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Erschienen in: Journal of Bone and Mineral Metabolism 5/2014

01.09.2014 | Original Article

Evaluating spine micro-architectural texture (via TBS) discriminates major osteoporotic fractures from controls both as well as and independent of site matched BMD: the Eastern European TBS study

verfasst von: Jelena Vasic, Tzvetanka Petranova, Vladyslav Povoroznyuk, Carmen Gabriela Barbu, Mirjana Karadzic, Filip Gojkovic, Jelena Elez, Renaud Winzenrieth, Didier Hans, Violeta CulaficVojinovic, Catalina Poiana, Nataliia Dzerovych, Rasho Rashkov, Aleksandar Dimic

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 5/2014

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Abstract

The aim of the study was to assess the clinical performance of the model combining areal bone mineral density (aBMD) at spine and microarchitecural texture (TBS) for the detection of the osteoporotic fracture. The Eastern European Study is a multicenter study (Serbia, Bulgaria, Romania and Ukraine) evaluating the role of TBS in routine clinical practice as a complement to aBMD. All scans were acquired on Hologic Discovery and GE Prodigy densitometers in a routine clinical manner. The additional clinical values of aBMD and TBS were analyzed using a two steps classification tree approach (aBMD followed by TBS tertiles) for all type of osteoporotic fracture (All-OP Fx). Sensitivity, specificity and accuracy of fracture detection as well as the Net Reclassification Index (NRI) were calculated. This study involves 1031 women subjects aged 45 and older recruited in east European countries. Clinical centers were cross-calibrated in terms of BMD and TBS. As expected, areal BMD (aBMD) at spine and TBS were only moderately correlated (r 2 = 0.19). Prevalence rate for All-OP Fx was 26 %. Subjects with fracture have significant lower TBS and aBMD than subjects without fracture (p < 0.01). TBS remains associated with the fracture even after adjustment for age and aBMD with an OR of 1.27 [1.07–1.51]. When using aBMD T-score of −2.5 and the lowest TBS tertile thresholds, both BMD and TBS were similar in terms of sensitivity (35 vs. 39 %), specificity (78 vs. 80 %) and accuracy (64 vs. 66 %). aBMD and TBS combination, induced a significant improvement in sensitivity (+28 %) and accuracy (+17 %) compared to aBMD alone whereas a moderate improvement was observed in terms of specificity (+9 %). The overall combination gain was 36 % as expressed using the NRI. aBMD and TBS combination decrease significantly the number of subjects needed to diagnose from 7 for aBMD alone to 2. In a multi-centre Eastern European cohort, we have shown that the use of TBS in addition to the aBMD permit to reclassified correctly more than one-third of the overall subjects. Furthermore, the number of subjects needed to diagnose fell to 2 subjects. Economical studies have to be performed to evaluate the gain induced by the use of TBS for the healthcare system.
Literatur
1.
Zurück zum Zitat WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis [Report of the WHO Study Group]. World Health Organ Tech Rep Ser. 843–1129 WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis [Report of the WHO Study Group]. World Health Organ Tech Rep Ser. 843–1129
2.
Zurück zum Zitat Johnell O, Kanis JA, Oden E, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ3, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194 Johnell O, Kanis JA, Oden E, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ3, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194
3.
Zurück zum Zitat Rice JC, Cowin SC, Bowman JA (1988) On the dependence of the elasticity and strength of cancellous bone on apparent density. J Biomech 21:155–168PubMedCrossRef Rice JC, Cowin SC, Bowman JA (1988) On the dependence of the elasticity and strength of cancellous bone on apparent density. J Biomech 21:155–168PubMedCrossRef
4.
Zurück zum Zitat Hordon LD, Raisi M, Paxton S, Beneton MM, Kanis JA, Aaron JE (2000) Trabecular architecture in women and men of similar bone mass with and without vertebral fracture: part I. 2-D histology. Bone 27:271–276PubMedCrossRef Hordon LD, Raisi M, Paxton S, Beneton MM, Kanis JA, Aaron JE (2000) Trabecular architecture in women and men of similar bone mass with and without vertebral fracture: part I. 2-D histology. Bone 27:271–276PubMedCrossRef
5.
Zurück zum Zitat McClung MR (2006) Do current management strategies and guidelines adequately address fracture risk? Bone 38:S13–S17PubMedCrossRef McClung MR (2006) Do current management strategies and guidelines adequately address fracture risk? Bone 38:S13–S17PubMedCrossRef
6.
