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Article ; Online: The Added Value of High-Resolution Peripheral Quantitative Computed Tomography in Fracture Risk Prediction.

Lorentzon, Mattias / Burghardt, Andrew J

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

2023 Volume 38, Issue 9, Page(s) 1225–1226

MeSH term(s)	Tomography, X-Ray Computed ; Fractures, Bone/diagnostic imaging ; Humans
Language	English
Publishing date	2023-09-13
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	632783-7
ISSN	1523-4681 ; 0884-0431
ISSN (online)	1523-4681
ISSN	0884-0431
DOI	10.1002/jbmr.4909
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Article ; Online: A Laplace-Hamming Binarization Approach for Second-Generation HR-pQCT Rescues Fine Feature Segmentation.

Sadoughi, Saghi / Subramanian, Aditya / Ramil, Gabby / Burghardt, Andrew J / Kazakia, Galateia J

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

2023 Volume 38, Issue 7, Page(s) 1006–1014

Abstract: Although second-generation high-resolution peripheral quantitative computed tomography (XCTII) provides the highest-resolution in vivo bone microstructure assessment, the manufacturer's standard image processing protocol omits fine features in both ... ...

Abstract	Although second-generation high-resolution peripheral quantitative computed tomography (XCTII) provides the highest-resolution in vivo bone microstructure assessment, the manufacturer's standard image processing protocol omits fine features in both trabecular and cortical compartments. To optimize fine structure segmentation, we implemented a binarization approach based on a Laplace-Hamming (LH) segmentation and documented the reproducibility and accuracy of XCTII structure segmentation using both the standard Gaussian-based binarization and the proposed LH segmentation approach. To evaluate reproducibility, 20 volunteers (9 women, 11 men; aged 23-75 years) were recruited, and three repeat scans of the radii and tibias were acquired using the manufacturer's standard in vivo protocol. To evaluate accuracy, cadaveric structure phantoms (14 radii, 6 tibias) were scanned on XCTII using the same standard in vivo protocol and on μCT at 24.5 μm resolution. XCTII images were analyzed twice-first, with the manufacturer's standard patient evaluation protocol and, second, with the proposed LH segmentation approach. The LH approach rescued fine features evident in the grayscale images but omitted or overrepresented (thickened) by the standard approach. The LH approach significantly reduced error in trabecular volume fraction (BV/TV) and thickness (Tb.Th) compared with the standard approach; however, higher error was introduced for trabecular separation (Tb.Sp). The LH approach improved the correlation between XCTII and μCT for cortical porosity (Ct.Po) and significantly reduced error in cortical pore diameter (Ct.Po.Dm) compared with the standard approach. The LH approach resulted in improved precision compared with the standard approach for BV/TV, Tb.Th, Ct.Po, and Ct.Po.Dm at the radius and for Ct.Po at the tibia. Our results suggest that the proposed LH approach produces substantially improved binary masks, reduces proportional bias, and provides greater accuracy and reproducibility in important outcome metrics, all due to more accurate segmentation of the fine features in both trabecular and cortical compartments. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
MeSH term(s)	Male ; Humans ; Female ; Reproducibility of Results ; Tomography, X-Ray Computed/methods ; Bone and Bones ; Image Processing, Computer-Assisted ; Radius ; Tibia/diagnostic imaging ; Bone Density
Language	English
Publishing date	2023-05-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	632783-7
ISSN	1523-4681 ; 0884-0431
ISSN (online)	1523-4681
ISSN	0884-0431
DOI	10.1002/jbmr.4819
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Article ; Online: Interactions Between HR-pQCT Bone Density and D

Kirk, Ben / Harrison, Stephanie L / Zanker, Jesse / Burghardt, Andrew J / Orwoll, Eric / Duque, Gustavo / Cawthon, Peggy M

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

2023 Volume 38, Issue 9, Page(s) 1245–1257

Abstract: We examined if an interaction exists between bone and muscle in predicting fractures in older men. Prospective data from the Osteoporotic Fractures in Men study was used to build Cox proportional hazards models. Predictors included HR-pQCT total ... ...

