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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Victoria, Australia
  • ,
  • Nicola L. Fazzalari

      Affiliations

    • 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

      Affiliations

    • University of Melbourne Department of Medicine, and Bone and Mineral Service, Royal Melbourne Hospital, Victoria, Australia
  • ,
  • John D. Wark

      Affiliations

    • University of Melbourne Department of Medicine, and Bone and Mineral Service, Royal Melbourne Hospital, Victoria, Australia
    • Corresponding Author InformationAddress correspondence to: John D Wark, University of Melbourne Department of Medicine, Royal Melbourne Hospital, Parkville, Victoria, 3050, Australia.

Received 2 October 2009 ,Revised 14 January 2010 ,Accepted 14 January 2010.

References 

  1. Singer K, Edmondston S, Day R, et al. Prediction of thoracic and lumbar vertebral body compressive strength. Correlations with bone mineral density and vertebral region. Bone. 1995;17:167–174
  2. Kleerekoper M, Nelson DA. Which bone density measurement?. J Bone Miner Res. 1997;12:712–714
  3. Blake GM, Fogelman I. Role of dual-energy X-ray absorptiometry in the diagnosis and treatment of osteoporosis. J Clin Densitom. 2007;10:102–110
  4. Kanis JA, Burlet N, Cooper C, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008;19:399–428
  5. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996;312:1254–1259
  6. Bhambhani M, Crisp AJ, Compston JE. Differential involvement of the dorsal and lumbar spine in osteoporosis. Ann Rheum Dis. 1992;51:1069–1070
  7. Eastell R, Cedel SL, Wahner HW, et al. Classification of vertebral fractures. J Bone Miner Res. 1991;6:207–215
  8. Grey C, Young R, Bearcroft PWP, Compston JE. Vertebral deformity in the thoracic spine in post-menopausal women: value of lumbar spine bone density. Brit J Radiol. 1996;69:137–142
  9. Hordon LD, Raisi M, Aaron JE, et al. Trabecular architecture in women and men of similar bone mass with and without vertebral fracture: I. Two-dimensional histology. Bone. 2000;27:271–276
  10. Jergas M, Breitenseher M, Gluer CC, et al. Which vertebrae should be assessed using lateral dual-energy X-ray absorptiometry of the lumbar spine. Osteoporos Int. 1995;5:196–204
  11. Legrand E, Chappard D, Pascaretti C, et al. Trabecular bone microarchitecture, bone mineral density, and vertebral fractures in male osteoporosis. J Bone Miner Res. 2000;15:13–19
  12. Mitra D, Elvins DM, Speden DJ, Collins AJ. The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology. 2000;39:85–89
  13. Peel NFA, Moore DJ, Barrington NA, Bax DE, Eastell R. Risk of vertebral fracture and relationship to bone mineral density in steroid-treated rheumatoid arthritis. Ann Rheum Dis. 1995;54:801–806
  14. Pors Nielsen S, Hermansen F, Barenholdt O. Interpretation of lumbar spine densitometry in women with fractures. Osteoporos Int. 1993;3:276–282
  15. Spector TD, Hall GM, McCloskey EV, Kanis JA. Risk of vertebral fracture in women with rheumatoid arthritis. BMJ. 1993;306:558
  16. Spector TD, McCloskey EV, Doyle DV, Kanis JA. Prevalence of vertebral fracture in women and the relationship with bone density and symptoms. The Chingford Study. J Bone Miner Res. 1993;8:817–822
  17. Stockbrugger RW, Schoon EJ, Bollani S, et al. Discordance between the degree of osteopenia and the prevalence of spontaneous vertebral fractures in Crohn's disease. Aliment Pharmacol Ther. 2002;16:1519–1527
  18. Arabi A, Baddoura R, Awada H, et al. Discriminative ability of dual energy X-ray absorptiometry site selection in identifying patients with osteoporotic fractures. Bone. 2007;40:1060–1065
  19. Briggs AM, Greig AM, Wark JD. The vertebral fracture cascade in osteoporosis. A review of aetiopathogenesis. Osteoporos Int. 2007;18:575–584
  20. Simpson EK, Parkinson IH, Manthey B, Fazzalari NL. Intervertebral disc disorganisation is related to trabecular bone architecture in the lumbar spine. J Bone Miner Res. 2001;16:681–687
  21. McCubbery DA, Cody DD, Peterson EL, et al. Static and fatigue failure properties of thoracic and lumbar vertebral bodies and their relation to regional density. J Biomech. 1995;28:891–899
  22. Kim DG, Hunt CA, Zauel R, et al. The effect of regional variations of the trabecular bone properties on the compressive strength of human vertebral bodies. Ann Biomed Engineering. 2007;35:1907–1913
  23. Briggs AM, Wark JD, Kantor S, et al. In vivo intra-rater and inter-rater precision of measuring apparent bone mineral density in vertebral subregions using supine lateral dual- energy x-ray absorptiometry (DXA). J Clin Densitom. 2005;8:314–319
