Bone structure determined by HR-MDCT does not correlate with micro-CT of lumbar vertebral biopsies: a prospective cross-sectional human in vivo study.
MDCT
Micro-CT
Osteoporosis
Spine
Vertebral biopsies
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
10 Sep 2020
10 Sep 2020
Historique:
received:
24
04
2020
accepted:
16
08
2020
entrez:
11
9
2020
pubmed:
12
9
2020
medline:
18
5
2021
Statut:
epublish
Résumé
Osteoporosis is characterized by a deterioration of bone structure and quantity that leads to an increased risk of fractures. The primary diagnostic tool for the assessment of the bone quality is currently the dual-energy X-ray absorptiometry (DXA), which however only measures bone quantity. High-resolution multidetector computed tomography (HR-MDCT) offers an alternative approach to assess bone structure, but still lacks evidence for its validity in vivo. The objective of this study was to assess the validity of HR-MDCT for the evaluation of bone architecture in the lumbar spine. We conducted a prospective cross-sectional study to compare the results of preoperative lumbar HR-MDCT scans with those from microcomputed tomography (μCT) analysis of transpedicular vertebral body biopsies. For this purpose, we included patients undergoing spinal surgery in our orthopedic department. Each patient underwent preoperative HR-MDCT scanning (L1-L4). Intraoperatively, transpedicular biopsies were obtained from intact vertebrae. Micro-CT analysis of these biopsies was used as a reference method to assess the actual bone architecture. HR-MDCT results were statistically analyzed regarding the correlation with results from μCT. Thirty-four patients with a mean age of 69.09 years (± 10.07) were included in the study. There was no significant correlation for any of the parameters (bone volume/total volume, trabecular separation, trabecular thickness) between μCT and HR-MDCT (bone volume/total volume: r = - 0.026 and p = 0.872; trabecular thickness: r = 0.074 and r = 6.42; and trabecular separation: r = - 0.18 and p = 0.254). To our knowledge, this is the first study comparing in vivo HR-MDCT with μCT analysis of vertebral biopsies in human patients. Our findings suggest that lumbar HR-MDCT is not valid for the in vivo evaluation of bone architecture in the lumbar spine. New diagnostic tools for the evaluation of osteoporosis and preoperative orthopedic planning are urgently needed.
Sections du résumé
BACKGROUND
BACKGROUND
Osteoporosis is characterized by a deterioration of bone structure and quantity that leads to an increased risk of fractures. The primary diagnostic tool for the assessment of the bone quality is currently the dual-energy X-ray absorptiometry (DXA), which however only measures bone quantity. High-resolution multidetector computed tomography (HR-MDCT) offers an alternative approach to assess bone structure, but still lacks evidence for its validity in vivo. The objective of this study was to assess the validity of HR-MDCT for the evaluation of bone architecture in the lumbar spine.
METHODS
METHODS
We conducted a prospective cross-sectional study to compare the results of preoperative lumbar HR-MDCT scans with those from microcomputed tomography (μCT) analysis of transpedicular vertebral body biopsies. For this purpose, we included patients undergoing spinal surgery in our orthopedic department. Each patient underwent preoperative HR-MDCT scanning (L1-L4). Intraoperatively, transpedicular biopsies were obtained from intact vertebrae. Micro-CT analysis of these biopsies was used as a reference method to assess the actual bone architecture. HR-MDCT results were statistically analyzed regarding the correlation with results from μCT.
RESULTS
RESULTS
Thirty-four patients with a mean age of 69.09 years (± 10.07) were included in the study. There was no significant correlation for any of the parameters (bone volume/total volume, trabecular separation, trabecular thickness) between μCT and HR-MDCT (bone volume/total volume: r = - 0.026 and p = 0.872; trabecular thickness: r = 0.074 and r = 6.42; and trabecular separation: r = - 0.18 and p = 0.254).
CONCLUSION
CONCLUSIONS
To our knowledge, this is the first study comparing in vivo HR-MDCT with μCT analysis of vertebral biopsies in human patients. Our findings suggest that lumbar HR-MDCT is not valid for the in vivo evaluation of bone architecture in the lumbar spine. New diagnostic tools for the evaluation of osteoporosis and preoperative orthopedic planning are urgently needed.
Identifiants
pubmed: 32912263
doi: 10.1186/s13018-020-01895-0
pii: 10.1186/s13018-020-01895-0
pmc: PMC7488144
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
398Références
J Bone Miner Res. 1992 Jun;7(6):625-32
pubmed: 1414480
Neurosurgery. 2015 Oct;77 Suppl 4:S98-107
pubmed: 26378363
Calcif Tissue Int. 2007 Jun;80(6):366-73
pubmed: 17520165
Clin Cases Miner Bone Metab. 2016 May-Aug;13(2):135-140
pubmed: 27920811
Eur Radiol. 2013 Feb;23(2):505-12
pubmed: 22932742
J Bone Miner Metab. 2005;23 Suppl:122-31
pubmed: 15984427
Osteoporos Int. 2005 Jun;16(6):581-9
pubmed: 15616758
JAMA. 2002 Oct 16;288(15):1889-97
pubmed: 12377088
Clin Orthop Relat Res. 2011 Aug;469(8):2237-47
pubmed: 21384210
J Biomech. 2008;41(2):368-75
pubmed: 17953972
Orthop Clin North Am. 2013 Apr;44(2):243-9
pubmed: 23544827
Osteoporos Int. 2014 Oct;25(10):2359-81
pubmed: 25182228
J Am Acad Orthop Surg. 2015 Apr;23(4):253-63
pubmed: 25808687
Eur Radiol. 2010 Nov;20(11):2707-14
pubmed: 20559834
Calcif Tissue Int. 2008 Nov;83(5):332-41
pubmed: 18855036
J Bone Miner Res. 2011 Apr;26(4):739-46
pubmed: 20928886
Osteoporos Int. 2003;14 Suppl 3:S13-8
pubmed: 12730800
Ann Rheum Dis. 2004 Mar;63(3):285-9
pubmed: 14962964
Calcif Tissue Int. 2012 Jun;90(6):481-7
pubmed: 22484555
Bone. 2009 May;44(5):976-83
pubmed: 19442610
Endocr Pract. 2016 Sep 2;22(Suppl 4):1-42
pubmed: 27662240
J Bone Miner Metab. 2014 Jan;32(1):56-64
pubmed: 23604586
Rofo. 2004 May;176(5):709-18
pubmed: 15122470
Arch Oral Biol. 2008 Jun;53(6):558-66
pubmed: 18190892
Bone. 1998 Jul;23(1):59-66
pubmed: 9662131
PLoS One. 2016 Nov 23;11(11):e0166540
pubmed: 27880788
Injury. 2016 Jun;47 Suppl 2:S27-32
pubmed: 27338223
Calcif Tissue Int. 1996 Jan;58(1):24-9
pubmed: 8825235
Eur J Radiol. 2011 Nov;80(2):e140-5
pubmed: 20851544
J Bone Miner Res. 2009 Sep;24(9):1628-37
pubmed: 19338434
Bone. 2007 Jul;41(1):138-54
pubmed: 17481978
J Bone Miner Res. 2011 Sep;26(9):2194-203
pubmed: 21590738
Am J Med. 1993 Jun;94(6):646-50
pubmed: 8506892
J Bone Miner Metab. 2011 May;29(3):352-8
pubmed: 20976512
BMC Musculoskelet Disord. 2016 Jan 12;17:13
pubmed: 26758746
Bone. 2012 Jun;50(6):1416-25
pubmed: 22430313
Med Phys. 2018 Jan;45(1):236-249
pubmed: 29064579