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Abstract: Objective: To demonstrate the validity and reliability of volumetric quantitative computed tomography (vQCT) with multi-slice computed tomography (MSCT) and dual energy X-ray absorptiometry (DXA) for hip bone mineral density (BMD) measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods: Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes <−2SD, with and without radiographically confirmed vertebral fracture (n=11 and 33, respectively). Group 3 comprised normal controls with BMD changes ≥−1SD (n=46). Post-MSCT (GE, LightSpeed16) scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters: volumetric BMD values of trabecular bone (TRAB), cortical bone (CORT), and integral bone (INTGL) of the left femoral neck, femoral neck axis length (NAL), and minimum cross-section area (mCSA). DXA BMD measurements of the lumbar spine (AP-SPINE) and the left femoral neck (NECK) also were performed for each subject. Results: The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women (P<0.05, respectively). Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture(s) [(109.8±9.61) and (243.3±33.0) mg/cm³, respectively] than in those without [(148.9±7.47) and (285.4±17.8) mg/cm³, respectively] (P<0.05, respectively), but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion: the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from those without. vQCT might be useful to evaluate the effect of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck.

[1] Black, D.M., Ardenn, K., Palermo, L., Person, J., Cummings, S.R., 1999. Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. J. Bone Miner. Res., 14(5):821-828.

[2] Black, D.M., Greenspan, S.L., Ensrud, K.E., Palermo, L., McGowan, J.A., Lang, T.F., Garnero, P., Bouxsein, M.L., Bilezikian, J.P., Rosen, C.J., PaTH Study Investigators, 2003. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N. Engl. J. Med., 349(13):1207-1215.

[3] Black, D.M., Bilezikian, J.P., Ensrud, K.E., Greenspan, S.L., Palermo, L., Hue, T., Lang, T.F., McGowan, J.A., Rosen, C.J., PaTH Study Investigators, 2005. One year of alendronate after one year of parathyroid hormone (1-84) for osteoporosis. N. Engl. J. Med., 353(6):555-565.

[4] Bousson, V., Le Bras, A., Roqueplan, F., Kang, Y., Mitton, D., Kolta, S., Bergot, C., Skalli, W., Vicaut, E., Kalender, W., Engelke, K., Laredo, J.D., 2006. Volumetric quantitative computed tomography of the proximal femur: relationships linking geometric and densitometric variables to bone strength. Role for compact bone. Osteoporos. Int., 17(6):855-864.

[5] Cummings, S.R., Melton, L.J., 2002. Epidemiology and outcomes of osteoporotic fractures. Lancet, 359(9319): 1761-1767.

[6] Genant, H.K., Wu, C.Y., van Kuijk, C., Nevitt, M.C., 1993. Vertebral fracture assessment using a semi-quantitative technique. J. Bone Miner Res., 8(9):1137-1148.

[7] Genant, H.K., Engelke, K., Fuerst, T., Glüer, C.C., Grampp, S., Harris, S.T., Jergas, M., Lang, T., Lu, Y., Majumdar, S., Mathur, A., Takada, M., 1996. Noninvasive assessment of bone mineral and structure: state of the art. J. Bone Miner Res., 11(6):707-730.

[8] Glüer, C.C., Blake, G., Blunt, B.A., Jergas, M., Genant, H.K., 1995. Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporosis Int., 5(4):262-270.

[9] Huber, M.B., Carballido-Gamio, J., Bauer, J.S., Baum, T., Eckstein, F., Lochmüller, E.M., Majumdar, S., Link, T.M., 2008. Proximal femur specimens: automated 3D trabecular bone mineral density analysis at multidetector CT-correlation with biomechanical strength measurement. Radiology, 247(2):472-481.

[10] Ito, M., Lang, T.F., Jergas, M., Ohki, M., Takada, M., Nakamura, T., Hayashi, K., Genant, H.K., 1997. Spinal trabecular bone loss and fracture in American and Japanese women. Calcif Tissue Int., 61(2):123-128.

[11] Kang, Y., Engelke, J., Fuchs, S., Kalender, W.A., 2005. Ananatomic coordinate system of the femoral neck for highly reproducible BMD measurements using 3D QCT. Comput. Med. Imaging Graph., 29(7):533-541.

[12] Lafferty, F.W., Rowland, D.Y., 1996. Correlations of dual-energy X-ray absorptiometry, quantitative computed tomography, and single photon absorptiometry with spinal and non-spinal fractures. Osteoporos. Int., 6(5): 407-415.

[13] Lane, N.E., Sanchez, S., Modin, G.W., Genant, H.K., Pierini, E., Arnaud, C.D., 1998. Parathyroid hormone treatment can reverse corticosteroid-induced osteoporosis. J. Clin. Invest., 102(8):1627-1633.

[14] Lang, T.F., Keyak, J.H., Heitz, M.W., Augat, P., Lu, Y., Mathur, A., Genant, H.K., 1997. Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength. Bone, 21(1):101-108.

[15] Lang, T.F., Li, J., Harris, S.T., Genant, H.K., 1999. Assessment of vertebral bone mineral density using volumetric quantitative CT. J. Comput. Assist. Tomogr., 23(1): 130-137.

[16] Lang, T.F., Guglielmi, G., van Kuijk, C., de Serio, A., Cammisa, M., Genant, H.K., 2002. Measurement of bone mineral density at the spine and proximal femur by volumetric quantitative computed tomography and dual-energy X-ray absorptiometry in elderly women with and without vertebral fractures. Bone, 30(1):247-250.

[17] Li, W., Sode, M., Saeed, I., Lang, T., 2006. Automated registration of hip and spine for longitudinal quantitative CT studies: integration with 3D densitometric and structural analysis. Bone, 38(2):273-279.

[18] Lian, K.C., Lang, T.F., Keyak, J.H., Modin, G.W., Rehman, Q., Do, L., Lane, N.E., 2005. Differences in hip quantitative computed tomography (QCT) measurements of bone mineral density and bone strength between glucocorticoid-treated and glucocorticoid-naïve postmenopausal women. Osteoporosis International, 16(6):642-650.

[19] Melton, L.J.III, Cooper, C., 2001. Magnitude and Impact of Osteoporosis and Fractures. In: Marcus, R., Feldman, D., Kelsey, J. (Eds.), Osteoporosis, 2nd Ed. Academic Press, San Diego, Vol. 1, p.557-567.

[20] Wu, X.P., Dai, R.C., Shan, P.F., Yuan, L.Q., Cao, X.Z., Liao, E.Y., Jiang, Y., 2005. Establishment of BMD reference curves at different skeletal sites in women, using a Cartesian coordinate numeration system. Osteoporos. Int., 16(12):1655-1662.