  24. Briggs AM, Wark JD, Greig AM, et al. Subregional bone mineral density measurement in the lumbar spine using DXA: Potential for the application to osteoporosis and vertebral fractures. In:  Mattingly BE,  Pillare AC editor. Osteoporosis: Etiology, Diagnosis and Treatment. New York: Nova Publishers; 2009;p. 1–50
  25. Hildebrand T, Laib A, Muller R, et al. Direct three-dimensional morphometric analysis of human cancellous bone: Microstructural data from spine, femur, iliac crest, and calcaneus. J Bone Miner Res. 1999;14:1167–1174
  26. Homminga J, Van-Rietbergen B, Lochmuller EM, et al. The osteoporotic vertebral structure is well adapted to the loads of daily life, but not to infrequent “error” loads. Bone. 2004;34:510–516
  27. Eswaran S, Gupta A, Adams MF, Keaveny TM. Cortical and trabecular load sharing in the human vertebral body. J Bone Miner Res. 2006;21:307–314
  28. Hulme PA, Boyd SK, Ferguson SJ. Regional variation in vertebral bone morphology and its contribution to vertebral fracture strength. Bone. 2007;41:946–957
  29. Edmondston SJ, Singer KP, Day RE, et al. Formalin fixation effects on vertebral bone density and failure mechanics. An in-vitro study of human and sheep vertebrae. Clin Biomech. 1994;9:175–179
  30. Briggs AM, Wark JD, Kantor S, et al. Bone mineral density distribution in thoracic and lumbar vertebrae: an ex vivo study using dual energy X-ray absorptiometry. Bone. 2006;38:286–288
  31. Burklein D, Lochmuller EM, Kuhn V, et al. Correlation of thoracic and lumbar vertebral failure loads with in situ vs. ex situ dual energy X-ray absorptiometry. J Biomech. 2001;34:579–587
  32. Edmondston SJ, Singer KP, Price RI, Breidahl PD. Accuracy of lateral dual-energy x-ray absorptiometry for the determination of bone mineral content in the thoracic and lumbar spine: an in vitro study. Brit J Radiol. 1993;66:309–313
  33. Kaymakci B, Wark JD. Precise accurate mineral measurements of excised sheep bones using X-Ray densitometry. Bone Miner. 1994;25:231–246
  34. Hologic Inc . QDR 4500 X-ray Bone Densitometer User's Guide. Waltham, MA: Hologic Inc.; 1996;
  35. Sran MM, Khan KM, Keiver K, et al. Accuracy of DXA scanning of the thoracic spine: cadaveric studies comparing BMC, areal BMD and geometric estimates of volumetric BMD against ash weight and CT measures of bone volume. Eur Spine J. 2005;14:971–976
  36. Jones G, White C, Nguyen T, et al. Prevalent vertebral deformities: relationship to bone mineral density and spinal osteophytosis in elderly men and women. Osteoporos Int. 1996;6:233–239
  37. Lane NE, Haupt D, Kimmel DB, et al. Early estrogen replacement therapy reverses the rapid loss of trabecular bone volume and prevents further deterioration of connectivity in the rat. J Bone Miner Res. 1999;14:206–214
  38. Lorensen WE, Cline HE. Marching Cubes: A high resolution 3D surface construction algorithm. Computer Graphics. 1987;21:163–169
  39. Jergas M, Breitenseher M, Gluer CC, et al. Estimates of volumetric bone density from projectional measurements improve the discriminatory capability of dual X-ray absorptiometry. J Bone Miner Res. 1995;10:1101–1110
  40. Muller R, Van Campenhout H, Van Damme B, et al. Morphometric analysis of human bone biopsies: A quantitative structural comparison of histological sections and micro-computed tomography. Bone. 1998;23:59–66
  41. Sornay-Rendu E, Boutroy S, Munoz F, Bouxsein ML. Cortical and trabecular architecture are altered in postmenopausal women with fractures. Osteoporos Int. 2009;20:1291–1297
  42. Perilli E, Baruffaldi F, Visentin M, et al. MicroCT examination of human bone specimens: effects of polymethylmethacrylate embedding on structural parameters. J Microscopy-Oxford. 2007;225:192–200
  43. Funke M, Kopka L, Conrad J, Grabbe E. Berechnung der volumenbezogenen Knochendichte in der planaren Osteodensitometrie. Osteologie. 1993;2:213–217
  44. Chen H, Shoumura S, Emura S, Bunai Y. Regional variations of vertebral trabecular bone microstructure with age and gender. Osteoporos Int. 2008;19:1473–1483
  45. Kopperdahl DL, Morgan EF, Keaveny TM. Quantitative computed tomography estimates of the mechanical properties of human vertebral trabecular bone. J Orthop Res. 2002;20:801–805
  46. Homminga J, Weinans H, Gowin W, et al. Osteoporosis changes the amount of vertebral trabecular bone at risk of fracture but not the vertebral load distribution. Spine. 2001;24:1555–1561
  47. Ebbesen EN, Thomsen JS, Beck-Nielsen H, et al. Vertebral bone density evaluated by DXA and QCT in vitro. Bone. 1998;23:283–290
  48. Cheng XG, Nicholson PHF, Boonen S, et al. Prediction of vertebral strength in vitro by spinal bone densitometry and calcaneal ultrasound. J Bone Miner Res. 1997;12:1721–1728

PII: S1094-6950(10)00121-6

doi: 10.1016/j.jocd.2010.01.120

Journal of Clinical Densitometry
Volume 13, Issue 2 , Pages 161-174 , April 2010