nach oben

Erschienen in:

01.12.2008 | Original Article

The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

verfasst von: E. Brannon Morris, John Shelso, Matthew P. Smeltzer, Nicole A. Thomas, E. Jane Karimova, Chin-Shang Li, Thomas Merchant, Amar Gajjar, Sue C. Kaste

Erschienen in: Pediatric Radiology | Ausgabe 12/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children.

Objective

To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion.

Materials and methods

A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed.

Results

No significant difference between CA and BA Z-scores was detected in the overall cohort (P = 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort.

Conclusion

Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males.

National Institutes of Health (2000) Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 17:1–45

Seeman E (2002) Pathogenesis of bone fragility in women and men. Lancet 359:1841–1850PubMedCrossRef

Johnston CC Jr, Slemenda CW, Melton LJ 3rd (1991) Clinical use of bone densitometry. N Engl J Med 324:1105–1109PubMed

Bachrach LK (2007) Consensus and controversy regarding osteoporosis in the pediatric population. Endocr Pract 13:513–520PubMed

Mora S, Gilsanz V (2003) Establishment of peak bone mass. Endocrinol Metab Clin North Am 32:39–63PubMedCrossRef

Javaid MK, Cooper C (2002) Prenatal and childhood influences on osteoporosis. Best Pract Res Clin Endocrinol Metab 16:349–367PubMedCrossRef

Kalkwarf HJ, Zemel BS, Gilsanz V et al (2007) The bone mineral density in childhood study: bone mineral content and density according to age, sex, and race. J Clin Endocrinol Metab 92:2087–2099PubMedCrossRef

Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer, New York

Pludowski P, Lebiedowski M, Lorenc RS (2005) Evaluation of practical use of bone age assessments based on DXA-derived hand scans in diagnosis of skeletal status in healthy and diseased children. J Clin Densitom 8:48–56PubMedCrossRef

10.

Ilich JZ, Hangartner TN, Skugor M et al (1996) Skeletal age as a determinant of bone mass in preadolescent females. Skeletal Radiol 25:431–439PubMedCrossRef

11.

Rose SR, Lustig RH, Pitukcheewanont P et al (1999) Diagnosis of hidden central hypothyroidism in survivors of childhood cancer. J Clin Endocrinol Metab 84:4472–4479PubMedCrossRef

12.

Rose SR, Danish RK, Kearney NS et al (2005) ACTH deficiency in childhood cancer survivors. Pediatr Blood Cancer 45:808–813PubMedCrossRef

13.

Berneis K, Staub JJ, Gessler A et al (2002) Combined stimulation of adrenocorticotropin and compound-S by single dose metyrapone test as an outpatient procedure to assess hypothalamic-pituitary-adrenal function. J Clin Endocrinol Metab 87:5470–5475PubMedCrossRef

14.

Crofton PM, Don-Wauchope AC, Bath LE et al (2004) Cortisol responses to the insulin hypoglycaemia test in children. Horm Res 61:92–97PubMedCrossRef

15.

Ibanez L, Potau N, Zampolli M et al (1994) Use of leuprolide acetate response patterns in the early diagnosis of pubertal disorders: comparison with the gonadotropin-releasing hormone test. J Clin Endocrinol Metab 78:30–35PubMedCrossRef

16.

Greulich W, Pyle S (1969) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Palo Alto, CA

17.

Brauner R, Adan L, Souberbielle JC (1999) Hypothalamic-pituitary function and growth in children with intracranial lesions. Childs Nerv Syst 15:662–669PubMedCrossRef

18.

Gurney JG, Kadan-Lottick NS, Packer RJ et al (2003) Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: Childhood Cancer Survivor Study. Cancer 97:663–673PubMedCrossRef

19.

Muirhead SE, Hsu E, Grimard L et al (2002) Endocrine complications of pediatric brain tumors: case series and literature review. Pediatr Neurol 27:165–170PubMedCrossRef

20.

