Fractal lacunarity of trabecular bone in vertebral MRI to predict osteoporotic fracture risk in over-fifties women. The LOTO study

Autor: A. Zaia, Pierluigi Maponi, Roberta Galeazzi, Manuela Sallei, Roberto Rossi, Pietro Scendoni
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Trabecular bone microarchitecture
lcsh:Diseases of the musculoskeletal system
Fracture risk
Population
Osteoporosis
Fractal lacunarity
030209 endocrinology & metabolism
Lumbar vertebrae
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Absorptiometry
Photon
Magnetic resonance imaging
Rheumatology
Bone Density
medicine
Bone mineral density
Humans
Orthopedics and Sports Medicine
Prospective Studies
education
Prospective cohort study
Aged
Bone mineral
education.field_of_study
Lumbar Vertebrae
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Bone fracture
medicine.disease
medicine.anatomical_structure
Cross-Sectional Studies
Fractals
Cancellous Bone
Spinal Fractures
Female
Radiology
Vertebral fracture
lcsh:RC925-935
business
Osteoporotic Fractures
Research Article
Zdroj: BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-13 (2021)
BMC Musculoskeletal Disorders
ISSN: 1471-2474
Popis: Background Osteoporotic fractures are a major cause of morbidity in the elderly. Menopausal women represent the population with the highest risk of early osteoporosis onset, often accompanied by vertebral fractures (VF). Bone mineral density (BMD) is commonly assessed by dual-energy X-ray absorptiometry (DXA) for osteoporosis diagnosis; however, BMD alone does not represent a significant predictor of fracture risk. Bone microarchitecture, instead, arises as a determinant of bone fragility independent of BMD. High-resolution magnetic resonance imaging (MRI) is an effective noninvasive/nonionizing tool for in vivo characterisation of trabecular bone microarchitecture (TBA). We have previously set up an MRI method able to characterise TBA changes in aging and osteoporosis by one parameter, trabecular bone lacunarity parameter β (TBLβ). Fractal lacunarity was used for TBA texture analysis as it describes discontinuity of bone network and size of bone marrow spaces, changes of which increase the risk of bone fracture. This study aims to assess the potential of TBLβ method as a tool for osteoporotic fracture risk. Methods An observational, cross-sectional, and prospective study on over-50s women at risk for VF was designed. TBLβ, our index of osteoporotic fracture risk, is the main outcome measure. It was calculated on lumbar vertebra axial images, acquired by 1.5 T MRI spin-echo technique, from 279 osteopenic/osteoporotic women with/without prior VF. Diagnostic power of TBLβ method, by Receiver Operating Characteristics (ROC) curve and other diagnostic accuracy measurements were compared with lumbar spine DXA-BMD. Results Baseline results show that TBLβ is able to discriminate patients with/without prevalent VF (p = 0.003). AUC (area under the curve from ROC) is 0.63 for TBLβ, statistically higher (p = 0.012) than BMD one (0.53). Contribution of TBLβ to prevalent VF is statistically higher (p p p = 0.297 for BMD). Preliminary 1-year prospective results suggest that TBA contribution to incident VF is even higher (sensitivity: 73% for TBLβ vs. 55% for BMD; RR: 3.00, p = 0.002 for TBLβ vs. 1.31, p = 0.380 for BMD). Conclusion Results from this study further highlight the usefulness of TBLβ as a biomarker of TBA degeneration and an index of osteoporotic fracture risk.
Databáze: OpenAIRE
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