High-resolution peripheral quantitative CT (HR pQCT) has emerged as a unique way to evaluate bone and joints, by producing high-resolution, 3D images of cortical and trabecular bone in vivo. In this Review, the authors describe how HR pQCT is used in the evaluation of bone and joint diseases, together with an evaluation of its technical features, advantages, limitations, and potential in basic research, clinical trials and clinical practice.
#1Arnd Kleyer(FAU: University of Erlangen-Nuremberg)H-Index: 25
#2Stephanie Finzel(FAU: University of Erlangen-Nuremberg)H-Index: 25
Last. Georg Schett(FAU: University of Erlangen-Nuremberg)H-Index: 131
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Objective Anticitrullinated protein antibodies (ACPA) are a major risk factor for bone loss in rheumatoid arthritis (RA). We have recently shown that ACPA directly induce bone loss by stimulating osteoclast differentiation. As ACPA precede the clinical onset of RA by years, we hypothesised that ACPA positive healthy individuals may already show skeletal changes. Methods We performed a comparative micro-CT analysis of the bone microstructure in the metacarpophalangeal joints of ACPA positive and ...
Asian women have lower rates of hip and forearm fractures compared to other racial groups despite lower areal bone mineral density (aBMD). We have demonstrated microarchitectural differences, including greater cortical thickness (Ct.Th) and cortical volumetric BMD (Ct.BMD), in Chinese American versus white women. Yet it is not known whether greater Ct.BMD in Chinese American women is a result of greater tissue mineral density (TMD) or reduced cortical porosity (Ct.Po). Using an advanced segmenta...
During early menopause, steady-state bone remodeling is perturbed; the number of basic multicellular units (BMUs) excavating cavities upon the endosteal surface exceeds the number (generated before menopause) concurrently refilling. Later in menopause, steady-state is restored; the many BMUs generated in early menopause refill as similarly large numbers of BMUs concurrently excavate new cavities. We hypothesized that risedronate reduces the number of cavities excavated. However, in younger postm...
Osteoporosis is frequently seen in patients with chronic obstructive pulmonary disease (COPD). Because research on bone structure and bone strength in COPD patients is limited, the objectives of this pilot study were as follows: (1) to compare bone structure, stiffness, and failure load, measured at the peripheral skeleton, between men with and without COPD after stratification for areal bone mineral density (aBMD); and (2) to relate clinical parameters with bone stiffness and failure load in me...
#1Andreas Albrecht(FAU: University of Erlangen-Nuremberg)H-Index: 2
#2Stephanie Finzel(FAU: University of Erlangen-Nuremberg)H-Index: 25
Last. Georg Schett(FAU: University of Erlangen-Nuremberg)H-Index: 131
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Objective To determine whether erosions appearing in MRI in patients with rheumatoid arthritis (RA) represent true erosions. Methods 50 RA patients received 1.5 T MRI and microCT (μCT) of the dominant hand. Erosion counts were assessed in coronal T1 weighted MRI sections and in coronal as well as axial μCT sections of the metacarpophalangeal (MCP) joints II–IV. Extent of erosions was assessed by RA MRI Score (RAMRIS) erosion score (MRI) and by three-dimensional assessment of erosion volume (μCT)...
#1Stephanie Finzel(FAU: University of Erlangen-Nuremberg)H-Index: 25
#2Sebastian Kraus(FAU: University of Erlangen-Nuremberg)H-Index: 15
Last. Georg Schett(FAU: University of Erlangen-Nuremberg)H-Index: 131
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Objectives To investigate whether methotrexate or tumour necrosis factor inhibitors (TNFi) affect osteophyte formation in patients with psoriatic arthritis (PsA). Methods 41 patients with PsA were examined for the presence of osteophytes and erosions at the metacarpophalangeal joints by high-resolution micro-CT imaging. The size of each individual lesion was quantified at baseline and 1-year follow-up in PsA patients treated with TNFi (N=28) or methotrexate (N=13). Groups were comparable for age...
Last. Ego Seeman(University of Melbourne)H-Index: 109
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Abstract A transitional or cortico-trabecular junctional zone exists at any location composed of both cortical and trabecular bones such as the metaphyses of tubular bones and short bones like the femoral neck. The transitional zone comprises the inner cortex adjacent to the medullary canal and trabeculae abutting against the cortex contiguous with the endocortical surface. This is a site of vigorous remodeling. Intracortical remodeling cavitates the inner cortex expanding this transitional zone...
Last. Georg Langs(Medical University of Vienna)H-Index: 38
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Abstract High resolution peripheral quantitative computed tomography (HR-pQCT) permits the non-invasive assessment of cortical and trabecular bone density, geometry, and microarchitecture. Although researchers have developed various post-processing algorithms to quantify HR-pQCT image properties, few of these techniques capture image features beyond global structure-based metrics. While 3D-texture analysis is a key approach in computer vision, it has been utilized only infrequently in HR-pQCT re...
