable to, dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) in postmenopausal women. However, its validity in monitoring bone growth in children is not well understood. Two hundred and fifty-eight 10–13yr pubertal girls and 9 37–43yr adults without diseases or history of medications known to affect bone metabolism were included in the 2-yr prospective study. Calcaneal broadband ultrasound attenuation (cBUA) was assessed using QUS-2 (Quidel, Santa Clara, CA), speed of sound of tibial shaft (tSOS) using Omnisense (Sunlight Technologies, Israel), apparent volumetric BMD (vBMD) of tibial shaft using peripheral quantitative computed tomography (pQCT; XCT2000, Stratec), and femoral neck (FN) and lumbar spine 2–4 (LS) areal BMD (aBMD) using DXA (Prodigy, GE). Over the 2yr in girls, FN and LS aBMD showed the largest increases (17±8% and 20±8%, respectively), followed by tibial vBMD and cBUA (10±5% and 9±9%, respectively). There was no apparent change in tSOS (2±3%). The increase in FN and LS aBMD attenuated 48% and 40%, respectively, after adjustment of the change in body size. The change of cBUA correlated significantly with change in tibial vBMD and FN and LS aBMD (r=0.24–0.40). At the matched location, tSOS correlated only with cortical vBMD, not with cortical thickness, apparent vBMD, or bone size. The long-term reproducibility, assessed using the concordance correlation coefficient of young adults' pre-post measurements, was substantially lower in tSOS than cBUA, tibial vBMD, FN, and LS aBMD (0.65 vs 0.97, 0.95, 0.98, and 0.96; p<0.05). The transverse transmission method-derived calcaneal BUA, but not the axial transmission method-derived SOS, is comparable to DXA and pQCT for monitoring bone densitometric change in pubertal girls. The role of QUS in fracture-risk prediction in children and adolescents needs further investigation.