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Bone Abstracts (2017) 6 P086 | DOI: 10.1530/boneabs.6.P086

ICCBH2017 Poster Presentations (1) (209 abstracts)

Feasibility and reproducibility using HRpQCTII in children and adolescents

Kyla Kent 1 , Jessica Whalen 1 , Ariana Strickland 1 , Mary Leonard 1 & Andrew J. Burghardt 2

1Stanford University School of Medicine, Stanford, California, USA; 2University of California, San Francisco, California, USA.

We recruited 60 healthy volunteers ages 5 to 21 to perform scan-rescan precision tests on the XtremeCT II. Participants were positioned in a carbon fiber immobilization cast. iPad-based video content was used to facilitate motion-free compliance. Distal radius and tibia scans were acquired starting 2 mm proximal to the proximal margin of the growth plate or growth plate remnant. Diaphyseal radius and tibia scans were centered at an offset from the same landmark, corresponding to 30% of limb length. Repeat scans were performed following complete repositioning of the participant. Scans were assessed for movement and the image quality was on the standard 5-point scale. The manufacturer’s image analysis pipeline was optimized for pediatric distal and diaphyseal scans to measure bone density and structure, and to estimate bone strength by micro-finite element analysis (μFEA). Precision errors were calculated from the test-retest measurements using root mean square of the coefficient of variation (CV%). The success rates for acceptable quality scans based on extreme (image grade ≤1), strict (≤2), and moderate criteria (≤3), are reported in Table 1 by age group and scan site. Precision errors measured from paired scans meeting the moderate quality criterion (≤3) by scan site are reported in Table 2. These data demonstrate that performance of HR-pQCT scans is feasible in the majority of children and adolescents. The performance in younger children was improved with the use of a video to provide distraction. With the exception of distal cortical porosity, precision was outstanding and greater than reported in prior XtremeCT I reproducibility studies in adults. Diaphyseal measurements of cortical porosity offer superior precision to measurements immediately adjacent to the growth plate.

Table 1 Probability to Satisfy Image Quality Criteria by Age (Image Grade: ≤1 I ≤2 I ≤3).
5-10 years (N=21)11–15 years (N=22)16–21 years (N=17)All Ages (N=60)
Distal Radius52% I 71% I 76%50% I 64% I 95%65% I 88% I 100%55% I 73% I 90%
Distal Tibia43% I 62% I 71%82% I 96% I 100%71% I 88% I 100%65% I 82% I 90%
30% Radius48% I 62% I 76%68% I 82% I 91%71% I 94% I 100%62% I 75% I 88%
30% Tibia71% I 86% I 95%100% I 100% I 100%88% I 94% I 94%87% I 93% I 97%
L. Based on a movement score of 1–5 where 1–2 is optimal and 3 is possible. (Burghardt, A.)
Table 2 Test-Retest Precision Data (RMS CV%).
BMDCt.BMDCt.ThCt.PoTb.BM DTb.NTb.ThFailure Load
Distal Radius0.40%0.83%1.27%16.3%0.55%1.35%0.86%3.7%
Distal Tibia0.27%0.61%1.57%7.4%0.43%1.47%0.78%3.4%
30% Radius0.18%0.23%0.38%5.59%---0.38%
30% Tibia0.46%0.35%0.94%5.07%---0.70%

Disclosure: The authors declared no competing interests.

Volume 6

8th International Conference on Children's Bone Health


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