Validation of Bone Density and Microarchitecture Measurements of the Load-Bearing Femur in the Human Knee Obtained Using In Vivo HR-pQCT Protocol.

Autor:	Keen CE; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Whittier DE; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Firminger CR; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada., Edwards WB; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada., Boyd SK; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada. Electronic address: skboyd@ucalgary.ca.
Jazyk:	angličtina
Zdroj:	Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry [J Clin Densitom] 2021 Oct-Dec; Vol. 24 (4), pp. 651-657. Date of Electronic Publication: 2021 Jan 19.
DOI:	10.1016/j.jocd.2021.01.004
Abstrakt:	High resolution peripheral quantitative computed tomography (HR-pQCT) was designed to study bone mineral density (BMD) and microarchitecture in peripheral sites at the distal radius and tibia. With the introduction of the second generation HR-pQCT scanner (XtremeCT II, Scanco Medical) that has a larger, longer gantry it is now possible to study the human knee in vivo using HR-pQCT. Previous validation of HR-pQCT measurements at the distal radius and tibia against micro-CT is not representative of the knee because the increased cross-sectional area, greater amount of soft tissue surrounding the scan region, and different imaging protocol result in potentially increased beam hardening effects and photon scatter and different signal-to-noise ratio. The objective of this study is to determine the accuracy of density and microarchitecture measurements in the human knee measured by HR-pQCT using an in vivo protocol. Twelve fresh-frozen cadaver knees were imaged using in vivo HR-pQCT (60.7 µm) protocol. Subsequentially, distal femurs were extracted and imaged using a higher resolution (30.3 µm) ex vivo protocol, replicating micro-CT imaging. Scans were registered so that agreement of density and bone microarchitecture measurements could be determined using linear regression and Bland-Altman plots. All density and microarchitecture outcomes were highly correlated between the 2 protocols (R 2 > 0.89) albeit with statistically significant differences between absolute measures based on paired t tests. All parameters showed accuracy between 4.5% and 8.7%, and errors were highly systematic, particularly for trabecular BMD and trabecular thickness (R 2 > 0.93). We found that BMD and microarchitecture measurements in the distal femur obtained using an in vivo HR-pQCT knee protocol contained systematic errors, and accurately represented measurements obtained using a micro-CT equivalent imaging protocol. This work establishes the validity and limitations of using HR-pQCT to study the BMD and microarchitecture of human knees in future clinical studies. (Copyright © 2021 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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