Assessment of the early stages of fracture healing via X-rays and computed tomography is limited by the low radio-opacity of cartilage. We validated a method of contrast-enhanced computed tomography (CECT) for non-destructive identification of cartilage within a healing fracture callus. Closed, stabilized fractures in femora of C57BL/6 mice were harvested on post-operative day 9.5 and imaged ex vivo with micro-computed tomography (µCT) before and after incubation in a cationic contrast agent tha...
#1Tracy Y. Zhu(CUHK: The Chinese University of Hong Kong)H-Index: 24
#2James F. Griffith(CUHK: The Chinese University of Hong Kong)H-Index: 61
Last. Lai-Shan Tam(CUHK: The Chinese University of Hong Kong)H-Index: 62
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The purpose of this work was to investigate the volumetric bone mineral density (vBMD), bone microstructure, and mechanical indices of the distal radius in female patients with rheumatoid arthritis (RA). We report a cross-sectional study of 66 middle-aged female RA patients and 66 age-matched healthy females. Areal BMD (aBMD) of the hip, lumbar spine, and distal radius was measured by dual-energy X-ray absorptiometry (DXA). High-resolution peripheral quantitative computed tomography (HR-pQCT) wa...
Bone health in psoriasis and psoriatic arthritis has been emphasized in recent years. Novel imaging modalities allow investigations into volumetric bone mineral density (vBMD) and bone microstructure in psoriatic patients. However, literature regarding vBMD measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) is inconclusive. We conducted a systematic review and meta-analysis to evaluate vBMD in patients with psoriatic disease. We searched PubMed, EMBASE, Web of Scie...
High-resolution peripheral computed tomography (HR-pQCT) was developed to image bone microarchitecture in vivo at peripheral skeletal sites. Since the introduction of HR-pQCT in 2005, clinical research to gain insight into pathophysiology of skeletal fragility and to improve prediction of fractures has grown. Meanwhile, the second-generation HR-pQCT device has been introduced, allowing novel applications such as hand joint imaging, assessment of subchondral bone and cartilage thickness in the kn...
Background Patients with rheumatoid arthritis (RA) are at increased risk of fractures. Although their decline in bone mineral density (BMD) is well-established, data regarding the alterations in bone microarchitecture are limited. In this study, we aimed to evaluate bone microarchitecture, geometry, and volumetric BMD among patients with RA in mainland China using high-resolution peripheral quantitative computed tomography (HRpQCT). Methods In this cross-sectional study, patients with RA were re...
Last. Julie P. Greeves(UEA: University of East Anglia)H-Index: 1
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Bone adapts to unaccustomed, high-impact loading but loses mechanosensitivity quickly. Short periods of military training (≤12 weeks) increase the density and size of the tibia in women. The effect of longer periods of military training, where the incidence of stress fracture is high, on tibial macrostructure and microarchitecture in women is unknown. This observational study recruited 51 women (age 19 to 30 years) at the start of 44 weeks of British Army Officer training. Tibial volumetric bone...
Imaging is essential for the assessment of bone and inflammatory joint diseases. There are several imaging techniques available that differ regarding resolution, radiation exposure, time expending,...
PURPOSE OF REVIEW Stress fractures at weight-bearing sites, particularly the tibia, are common in military recruits and athletes. This review presents recent findings from human imaging and biomechanics studies aimed at predicting and preventing stress fractures. RECENT FINDINGS Peripheral quantitative computed tomography (pQCT) provides evidence that cortical bone geometry (tibial width and area) is associated with tibial stress fracture risk during weight-bearing exercise. The contribution of ...
Abstract The operational definition of osteoporosis used in clinical practice is based on central areal bone mineral density (aBMD) measured at the spine and hip by dual-energy X-ray absorptiometry (DXA). The Fracture Risk Assessment Tool (FRAX) combines femoral neck (FN) aBMD with clinical risk factors. However, about half of fragility fractures occur in individuals not qualified at high risk of fracture with these tools, that is, with nonosteoporotic status on central DXA or with FRAX score be...
Abstract Over the last decades, the use of high-resolution imaging systems to assess bone microstructural parameters has grown immensely. Yet, no standard defining the quantification of these parameters exists. It has been reported that different voxel size and/or segmentation techniques lead to different results. However, the effect of the evaluation software has not been investigated so far. Therefore, the aim of this study was to compare the bone microstructural parameters obtained with two c...
Last. Ego Seeman(University of Melbourne)H-Index: 109
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Abstract Background Modelling and remodelling adapt bone morphology to accommodate strains commonly encountered during loading. If strains exceed a threshold threatening fracture, modelling-based bone formation increases bone volume reducing these strains. If unloading reduces strains below a threshold that inhibits resorption, increased remodelling-based bone resorption reduces bone volume restoring strains, but at the price of compromised bone volume and microstructure. As weight-bearing regio...
Osteoporosis is a common complication of ankylosing spondylitis (AS) even in the early stages of disease; however, previously published studies have demonstrated large discrepancies in the reported incidence of osteoporosis, based on measurement of bone mineral density (BMD). The aim of the present study was to compare bone quality using trabecular bone score (TBS) between AS patients and healthy controls and to evaluate factors associated with TBS in patients with AS. Ankylosing spondylitis pat...
