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This version published online on September 27, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-1258
A more recent version of this article appeared on December 1, 2005
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*CT Scans

Submitted on June 3, 2005
Accepted on September 15, 2005

In Vivo Assessment of Trabecular Bone Microarchitecture by High-Resolution Peripheral Quantitative Computed Tomography."

Stephanie BOUTROY, Mary L BOUXSEIN, Francoise MUNOZ, and Pierre D DELMAS*

Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 403 and Claude Bernard University of Lyon, Lyon, France; Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

* To whom correspondence should be addressed. E-mail: delmas{at}lyon.inserm.fr.

Context: Assessment of trabecular microarchitecture may enhance the prediction of fracture risk and improve monitoring of treatment response. A new high-resolution pQCT system permits in vivo assessment of trabecular architecture and volumetric BMD at the distal radius and tibia with a voxel size of 82 µm3.

Objective and Patients: We determined the short-term reproducibility of this device by measuring 15 healthy volunteers 3 times each. We compared HR-pQCT measurements in 108 healthy premenopausal, 113 postmenopausal osteopenic and 35 postmenopausal osteoporotic women. Furthermore, we compared values in postmenopausal osteopenic women with (n = 42) and without prior fracture history (n = 71).

Design and Setting: Cross-sectional study in a private clinical research center.

Intervention and main outcome measure: HR-pQCT measurements of the radius and tibia. Femoral neck and spine BMD were measured in postmenopausal women by DXA.

Results: Precision of HR-pQCT measurements was 0.7 to 1.5% for total, trabecular and cortical densities and 2.5 to 4.4% for trabecular architecture. Postmenopausal women had lower density, trabecular number and cortical thickness than premenopausal women (P < 0.001) at both radius and tibia. Osteoporotic women had lower density, cortical thickness and increased trabecular separation than osteopenic women (P < 0.01) at both sites. Furthermore, although spine and hip BMD were similar, fractured osteopenic women had lower trabecular density, and more heterogeneous trabecular distribution (P < 0.02) at the radius compared with unfractured osteopenic women.

Conclusion: HR-pQCT appears promising to assess bone density and microarchitecture at peripheral sites, in terms of reproducibility and ability to detect age- and disease-related changes.
Key words: bone density • cortical thickness • microcomputed tomography • osteoporosis • trabecular microarchitecture




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