In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography

J Clin Endocrinol Metab. 2005 Dec;90(12):6508-15. doi: 10.1210/jc.2005-1258. Epub 2005 Sep 27.


Context: Assessment of trabecular microarchitecture may enhance the prediction of fracture risk and improve monitoring of treatment response. A new high-resolution peripheral quantitative computed tomography (HR-pQCT) system permits in vivo assessment of trabecular architecture and volumetric bone mineral density (BMD) at the distal radius and tibia with a voxel size of 82 microm3.

Objective and patients: We determined the short-term reproducibility of this device by measuring 15 healthy volunteers three 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 = 35) and without previous fracture history (n = 78).

Design and setting: We conducted a cross-sectional study in a private clinical research center.

Intervention and main outcome measure: We took HR-pQCT measurements of the radius and tibia. Femoral neck and spine BMD were measured in postmenopausal women by dual-energy x-ray absorptiometry.

Results: Precision of HR-pQCT measurements was 0.7-1.5% for total, trabecular, and cortical densities and 2.5-4.4% 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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aging / metabolism
  • Bone Density
  • Bone Diseases, Metabolic / complications
  • Bone Diseases, Metabolic / diagnostic imaging
  • Bone Diseases, Metabolic / metabolism
  • Cross-Sectional Studies
  • Female
  • Femur Neck / diagnostic imaging
  • Femur Neck / metabolism
  • Fractures, Bone / etiology
  • Hip Joint / diagnostic imaging
  • Hip Joint / metabolism
  • Humans
  • Medical Records
  • Middle Aged
  • Osteoporosis, Postmenopausal / diagnostic imaging
  • Osteoporosis, Postmenopausal / metabolism
  • Postmenopause
  • Premenopause
  • Radius / diagnostic imaging*
  • Radius / metabolism
  • Reproducibility of Results
  • Spine / diagnostic imaging
  • Spine / metabolism
  • Tibia / diagnostic imaging*
  • Tibia / metabolism
  • Tomography, X-Ray Computed / methods*