Clinical cone beam computed tomography compared to high-resolution peripheral computed tomography in the assessment of distal radius bone. Issue 10 (October 2016)

• Record Type: Journal Article
• Authors: Charry, C.; Boutroy, S.; Ellouz, R.; Duboeuf, F.; Chapurlat, R.; Follet, H.; Pialat, J.
• Is Part Of: Osteoporosis international. Volume 27:Issue 10(2016)
• Page Start: 3073
• Page End: 3082
• Publication Date: 2016-10
• Subjects: 3D registration -- Bone microarchitecture -- CBCT -- HR-pQCT; Osteoporosis -- Periodicals; Bones -- Metabolism -- Disorders -- Periodicals; 616.716005
• DOI: 10.1007/s00198-016-3609-4
• Languages: English
• ISSNs: 0937-941X

Abstract

Abstract Summary Clinical cone beam computed tomography (CBCT) was compared to high-resolution peripheral quantitative computed tomography (HR-pQCT) for the assessment of ex vivo radii. Strong correlations were found for geometry, volumetric density, and trabecular structure. Using CBCT, bone architecture assessment was feasible but compared to HR-pQCT, trabecular parameters were overestimated whereas cortical ones were underestimated. Introduction HR-pQCT is the most widely used technique to assess bone microarchitecture in vivo. Yet, this technology has been only applicable at peripheral sites, in only few research centers. Clinical CBCT is more widely available but quantitative assessment of the bone structure is usually not performed. We aimed to compare the assessment of bone structure with CBCT (NewTom 5G, QR, Verona, Italy) and HR-pQCT (XtremeCT, Scanco Medical AG, Brüttisellen, Switzerland). Methods Twenty-four distal radius specimens were scanned with these two devices with a reconstructed voxel size of 75 μm for Newtom 5G and 82 μm for XtremeCT, respectively. A rescaling-registration scheme was used to define the common volume of interest. Cortical and trabecular compartments were separated using a semiautomated double contouring method. Density and microstructure were assessed with the HR-pQCT software on both modality images. Results Strong correlations were found for geometry parameters (r = 0.98–0.99), volumetric density (r = 0.91–0.99), and trabecular structure (r = 0.94–0.99), allp < 0.001. Correlations were lower for cortical microstructure (r = 0.80–0.89), p < 0.001. However, absolute differences were observed between modalities for all parameters, with an overestimation of the trabecular structure (trabecular number, 1.62 ± 0.37 vs. 1.47 ± 0.36 mm−1 ) and an underestimation of the cortical microstructure (cortical porosity, 3.3 ± 1.3 vs. 4.4 ± 1.4 %) assessed on CBCT images compared to HR-pQCT images. Conclusions Clinical CBCT devices are able to analyze large portions of distal bones with good spatial resolution and limited irradiation. However, compared to dedicated HR-pQCT, the assessment of microarchitecture by NewTom 5G dental CBCT showed some discrepancies, for density measurements mainly. Further technical developments are required to reach optimal assessment of bone characteristics.