Novel Assessment of Subregional Bone Mineral Density Using DXA and pQCT and Subregional Microarchitecture Using Micro-CT in Whole Human Vertebrae: Applications, Methods, and Correspondence Between Technologies

Briggs, Andrew M.; Perilli, Egon; Parkinson, Ian H.; Wrigley, Tim V.; Fazzalari, Nicola L.; Kantor, Susan; Wark, John D.

doi:10.1016/j.jocd.2010.01.120

« Previous Next »Journal of Clinical Densitometry
Volume 13, Issue 2 , Pages 161-174, April 2010

Novel Assessment of Subregional Bone Mineral Density Using DXA and pQCT and Subregional Microarchitecture Using Micro-CT in Whole Human Vertebrae: Applications, Methods, and Correspondence Between Technologies

Andrew M. Briggs
- School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia
- University of Melbourne Department of Medicine, and Bone and Mineral Service, Royal Melbourne Hospital, Victoria, Australia
Egon Perilli
- Bone and Joint Research Laboratory, SA Pathology and Hanson Institute, Adelaide, South Australia; and Discipline of Pathology, University of Adelaide, Adelaide, South Australia, Australia
Ian H. Parkinson
- Bone and Joint Research Laboratory, SA Pathology and Hanson Institute, Adelaide, South Australia; and Discipline of Pathology, University of Adelaide, Adelaide, South Australia, Australia
Tim V. Wrigley
- Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Victoria, Australia
Nicola L. Fazzalari
- Bone and Joint Research Laboratory, SA Pathology and Hanson Institute, Adelaide, South Australia; and Discipline of Pathology, University of Adelaide, Adelaide, South Australia, Australia
Susan Kantor
- University of Melbourne Department of Medicine, and Bone and Mineral Service, Royal Melbourne Hospital, Victoria, Australia
John D. Wark
- University of Melbourne Department of Medicine, and Bone and Mineral Service, Royal Melbourne Hospital, Victoria, Australia
- Address correspondence to: John D Wark, University of Melbourne Department of Medicine, Royal Melbourne Hospital, Parkville, Victoria, 3050, Australia.

Received 2 October 2009; received in revised form 14 January 2010; accepted 14 January 2010. published online 29 March 2010.

Abstract

In the clinical environment dual-energy X-ray absorptiometry (DXA) is the current tool of first choice for assessing and monitoring skeletal integrity. A major drawback of standard DXA is that the bone mineral density (BMD) data cannot be used with certainty to predict who will sustain a vertebral fracture. However, measurement of BMD within vertebral subregions, instead of relying on a gross estimate of vertebral BMD, may improve diagnostic sensitivity. The aim of this article was to describe a validation study for subregional BMD measurement using lateral-projection DXA and to present preliminary data. Concurrent validity of measuring subregional BMD with DXA was established against measures of volumetric subregional BMD from peripheral quantitative computed tomography (pQCT) and subregional bone volume fraction from μCT at the L2 vertebral body in 8 cadaver spine specimens. The novel approaches for measuring subregional parameters with each imaging modality are described. Significant differences in bone parameters between vertebral subregions were observed for each imaging modality (p<0.05). Correspondence ranged from R²=0.01–0.79 and R²=0.06–0.80 between “DXA vs. pQCT” and “DXA vs. micro-CT,” respectively. For both imaging modalities, correspondence with DXA was high for centrally and anteriorly positioned subregions. These data provide a basis for larger studies to examine the biological significance of heterogeneity in vertebral BMD.