Discrimination of osteoporosis-related vertebral fractures by DXA-derived 3D measurements: a retrospective case-control study.

A retrospective case-control study assessing the association of DXA-derived 3D measurements with osteoporosis-related vertebral fractures was performed. Trabecular volumetric bone mineral density was the measurement that best discriminates between fracture and control groups. INTRODUCTION: The aim of the present study was to evaluate the association of DXA-derived 3D measurements at the lumbar spine with osteoporosis-related vertebral fractures. METHODS: We retrospectively analyzed a database of 74 postmenopausal women: 37 subjects with incident vertebral fractures and 37 age-matched controls without any type of fracture. DXA scans at the lumbar spine were acquired at baseline (i.e., before the fracture event for subjects in the fracture group), and areal bone mineral density (aBMD) was measured. DXA-derived 3D measurements, such as volumetric BMD (vBMD), were assessed using a DXA-based 3D modeling software (3D-SHAPER). vBMD was computed at the trabecular, cortical, and integral bone. Cortical thickness and cortical surface BMD were also measured. Differences in DXA-derived measurements between fracture and control groups were evaluated using unpaired t test. Odds ratio (OR) and area under the receiver operating curve (AUC) were also computed. Subgroup analyses according to fractured vertebra were performed. RESULTS: aBMD of fracture group was 9.3% lower compared with control group (p < 0.01); a higher difference was found for trabecular vBMD in the vertebral body (- 16.1%, p < 0.001). Trabecular vBMD was the measurement that best discriminates between fracture and control groups, with an AUC of 0.733, against 0.682 for aBMD. Overall, similar findings were observed within the subgroup analyses. The L1 vertebral fractures subgroup had the highest AUC at trabecular vBMD (0.827), against aBMD (0.758). CONCLUSION: This study showed the ability of cortical and trabecular measurements from DXA-derived 3D models to discriminate between fracture and control groups. Large cohorts need to be analyzed to determine if these measurements could improve fracture risk prediction in clinical practice.

Análisis morfológico, biomecánico y textural de imágenes de densitómetro central DEXA como complemento diagnóstico de la osteoporosis / Morphological, textural and biomechanical analysis of central DXA images as a diagnostic complement of osteoporosis

Objetivo: analizar asistido por ordenador, imágenes densitométricas digitalizadas de cadera mediante DEXA, para determinar su utilidad en el análisis textural óptico-fractal del hueso, y diferenciar poblaciones con densidad mineral ósea (DMO) de rango normal, osteopénico u osteoporótico. Una única prueba diagnóstica, obtendría además de la DMO, otros parámetros relacionados con la estructura y resistencia ósea. Material y método: se seleccionaron imágenes densitométricas DEXA de cadera de 18 pacientes con DMO en rango normal, 16 pacientes osteopénicos y otros 16 pacientes osteoporóticos, efectuando sobre ellas un análisis morfológico, biomecánico y textural-fractal mediante el programa informático Q-Bone®. Resultados: Las variables morfológicas y biomecánicas analizadas proporcionan una información complementaria y discriminadora entre los referidos grupos. Sin embargo, el análisis textural fractal uni o multidireccional aportó escasa información adicional, aunque asociado a variables ópticas (densidad lumínica) permitió una mayor capacidad de diferenciación entre grupos de pacientes con DMO en rango normal y patológico

Objective: the computational analysis of digitized hip densitometric DXA images to determining if this type of images are useful for the optical-fractal textural analysis of bone, and, to differentiate better among populations with normal, osteopenic or osteoporótic bone mineral density (BMD) levels. Material and methods: DXA densitometric hip images of 18 patients with normal BMD, 16 patients with osteopenic BMD levels and 16 patients with osteoporotic BMD levels were selected. Morphological, biomechanical and texturalfractal analyses of these images were carried out by means of Q-Bone® software. Results: the analyzed morphological and biomechanical variables give complementary and discriminating information between the referred groups. Nevertheless, the unidirectional and multidirectional fractal textural analysis give only a little additional information, although when associated to optical variables (luminic density) seem to add a greater capacity of differentiation between groups of patients with normal and pathological BMD

Bone mineral density in two different socio-economic population groups.

We have studied the bone mineral density (BMD) of the lumbar spine in two healthy population groups in Spain with similar characteristics but with different socio-economic levels. BMD was measured in 1116 individuals of both sexes in two selected groups: (A) 832 volunteers in the urban Barcelona area and (B) 284 volunteers from a suburb with lower socio-economic level. Individuals of group A have greater spine BMD than group B. The maximum difference was found in the group between 20 to 39 years: 5% (P less than 0.001) in men and 3% (P less than 0.05) in women. The patterns of bone loss in both groups were similar in onset, rate and quantity, suggesting a possible developmental cause for this difference. Bone loss in women began before the menopause and increased considerably in the following years. The BMD values show that most people at advanced age from the low socio-economic group cross the fracture threshold earlier than the first group.