Use of high resolution dual-energy x-ray absorptiometry-region free analysis (DXA-RFA) to detect local periprosthetic bone remodeling events.

Autor: Wilkinson JM; Academic Unit of Bone Metabolism, Northern General Hospital, University of Sheffield, Sheffield, United Kingdom., Morris RM, Martin-Fernandez MA, Pozo JM, Frangi AF, Maheson M, Yang L
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2015 May; Vol. 33 (5), pp. 712-6. Date of Electronic Publication: 2015 Mar 08.
DOI: 10.1002/jor.22823
Abstrakt: Dual-energy x-ray absorptiometry (DXA) is the gold standard method for measuring periprosthetic bone remodeling, but relies on a region of interest (ROI) analysis approach. While this addresses issues of anatomic variability, it is insensitive to bone remodeling events at the sub-ROI level. We have validated a high-spatial resolution tool, termed DXA-region free analysis (DXA-RFA) that uses advanced image processing approaches to allow quantitation of bone mineral density (BMD) at the individual pixel (data-point) level. Here we compared the resolution of bone remodeling measurements made around a stemless femoral prosthesis in 18 subjects over 24 months using ROI-based analysis versus that made using DXA-RFA. Using the ROI approach the regional pattern of BMD change varied by region, with greatest loss in ROI5 (20%, p < 0.001), and largest gain in ROI4 (6%, p < 0.05). Analysis using DXA-RFA showed a focal zone of increased BMD localized to the prosthesis-bone interface (30-40%, p < 0.001) that was not resolved using conventional DXA analysis. The 20% bone loss observed in ROI5 with conventional DXA was resolved to a focal area adjacent to the cut surface of the infero-medial femoral neck (up to 40%, p < 0.0001). DXA-RFA enables high resolution analysis of DXA datasets without the limitations incurred using ROI-based approaches.
(© 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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