Abstract	We examined if an interaction exists between bone and muscle in predicting fractures in older men. Prospective data from the Osteoporotic Fractures in Men study was used to build Cox proportional hazards models. Predictors included HR-pQCT total volumetric BMD (Tt.BMD), trabecular BMD (Tb.BMD), cortical BMD (Ct.BMD) and cortical area (Ct.Ar) at distal radius/tibia, HR-pQCT muscle volume and density (diaphyseal tibia), D
MeSH term(s)	Male ; Humans ; Aged ; Aged, 80 and over ; Bone Density ; Prospective Studies ; Osteoporotic Fractures/diagnostic imaging ; Proportional Hazards Models ; Fractures, Bone ; Radius ; Tibia ; Muscles
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	632783-7
ISSN	1523-4681 ; 0884-0431
ISSN (online)	1523-4681
ISSN	0884-0431
DOI	10.1002/jbmr.4874
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Article ; Online: Analysis of Hand Joint Space Morphology in Women and Men with Hereditary Hemochromatosis.

Heilmeier, Ursula / Burghardt, Andrew J / Tse, Justin J / Kapoor, Puneet / Stok, Kathryn S / Manske, Sarah / Voll, Reinhard E / Schett, Georg / Finzel, Stephanie

Calcified tissue international

2023 Volume 112, Issue 4, Page(s) 440–451

Abstract: Hereditary hemochromatosis (HH) causes unbalanced iron deposition in many organs including the joints leading to severe cartilage loss and bone damage in the metacarpophalangeal joints (MCPJ). High-resolution peripheral quantitative computed tomography ( ... ...

Abstract	Hereditary hemochromatosis (HH) causes unbalanced iron deposition in many organs including the joints leading to severe cartilage loss and bone damage in the metacarpophalangeal joints (MCPJ). High-resolution peripheral quantitative computed tomography (HR-pQCT) and its joint space width (JSW) quantification algorithm quantifies in vivo 3D joint morphology. We therefore aimed to (i) determine feasibility and performance of the JSW algorithm in HH, (ii) quantify joint space morphology, and (iii) investigate the relationship between morphological and clinical parameters in HH. Here, we performed an exploratory study on 24 HH patients and sex- and age-matched controls using HR-pQCT imaging of MCPJ. Mineralized bone structure was automatically segmented from the grayscale image data and periosteal surface bone masks and joint space masks were generated. Mean, minimal, and maximal joint space width (JSW; JSW.MIN; JSW.MAX), JSW heterogeneity (JSW.SD), JSW asymmetry (JSW.AS), and joint space volume (JSV) were computed. Demographics and, for HH patients, disease-specific parameters were recorded. Segmentation of JS was very good with 79.7% of MCPJs successfully segmented at first attempt and 20.3% requiring semi-manual correction. HH men showed larger JSV at all MCPs (+ 25.4% < JSV < + 41.8%, p < 0.05), larger JSW.MAX at MCP 3-4 (+ 14%, 0.006 < p < 0.062), and wider JSW (+ 13%, p = 0.043) at MCP 4 relative to HH women. Compared to controls, both HH men and HH women showed larger JSW.AS and smaller JSW.MIN at all MCP levels, reaching significance for HH men at MCP 2 and 3 (JSW.AS: + 323% < JSW.AS < + 359%, 0.020 < p < 0.043; JSW.MIN: - 216% < JSW.MIN < - 225%, p < 0.043), and for women at MCP 3 (JSW.AS: + 180%, p = 0.025; JSW.MIN: - 41.8%, p = 0.022). Time since HH diagnosis was correlated positively with MCP 4 JSW.AS and JSW.SD (0.463 < ρ < 0.499, p < 0.040), and the number of phlebotomies since diagnosis was correlated with JSW.SD at all MCPs (0.432 < ρ < 0.535, p < 0.050). HR-pQCT-based JSW quantification in MCPJ of HH patients is feasible, performs well even in narrow JS, and allows to define the microstructural joint burden of HH.
MeSH term(s)	Male ; Humans ; Female ; Hemochromatosis ; Hand Joints ; Metacarpophalangeal Joint/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Algorithms
Language	English
Publishing date	2023-02-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	304266-2
ISSN	1432-0827 ; 0944-0747 ; 0008-0594 ; 0171-967X
ISSN (online)	1432-0827
ISSN	0944-0747 ; 0008-0594 ; 0171-967X
DOI	10.1007/s00223-022-01050-3
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Article: Global and Spatial Compartmental Interrelationships of Bone Density, Microstructure, Geometry and Biomechanics in the Distal Radius in a Colles' Fracture Study Using HR-pQCT.

Shiraishi, Kazuteru / Burghardt, Andrew J / Osaki, Makoto / Khosla, Sundeep / Carballido-Gamio, Julio

Frontiers in endocrinology

2021 Volume 12, Page(s) 568454

Abstract: Background: Bone parameters derived from HR-pQCT have been investigated on a parameter-by-parameter basis for different clinical conditions. However, little is known regarding the interrelationships of bone parameters and the spatial distribution of ... ...

Abstract	Background: Bone parameters derived from HR-pQCT have been investigated on a parameter-by-parameter basis for different clinical conditions. However, little is known regarding the interrelationships of bone parameters and the spatial distribution of these interrelationships. In this work: 1) we investigate compartmental interrelationships of bone parameters; 2) assess the spatial distribution of interrelationships of bone parameters; and 3) compare interrelationships of bone parameters between postmenopausal women with and without a recent Colles' fracture. Methods: Images from the unaffected radius in fracture cases (n=84), and from the non-dominant radius of controls (n=98) were obtained using HR-pQCT. Trabecular voxel-based maps of local bone volume fraction (L.Tb.BV/TV), homogenized volumetric bone mineral density (H.Tb.BMD), homogenized μFEA-derived strain energy density (H.Tb.SED), and homogenized inter-trabecular distances (H.Tb.1/N) were generated; as well as surface-based maps of apparent cortical bone thickness (Surf.app.Ct.Th), porosity-weighted cortical bone thickness (Surf.Ct.SIT), mean cortical BMD (Surf.Ct.BMD), and mean cortical SED (Surf.Ct.SED). Anatomical correspondences across the parametric maps in the study were established Results: All within-group global trabecular and cortical Spearman's rank partial correlations were significant; and the correlations of H.Tb.BMD-L.Tb.BV/TV, H.Tb.BMD-H.Tb.1/N, L.Tb.BV/TV-H.Tb.1/N, Surf.Ct.BMD-Surf.Ct.SED and Surf.Ct.SIT-Surf.Ct.SED were significantly different between controls and fracture cases. The spatial analyses revealed significant heterogeneous voxel- and surface-based correlation coefficient maps across the distal radius for both groups; and the correlation maps of H.Tb.BMD-L.Tb.BV/TV, H.Tb.BMD-H.Tb.1/N, L.Tb.BV/TV-H.Tb.1/N, H.Tb.1/N-H.Tb.SED and Surf.app.Ct.Th - Surf.Ct.SIT yielded small clusters of significant correlation differences between groups. Discussion: The heterogeneous spatial distribution of interrelationships of bone parameters assessing density, microstructure, geometry and biomechanics, along with their global and local differences between controls and fracture cases, may help us further understand different bone mechanisms of bone fracture.
MeSH term(s)	Aged ; Biomechanical Phenomena ; Bone Density/physiology ; Bone and Bones/pathology ; Bone and Bones/physiopathology ; Bone and Bones/ultrastructure ; Carpal Bones/diagnostic imaging ; Carpal Bones/pathology ; Carpal Bones/physiopathology ; Carpal Bones/ultrastructure ; Case-Control Studies ; Colles' Fracture/diagnosis ; Colles' Fracture/etiology ; Colles' Fracture/pathology ; Colles' Fracture/physiopathology ; Female ; Forearm/diagnostic imaging ; Forearm/physiopathology ; Forearm Injuries/diagnosis ; Forearm Injuries/pathology ; Forearm Injuries/physiopathology ; Humans ; Middle Aged ; Minnesota ; Porosity ; Radius/diagnostic imaging ; Radius/pathology ; Radius/physiopathology ; Radius/ultrastructure ; Spatial Analysis ; Tomography, X-Ray Computed/methods ; Wrist Joint/diagnostic imaging ; Wrist Joint/pathology ; Wrist Joint/physiopathology ; Wrist Joint/ultrastructure
Language	English
Publishing date	2021-05-26
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2021.568454
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Article ; Online: Augmenting Osteoporosis Imaging with Machine Learning.

Pedoia, Valentina / Caliva, Francesco / Kazakia, Galateia / Burghardt, Andrew J / Majumdar, Sharmila

Current osteoporosis reports

2021 Volume 19, Issue 6, Page(s) 699–709

Abstract: Purpose of review: In this paper, we discuss how recent advancements in image processing and machine learning (ML) are shaping a new and exciting era for the osteoporosis imaging field. With this paper, we want to give the reader a basic exposure to the ...

Abstract	Purpose of review: In this paper, we discuss how recent advancements in image processing and machine learning (ML) are shaping a new and exciting era for the osteoporosis imaging field. With this paper, we want to give the reader a basic exposure to the ML concepts that are necessary to build effective solutions for image processing and interpretation, while presenting an overview of the state of the art in the application of machine learning techniques for the assessment of bone structure, osteoporosis diagnosis, fracture detection, and risk prediction. Recent findings: ML effort in the osteoporosis imaging field is largely characterized by "low-cost" bone quality estimation and osteoporosis diagnosis, fracture detection, and risk prediction, but also automatized and standardized large-scale data analysis and data-driven imaging biomarker discovery. Our effort is not intended to be a systematic review, but an opportunity to review key studies in the recent osteoporosis imaging research landscape with the ultimate goal of discussing specific design choices, giving the reader pointers to possible solutions of regression, segmentation, and classification tasks as well as discussing common mistakes.
MeSH term(s)	Bone Density ; Humans ; Image Processing, Computer-Assisted/methods ; Machine Learning ; Osteoporosis/diagnostic imaging ; Osteoporotic Fractures/diagnostic imaging ; Risk Factors
Language	English
Publishing date	2021-11-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2186581-4
ISSN	1544-2241 ; 1544-1873
ISSN (online)	1544-2241
ISSN	1544-1873
DOI	10.1007/s11914-021-00701-y
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Article ; Online: Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography.

Al-Khoury, Yousif / Finzel, Stephanie / Figueiredo, Camille / Burghardt, Andrew J / Stok, Kathryn S / Tam, Lai-Shan / Cheng, Isaac / Tse, Justin J / Manske, Sarah L

Journal of visualized experiments : JoVE

2023 , Issue 200

Abstract: Bone erosions are a pathological feature of several forms of inflammatory arthritis including rheumatoid arthritis (RA). The increased presence and size of erosions are associated with poor outcomes, joint function, and disease progression. High- ... ...

Abstract	Bone erosions are a pathological feature of several forms of inflammatory arthritis including rheumatoid arthritis (RA). The increased presence and size of erosions are associated with poor outcomes, joint function, and disease progression. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides unparalleled in vivo visualization of bone erosions. However, at this resolution, discontinuities in the cortical shell (cortical breaks) that are associated with normal physiological processes and pathology are also visible. The Study grouP for xtrEme Computed Tomography in Rheumatoid Arthritis previously used a consensus process to develop a definition of pathological erosion in HR-pQCT: a cortical break detected in at least two consecutive slices, in at least two perpendicular planes, non-linear in shape, with underlying trabecular bone loss. However, despite the availability of a consensus definition, erosion identification is a demanding task with challenges in inter-rater variability. The purpose of this work is to introduce a training tool to provide users with guidance on identifying pathological cortical breaks on HR-pQCT images for erosion analysis. The protocol presented here uses a custom-built module (Bone Analysis Module (BAM) - Training), implemented as an extension to an open-source image processing software (3D Slicer). Using this module, users can practice identifying erosions and compare their results to erosions annotated by expert rheumatologists.
MeSH term(s)	Humans ; Metacarpophalangeal Joint/diagnostic imaging ; Metacarpophalangeal Joint/pathology ; Arthritis, Rheumatoid/diagnostic imaging ; Arthritis, Rheumatoid/pathology ; Tomography, X-Ray Computed/methods ; Bone and Bones/pathology ; Disease Progression
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article ; Video-Audio Media ; Research Support, Non-U.S. Gov't
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/65802
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Article ; Online: Corrigendum to: CT Muscle Density, D3Cr Muscle Mass, and Body Fat Associations With Physical Performance, Mobility Outcomes, and Mortality Risk in Older Men.

Orwoll, Eric S / Blackwell, Terri / Cummings, Steven R / Cauley, Jane A / Lane, Nancy E / Hoffman, Andrew R / Burghardt, Andrew J / Evans, William J / Cawthon, Peggy M

The journals of gerontology. Series A, Biological sciences and medical sciences

2021 Volume 77, Issue 4, Page(s) 881

Language	English
Publishing date	2021-12-23
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glab364
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Article: Interpretation of Bone Mineral Density Z-Scores by Dual-Energy X-Ray Absorptiometry in Transgender and Gender Diverse Youth Prior to Gender-Affirming Medical Therapy.

Lee, Janet Y / Fan, Bo / Montenegro, Gabrielle / Long, Roger K / Sanda, Srinath / Capodanno, Gina / Schafer, Anne L / Burghardt, Andrew J / Rosenthal, Stephen M / Fung, Ellen B

Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry

2022 Volume 25, Issue 4, Page(s) 559–568

MeSH term(s)	Adolescent ; Humans ; Absorptiometry, Photon ; Transgender Persons ; Bone Density ; Osteoporosis/diagnostic imaging ; Osteoporosis/drug therapy ; Lumbar Vertebrae
Language	English
Publishing date	2022-07-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2040951-5
ISSN	1094-6950
ISSN	1094-6950
DOI	10.1016/j.jocd.2022.07.002
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Article ; Online: Diabetes Risk Factors and Bone Microarchitecture as Assessed by High-Resolution Peripheral Quantitative Computed Tomography in Adults With Long-Standing Type 1 Diabetes.

Sinha Gregory, Naina / Burghardt, Andrew J / Backlund, Jye-Yu C / Rubin, Mishaela R / Bebu, Ionut / Braffett, Barbara H / Kenny, David J / Link, Thomas M / Kazakia, Galateia J / Barnie, Annette / Lachin, John M / Gubitosi-Klug, Rose / de Boer, Ian H / Schwartz, Ann V

Diabetes care

2023

Abstract: Objective: To determine whether type 1 diabetes and its complications are associated with bone geometry and microarchitecture.: Research design and methods: This cross-sectional study was embedded in a long-term observational study. High-resolution ... ...

Abstract	Objective: To determine whether type 1 diabetes and its complications are associated with bone geometry and microarchitecture. Research design and methods: This cross-sectional study was embedded in a long-term observational study. High-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the distal radius and distal and diaphyseal tibia were performed in a subset of 183 participants with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study and 94 control participants without diabetes. HbA1c, skin advanced glycation end products (AGEs), and diabetes-related complications were assessed in EDIC participants with >30 years of follow-up. Results: Compared with control participants (aged 60 ± 8 years, 65% female), EDIC participants (aged 60 ± 7 years, diabetes duration 38 ± 5 years, 51% female) had lower total bone mineral density (BMD) at the distal radius (-7.9% [95% CI -15.2%, -0.6%]; P = 0.030) and distal tibia (-11.3% [95% CI -18.5%, -4.2%]; P = 0.001); larger total area at all sites (distal radius 4.7% [95% CI 0.5%, 8.8%; P = 0.030]; distal tibia 5.9% [95% CI 2.1%, 9.8%; P = 0.003]; diaphyseal tibia 3.4% [95% CI 0.8%, 6.1%; P = 0.011]); and poorer radius trabecular and cortical microarchitecture. Estimated failure load was similar between the two groups. Among EDIC participants, higher HbA1c, AGE levels, and macroalbuminuria were associated with lower total BMD. Macroalbuminuria was associated with larger total area and lower cortical thickness at the distal radius. Higher HbA1c and AGE levels and lower glomerular filtration rate, peripheral neuropathy, and retinopathy were associated with deficits in trabecular microarchitecture. Conclusions: Type 1 diabetes is associated with lower BMD, larger bone area, and poorer trabecular microarchitecture. Among participants with type 1 diabetes, suboptimal glycemic control, AGE accumulation, and microvascular complications are associated with deficits in bone microarchitecture and lower BMD.
Language	English
Publishing date	2023-11-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc23-0839
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