Zurück zum Zitat Compston J (2009) Monitoring osteoporosis treatment. Best Pract Res Clin Rheumatol. 23:781–788PubMedCrossRef Compston J (2009) Monitoring osteoporosis treatment. Best Pract Res Clin Rheumatol. 23:781–788PubMedCrossRef
7.
Zurück zum Zitat Seeman E, Delmas PD (2006) Bone quality—the material and structural basis of bone strength and fragility. N Engl J Med 354:2250–2261PubMedCrossRef Seeman E, Delmas PD (2006) Bone quality—the material and structural basis of bone strength and fragility. N Engl J Med 354:2250–2261PubMedCrossRef
8.
Zurück zum Zitat Ito M, Ikeda K, Nishiguchi M, Shindo H, Uetani M, Hosoi T, Orimo H (2005) Multi-detector row CT imaging of vertebral microstructure for evaluation of fracture risk. J Bone Miner Res 20:1828–1836PubMedCrossRef Ito M, Ikeda K, Nishiguchi M, Shindo H, Uetani M, Hosoi T, Orimo H (2005) Multi-detector row CT imaging of vertebral microstructure for evaluation of fracture risk. J Bone Miner Res 20:1828–1836PubMedCrossRef
9.
Zurück zum Zitat Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA (2011) Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom 14:302–312PubMedCrossRef Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA (2011) Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom 14:302–312PubMedCrossRef
10.
Zurück zum Zitat Winzenrieth R, Michelet F, Hans D (2012) 3D microarchitecture correlations with 2D projection image grey level variations assessed by TBS using high Resolution CT acquisitions: effects of resolution and noise. J Clin Densitom (Epub ahead of print) Winzenrieth R, Michelet F, Hans D (2012) 3D microarchitecture correlations with 2D projection image grey level variations assessed by TBS using high Resolution CT acquisitions: effects of resolution and noise. J Clin Densitom (Epub ahead of print)
11.
Zurück zum Zitat Resch H, Trubrich A, Muschitz C, Kocijan R, Bittighofer C, Pirker T, Hans D (2012) The impact of TBS in the analysis of gender specific differences in bone microarchitecture in females and males with fragility fractures. ASBMR annual meeting (S434) Resch H, Trubrich A, Muschitz C, Kocijan R, Bittighofer C, Pirker T, Hans D (2012) The impact of TBS in the analysis of gender specific differences in bone microarchitecture in females and males with fragility fractures. ASBMR annual meeting (S434)
12.
Zurück zum Zitat Roux JP, Wegrzyn J, Boutroy S, Bouxsein ML, Hans D, Chapurlat R (2013) The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex vivo study. Osteoporos Int (Epub ahead of print) Roux JP, Wegrzyn J, Boutroy S, Bouxsein ML, Hans D, Chapurlat R (2013) The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex vivo study. Osteoporos Int (Epub ahead of print)
13.
Zurück zum Zitat Winzenrieth R, Dufour R, Pothuaud L, Hans D (2010) A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif Tissue Int 86:104–109PubMedCrossRef Winzenrieth R, Dufour R, Pothuaud L, Hans D (2010) A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif Tissue Int 86:104–109PubMedCrossRef
14.
Zurück zum Zitat Winzenrieth R, Cormier C, Del Rio L, Di Gregorio S (2013) Is bone micro-architecture status at spine assessed by TBS related to femoral neck fracture? A Spanish case-control study. Osteoporos Int. 24:991–998PubMedCrossRef Winzenrieth R, Cormier C, Del Rio L, Di Gregorio S (2013) Is bone micro-architecture status at spine assessed by TBS related to femoral neck fracture? A Spanish case-control study. Osteoporos Int. 24:991–998PubMedCrossRef
15.
Zurück zum Zitat Lamy O, Metzger M, Krieg MA, Aubry-Rozier B, Stoll D, Hans D (2011) OsteoLaus: prediction of osteoporotic fractures by clinical risk factors and DXA, IVA and TBS. Rev Med Suisse 7:2130–2136PubMed Lamy O, Metzger M, Krieg MA, Aubry-Rozier B, Stoll D, Hans D (2011) OsteoLaus: prediction of osteoporotic fractures by clinical risk factors and DXA, IVA and TBS. Rev Med Suisse 7:2130–2136PubMed
16.
Zurück zum Zitat Krueger D, Fidler E, Libber J, Aubry-Rosier B, Hans D, Binkley N (2012) Spine trabecular bone score (TBS) subsequent to BMD improves vertebral and OP fracture discrimination in women. J Clin Densitom (accepted) Krueger D, Fidler E, Libber J, Aubry-Rosier B, Hans D, Binkley N (2012) Spine trabecular bone score (TBS) subsequent to BMD improves vertebral and OP fracture discrimination in women. J Clin Densitom (accepted)
17.
Zurück zum Zitat Leib E, Lamy O, Winzenrieth R, Hans D (2013) Assessment of women microarchitecture with and without osteoporotic fracture by TBS on white non Hispanic US women. 19th Annual ISCD meeting, Tampa, USA Leib E, Lamy O, Winzenrieth R, Hans D (2013) Assessment of women microarchitecture with and without osteoporotic fracture by TBS on white non Hispanic US women. 19th Annual ISCD meeting, Tampa, USA
18.
Zurück zum Zitat Hans D, Goertzen A, Krieg MA, Leslie W (2011) Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 26:2762–2769PubMedCrossRef Hans D, Goertzen A, Krieg MA, Leslie W (2011) Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 26:2762–2769PubMedCrossRef
19.
Zurück zum Zitat Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N et al (2013) Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos Int 24:77–85PubMedCrossRef Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N et al (2013) Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos Int 24:77–85PubMedCrossRef
20.
Zurück zum Zitat Popp AW, Meer S, Krieg MA, Perrelet R, Hans D, Lippuner K (2012) Bone mineral density (BMD) combined with micro-architecture parameters (TBS) significantly improves the identification of women at high risk of fracture: the SEMOF cohort study. ECCEO-IOF joint meeting, Bordeaux, France Popp AW, Meer S, Krieg MA, Perrelet R, Hans D, Lippuner K (2012) Bone mineral density (BMD) combined with micro-architecture parameters (TBS) significantly improves the identification of women at high risk of fracture: the SEMOF cohort study. ECCEO-IOF joint meeting, Bordeaux, France
21.
Zurück zum Zitat Fan B, Lu Y, Genant H, Fuerst T, Shepherd J (2010) Does standardized BMD still remove differences between Hologic and GE-Lunar state-of-the-art DXA systems? Osteoporos Int 21:1227–1236PubMedCentralPubMedCrossRef Fan B, Lu Y, Genant H, Fuerst T, Shepherd J (2010) Does standardized BMD still remove differences between Hologic and GE-Lunar state-of-the-art DXA systems? Osteoporos Int 21:1227–1236PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Pencina MJ, D’Agostino RB Sr, D’Agostino RB Jr, Vasan RS (2008) Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 27:157–172PubMedCrossRef Pencina MJ, D’Agostino RB Sr, D’Agostino RB Jr, Vasan RS (2008) Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 27:157–172PubMedCrossRef
24.
Zurück zum Zitat Breban S, Briot K, Kolta S, Paternotte S, Ghazi M, Fechtenbaum J, Roux C (2012) Identification of rheumatoid arthritis patients with vertebral fractures using bone mineral density and trabecular bone score. J Clin Densitom 15:260–266PubMedCrossRef Breban S, Briot K, Kolta S, Paternotte S, Ghazi M, Fechtenbaum J, Roux C (2012) Identification of rheumatoid arthritis patients with vertebral fractures using bone mineral density and trabecular bone score. J Clin Densitom 15:260–266PubMedCrossRef
25.
Zurück zum Zitat Romagnoli E, Cipriani C, Nofroni I, Castro C, Angelozzi M, Scarpiello A, Pepe J, Diacinti D, Piemonte S, Carnevale V, Minisola S (2013) “Trabecular Bone Score” (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism. Bone 53:154–159PubMedCrossRef Romagnoli E, Cipriani C, Nofroni I, Castro C, Angelozzi M, Scarpiello A, Pepe J, Diacinti D, Piemonte S, Carnevale V, Minisola S (2013) “Trabecular Bone Score” (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism. Bone 53:154–159PubMedCrossRef
26.
Zurück zum Zitat Eller-Vainicher C, Morelli V, Ulivieri FM, Palmieri S, Zhukouskaya VV, Cairoli E, Pino R, Naccarato A, Scillitani A, Beck-Peccoz P, Chiodini I (2012) Bone quality, as measured by trabecular bone score in patients with adrenal incidentalomas with and without subclinical hypercortisolism. J Bone Miner Res 27:2223–2230PubMedCrossRef Eller-Vainicher C, Morelli V, Ulivieri FM, Palmieri S, Zhukouskaya VV, Cairoli E, Pino R, Naccarato A, Scillitani A, Beck-Peccoz P, Chiodini I (2012) Bone quality, as measured by trabecular bone score in patients with adrenal incidentalomas with and without subclinical hypercortisolism. J Bone Miner Res 27:2223–2230PubMedCrossRef
27.
Zurück zum Zitat Paggiosi M, Eastell R (2012) The impact of glucocorticoid therapy on trabecular bone score in older women. ASBMR annual meeting, Minneapolis, USA Paggiosi M, Eastell R (2012) The impact of glucocorticoid therapy on trabecular bone score in older women. ASBMR annual meeting, Minneapolis, USA
Metadaten
Titel
Evaluating spine micro-architectural texture (via TBS) discriminates major osteoporotic fractures from controls both as well as and independent of site matched BMD: the Eastern European TBS study
verfasst von
Jelena Vasic
Tzvetanka Petranova
Vladyslav Povoroznyuk
Carmen Gabriela Barbu
Mirjana Karadzic
Filip Gojkovic
Jelena Elez
Renaud Winzenrieth
Didier Hans
Violeta CulaficVojinovic
Catalina Poiana
Nataliia Dzerovych
Rasho Rashkov
Aleksandar Dimic
Publikationsdatum
01.09.2014
Verlag
Springer Japan
Erschienen in
Journal of Bone and Mineral Metabolism / Ausgabe 5/2014
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-013-0529-7

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