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Semin Musculoskelet Radiol 2002; 06(3): 219-228
DOI: 10.1055/s-2002-36719
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Quantitative Computed Tomography

Giuseppe Guglielmi1 , Thomas F. Lang2
  • 1Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy
  • 2Department of Radiology, University of California at San Francisco, San Francisco, California, USA
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Publication History

Publication Date:
23 January 2003 (online)

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ABSTRACT

Quantitative computed tomography (QCT) is an established technique for measuring bone mineral density (BMD) in the axial spine and peripheral skeleton (forearm, tibia). QCT can determine in three dimensions the true volumetric density (mg/cm3) of trabecular or cortical bone at any skeletal site. However, because of the high responsiveness of spinal trabecular bone and its importance for vertebral strength, QCT has been principally employed to determine trabecular BMD in the vertebral body. QCT has been used for assessment of vertebral fracture risk, measurement of age-related bone loss, and follow-up of osteoporosis and other metabolic bone diseases. This article reviews the current capabilities of QCT at different skeletal sites and the recent technical developments, including volumetric acquisition.

KEYWORD

Spinal quantitative computed tomography (QCT) - peripheral QCT - volumetric QCT

REFERENCES

  • 1 Genant H K, Cann C E, Ettinger B. Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy.  Ann Intern Med . 1982;  97 699-705
    PubMedGoogle Scholar
  • 2 Pacifici R, Susman N, Carr P L. Single and dual energy tomography analysis of spinal trabecular bone: a comparative study in normal and osteoporotic women.  J Clin Endocrinol Metab . 1987;  64 209-214
    PubMedGoogle Scholar
  • 3 Glüer C C, Reiser U J, Davis C A. Vertebral mineral determination by quantitative computed tomography (QCT): accuracy of single and dual energy measurements.  J Comput Assist Tomogr . 1988;  12 242-258
    PubMedGoogle Scholar
  • 4 Block J E, Smith R, Glüer C C. Models of spinal trabecular bone loss as determined by quantitative computed tomography.  J Bone Miner Res . 1989;  4 249-257
    PubMedGoogle Scholar
  • 5 Steiger P, Block J E, Steiger S. Spinal bone mineral density by quantitative computed tomography: effect of region of interest, vertebral level, and technique.  Radiology . 1990;  175 537-543
    PubMedGoogle Scholar
  • 6 Boden S D, Goodenough D J, Stockam C D. Precise measurement of vertebra bone density using computed tomography without the use of an external reference phantom.  J Digit Imag . 1989;  2 31-38
    PubMedGoogle Scholar
  • 7 Goodsitt M M. Conversion relations for quantitative CT bone mineral density measured with solid and liquid calibration standards.  Bone Miner . 1992;  19 145-148
    CrossrefPubMedGoogle Scholar
  • 8 Faulkner K G, Glüer C C, Grampp S. Cross calibration of liquid and solid QCT calibration standards: corrections to UCSF normative data.  Osteoporos Int . 1993;  3 36-43
    CrossrefPubMedGoogle Scholar
  • 9 Glüer C C, Engelke K, Jergas M. Changes in calibration standards for quantitative computed tomography: recommendations for clinical practice.  Osteoporos Int . 1993;  3 286-287
    CrossrefPubMedGoogle Scholar
  • 10 Genant H K, Guglielmi G, Jergas M. Bone Densitometry and Osteoporosis.  Berlin: Springer Verlag; 1998
    Google Scholar
  • 11 Genant H K, Grampp S, Glüer C C. Universal standardization for dual x-ray absorptiometry: patient and phantom cross-calibration results.  J Bone Miner Res . 1994;  9 1503-1514
    PubMedGoogle Scholar
  • 12 Guglielmi G, Schneider P, Lang T F. Quantitative computed tomography at the axial and peripheral skeleton.  Eur Radiol . 1997;  7(Suppl 2) 32-42
    PubMedGoogle Scholar
  • 13 Guglielmi G, Lang T F, Cammisa M, Genant H K. Quantitative computed tomography at the axial skeleton. In: Genant HK, Guglielmi G, Jergas M, eds. Bone Densitometry and Osteoporosis Berlin: Springer Verlag 1998: 335-347