Gilsanz V, Carlson ME, Roe TF et al (1990) Osteoporosis after cranial irradiation for acute lymphoblastic leukemia. J Pediatr 117:238–244PubMedCrossRef

21.

Krishnamoorthy P, Freeman C, Bernstein ML et al (2004) Osteopenia in children who have undergone posterior fossa or craniospinal irradiation for brain tumors. Arch Pediatr Adolesc Med 158:491–496PubMedCrossRef

22.

Hodgson SF (1990) Corticosteroid-induced osteoporosis. Endocrinol Metab Clin North Am 19:95–111PubMed

23.

Leonard MB (2007) Glucocorticoid-induced osteoporosis in children: impact of the underlying disease. Pediatrics 119 Suppl 2:S166–174PubMedCrossRef

24.

Janz KF, Gilmore JM, Burns TL et al (2006) Physical activity augments bone mineral accrual in young children: the Iowa bone development study. J Pediatr 148:793–799PubMedCrossRef

25.

Lannering B, Marky I, Lundberg A et al (1990) Long-term sequelae after pediatric brain tumors: their effect on disability and quality of life. Med Pediatr Oncol 18:304–310PubMedCrossRef

26.

Macedoni-Luksic M, Jereb B, Todorovski L (2003) Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap. Pediatr Hematol Oncol 20:89–101PubMedCrossRef

27.

Packer RJ, Gurney JG, Punyko JA et al (2003) Long-term neurologic and neurosensory sequelae in adult survivors of a childhood brain tumor: childhood cancer survivor study. J Clin Oncol 21:3255–3261PubMedCrossRef

28.

Babayigit A, Dirik E, Bober E et al (2006) Adverse effects of antiepileptic drugs on bone mineral density. Pediatr Neurol 35:177–181PubMedCrossRef

29.

Souverein PC, Webb DJ, Weil JG et al (2006) Use of antiepileptic drugs and risk of fractures: case-control study among patients with epilepsy. Neurology 66:1318–1324PubMedCrossRef

30.

Anderson DM, Rennie KM, Ziegler RS et al (2001) Medical and neurocognitive late effects among survivors of childhood central nervous system tumors. Cancer 92:2709–2719PubMedCrossRef

31.

Barr RD, Simpson T, Webber CE et al (1998) Osteopenia in children surviving brain tumours. Eur J Cancer 34:873–877PubMedCrossRef

32.

Mithal NP, Almond MK, Evans K et al (1993) Reduced bone mineral density in long-term survivors of medulloblastoma. Br J Radiol 66:814–816PubMedCrossRef

33.

Petraroli M, D’Alessio E, Ausili E et al (2007) Bone mineral density in survivors of childhood brain tumours. Childs Nerv Syst 23:59–65PubMedCrossRef

34.

CureSearch National Childhood Cancer Foundation (2006) Long-term follow-up guidelines for survivors of childhood, adolescent and young adult cancers. Children’s Oncology Group. http://www.survivorshipguidelines.org/. Accessed 18 Aug 2008

35.

Kaste SC, Tong X, Hendrick JM et al (2006) QCT versus DXA in 320 survivors of childhood cancer: association of BMD with fracture history. Pediatr Blood Cancer 47:936–943PubMedCrossRef

36.

Wren TA, Kim PS, Janicka A et al (2007) Timing of peak bone mass: discrepancies between CT and DXA. J Clin Endocrinol Metab 92:938–941PubMedCrossRef

37.

Wren TA, Liu X, Pitukcheewanont P et al (2005) Bone densitometry in pediatric populations: discrepancies in the diagnosis of osteoporosis by DXA and CT. J Pediatr 146:776–779PubMedCrossRef

Titel: The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients
verfasst von: E. Brannon Morris
John Shelso
Matthew P. Smeltzer
Nicole A. Thomas
E. Jane Karimova
Chin-Shang Li
Thomas Merchant
Amar Gajjar
Sue C. Kaste
Publikationsdatum: 01.12.2008
Verlag: Springer-Verlag
Erschienen in: Pediatric Radiology / Ausgabe 12/2008
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-008-0991-x

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients