High-resolution peripheral quantitative computed tomography (HR-pQCT) provides a non-invasive measure of 3D micro-architecture at a nominal isotropic resolution of 82 μm, and more recently 61 μm with the new generation of scanners. The typical measurement site is at the peripheral skeleton, including the distal radius and distal tibia. The measurement is performed in <2 min now, and radiation dose is low for each scan (~5 μSv). Since its introduction in 2005, there are many studies that have used this technology to explore natural variations in bone microarchitecture between men and women and across the lifespan, the influence of disease on bone microarchitecture, and the effects of interventions including anti-osteoporosis treatments. Owing to the low radiation dose, the technology is suitable for measurements in children, and has been used to show growth patterns in youth, and explore whether there is a difference in microarchitecture in children who sustain fractures during periods of rapid growth. There are challenges, however, to performing measurements in youth, and these will be discussed. This presentation will describe the technology and its applications, and the use of analysis techniques for these complex data. This includes strategies to maximize longitudinal measurement precision using methods such as 3D image registration, and the use of computer methods such as the finite element analysis to provide a non-invasive estimate of bone strength. The recent introduction of the second generation of HR-pQCT scanners provides new opportunities for assessment of bone, and some recent data on measurements at joints such as the knee will be presented. The study of in vivo bone microarchitecture provides a basis to assess individual patient bone strength, understand natural changes through the lifespan, monitor disease processes, and understand the role of interventions (physical exercise or pharmaceutical treatment) on bone microarchitecture. In summary, the introduction of new HR-pQCT technology offers exciting new opportunities for the study of bone quality.
Disclosure: Receipt of grants/research support: Merck Canada, Amgen.
27 - 30 Jun 2015