    Google Scholar
  • 14 Guglielmi G, Glüer C C, Majumdar S. Current methods and advances in bone densitometry.  Eur Radiol . 1995;  5 129-139
    CrossrefPubMedGoogle Scholar
  • 15 Adams J E. Single and dual energy X-ray absorptiometry.  Eur Radiol . 1997;  7(Suppl 2) 20-31
    PubMedGoogle Scholar
  • 16 Guglielmi G, Giannatempo G M, Blunt B A. Spinal bone mineral density by quantitative computed tomography in a normal Italian population.  Eur Radiol . 1995;  5 269-275
    PubMedGoogle Scholar
  • 17 Guglielmi G. Quantitative computed tomography (QCT) and dual x-ray absorptiometry (DXA) in the diagnosis of osteoporosis.  Eur J Radiol . 1995;  20 185-187
    CrossrefPubMedGoogle Scholar
  • 18 Guglielmi G, Grimston S K, Fischer K C. Osteoporosis: diagnosis with lateral and postero-anterior dual x-ray absorptiometry compared with quantitative CT.  Radiology . 1994;  192 845-850
    PubMedGoogle Scholar
  • 19 Yu W, Glüer C C, Grampp S. Spinal bone mineral assessment in postmenopausal women: a comparison between dual X-ray absorptiometry and quantitative computed tomography.  Osteoporos Int . 1995;  5 433-439
    CrossrefPubMedGoogle Scholar
  • 20 Jergas M, Breitenseher M, Glüer C C, Yu W, Genant H K. Estimates of volumetric bone density from projectional measurements improve the discriminatory capability of dual x-ray absorptiometry.  J Bone Miner Res . 1995;  10 1101-1110
    PubMedGoogle Scholar
  • 21 Grampp S, Genant H K, Mathur A. Comparison of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification.  J Bone Miner Res . 1997;  12 697-711
    PubMedGoogle Scholar
  • 22 Kröger H, Lunt M, Reeve J. Bone density reduction in various measurement sites in men and women with osteoporotic fractures of spine and hip: the European quantitation of osteoporosis study.  Calcif Tissue Int . 1999;  64 191-199
    PubMedGoogle Scholar
  • 23 Heneghan J P, Kirke P N, Murphy B L. Evaluation of quantitative CT vertebral bone mineral density measurement and the Singh index in elderly females with hip fractures: a case control study.  Br J Radiol . 1997;  70 923-928
    PubMedGoogle Scholar
  • 24 Firooznia H, Rafii M, Golimbu C. Trabecular mineral content of the spine in women with hip fractures: CT measurements.  Musculoskel Radiol . 1986;  159 737-740
    PubMedGoogle Scholar
  • 25 Lang T F, Augat P, Lane N E, Genant H K. Trochanteric hip fracture: strong association with spinal trabecular bone mineral density measured with quantitative CT.  Radiology . 1998;  209 525-530
    PubMedGoogle Scholar
  • 26 Schneider P, Borner W. Periphere quantitative Computer tomographie zur Knochenmineralmessung mit einem neuen speziellen QCT scanner.  RoFo . 1991;  154 292-299
    PubMedGoogle Scholar
  • 27 Guglielmi G, Genant H K, Passariello R. Bone densitometry: an update.  Eur Radiol . 1997;  7S 1-56
    PubMedGoogle Scholar
  • 28 Rüegsegger P, Elasser U, Anliker M. Quantification of bone mineralization using computed tomography.  Radiology . 1976;  121 93-97
    PubMedGoogle Scholar
  • 29 Schneider P, Reiners C. Peripheral quantitative computed tomography. In: Genant HK, Guglielmi G, Jergas M, eds. Bone Densitometry and Osteoporosis Berlin: Springer Verlag 1998: 349-363
    Google Scholar
  • 30 Rüegsegger P, Durand E, Dambacher M A. Localization of regional forearm bone loss from high resolution computed tomographic images.  Osteoporos Int . 1991;  1 76-80
    CrossrefPubMedGoogle Scholar
  • 31 Rüegsegger P, Durand E, Dambacher M A. Differential effects of aging and disease on trabecular and compact bone density of the radius.  Bone . 1991;  12 99-105
    CrossrefPubMedGoogle Scholar
  • 32 Takada M, Engelke K, Hagiwara S, Grampp S, Genant H K. Accuracy and precision study in vitro for peripheral quantitative computed tomography.  Osteoporos Int . 1996;  6 307-312
    PubMedGoogle Scholar
  • 33 Guglielmi G, Cammisa M, De Serio A. Long term in vitro precision of single slice peripheral quantitative computed tomography (pQCT): multicenter comparison.  Tech Health Care . 1997;  5 375-381
    PubMedGoogle Scholar
  • 34 Grampp S, Lang P, Jergas M. Assessment of the skeletal status by quantitative peripheral computed tomography: short-term precision in-vivo and comparison to dual x-ray absorptiometry.  J Bone Miner Res . 1995;  10 1566-1576
    PubMedGoogle Scholar
  • 35 Schneider P, Butz S, Allolio B. Multicenter German reference data base for peripheral quantitative computer tomography.  Technol Health Care . 1995;  3 69-73
    PubMedGoogle Scholar
  • 36 Butz S, Wuster C, Scheidt Nave C. Forearm BMD as measured by peripheral quantitative computed tomography (pQCT) in a German reference population.  Osteoporos Int . 1994;  4 179-184
    CrossrefPubMedGoogle Scholar
  • 37 Guglielmi G, De Serio A, Fusilli S. Age-related changes assessed by peripheral QCT in healthy Italian women.  Eur Radiol . 2000;  10 609-614
    CrossrefPubMedGoogle Scholar
  • 38 Ferretti J L, Capozza R F, Mondelo N. Interrelationship between densitometric properties of rat femora: inferences concerning mechanical regulation of bone modeling.  J Bone Miner Res . 1993;  8 1389-1396
    PubMedGoogle Scholar
  • 39 Ferretti J L, Gaffuri O, Capozza R F. Dexametasone effects on mechanical, geometric and densitometric properties of rat femur diaphyses by peripheral computerized tomography and bending tests.  Bone . 1995;  16 119-124
    CrossrefPubMedGoogle Scholar
  • 40 Augat P, Reeb H, Claes L E. Prediction of fracture load at different skeletal sites by geometric properties of the cortical shell.  J Bone Miner Res . 1996;  11 1356-1363
    CrossrefPubMedGoogle Scholar
  • 41 Genant H K, Gordon C, Jiang Y. Advanced imaging of bone macro and micro structure.  Bone . 1999;  25 149-152
    CrossrefPubMedGoogle Scholar
  • 42 Jiang Y, Zhao J, Augat P. Trabecular bone mineral and calculated structure of human bone specimens scanned by peripheral quantitative computed tomography: relation to biomechanical properties.  J Bone Miner Res . 1998;  13 1783-1790
    PubMedGoogle Scholar
  • 43 Müller R, Hildebrand T, Hauselmann H J, Rüegsegger P. In vivo reproducibility of three-dimensional structural properties of noninvasive bone biopsies using 3D-pQCT.  J Bone Miner Res . 1996;  11 1745-1750
    PubMedGoogle Scholar
  • 44 Link T M, Majumdar S, Grampp S. Imaging of trabecular bone structure in osteoporosis.  Eur Radiol . 1999;  9 1781-1788
    CrossrefPubMedGoogle Scholar
  • 45 Heitz M, Kalender W. Evaluation of femoral density and strength using volumetric CT and anatomical coordinate systems.  Bone . 1994;  25 S11
    PubMedGoogle Scholar
  • 46 Sartoris D J, Andre M, Resnick C. Trabecular bone density in the proximal femur: quantitative CT assessment.  Radiology . 1986;  160 707-712
    PubMedGoogle Scholar
  • 47 Bhasin S, Sartoris D J, Fellingham L. Three-dimensional quantitative CT of the proximal femur: relationship to vertebral trabecular bone density in postmenopausal women.  Radiology . 1988;  167 145-149
    PubMedGoogle Scholar
  • 48 Lang T F, Kejak J, Heitz M. Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength.  Bone . 1997;  21 101-108
    CrossrefPubMedGoogle Scholar
  • 49 Lang T F, Li J, Harris S T. Assessment of vertebral bone mineral density using volumetric quantitative CT.  J Comput Assist Tomogr . 1999;  23 130-137
    CrossrefPubMedGoogle Scholar
  • 50 Guglielmi G, Lang T F, Li J. Influence of anthropometric parameters and bone size on bone mineral density using volumetric quantitative CT and dual x-ray absorptiometry at the hip.  Eur Radiol . 2000;  10(Suppl) G27
    PubMedGoogle Scholar
  • 51 Guglielmi G, Lang T F, van Kuijk C. The effect of spinal degenerative changes on volumetric bone mineral density of the central skeleton as measured by quantitative CT.  Eur Radiol . 2000;  10(Suppl) G27
    PubMedGoogle Scholar
  • 52 Lang T F, Guglielmi G, Van Kuijk C. Measurement of vertebral bone mineral density at the spine and proximal femur by volumetric quantitative computed tomography and dual-energy X-ray absorptiometry in elderly women with and without vertebral fractures.  Bone . 2002;  30 247-250
    CrossrefPubMedGoogle Scholar
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