Abstract
BackgroundBone strain index (BSI) is a tool measuring bone strain, derived from dual x-ray photon absorptiometry. It is able to characterise an aspect of bone quality that, joined to the quantity and quality parameters of bone mineral density (BMD) and trabecular bone score (TBS), permits an accurate definition of fracture risk. As no data are available about BSI precision, our aim was to assess its in vitro reproducibility.MethodsA Hologic spine phantom was used to perform BSI scans with three different scan modes: fast array (FA), array (A), and high definition (HD). Different soft tissue thicknesses (1, 3, 6 cm) of fresh pork rind layers as a surrogate of abdominal fat were interposed. For each scan mode, the phantom was consecutively scanned 25 times without repositioning.ResultsIn all scan modes (FA, A, HD) and at every fat thickness, BSI reproducibility was lower than that of BMD. The highest reproducibility was found using HD-mode with 1 cm of pork rind and the lowest one using HD-mode with 6 cm of pork rind. Increasing fat thickness, BSI reproducibility tended to decrease. BSI least significant change appeared to be about three times that of BMD in all modalities and fat thicknesses. Without pork rind superimposition and with 1-cm fat layer, BSI reproducibility was highest with HD-mode; with 3 or 6 cm fat thickness, it was higher with A-mode.ConclusionsBSI reproducibility was worse than that of BMD, but it is less sensitive to fat thickness increase, similarly to TBS.
Highlights
Bone strain index (BSI) is a tool measuring bone strain, derived from dual x-ray photon absorptiometry
Once Dual x-ray photon absorptiometry (DXA) analysis was completed, data were obtained from the same region of interest (ROI) used for phantom bone mineral density (BMD)
Without soft tissue superimposition, the LSC% of BSI was about three times higher than that of BMD, with the greatest difference for A-mode and FAmode. This difference was somewhat lower at increasing thickness, with BSI LSC reaching the lowest value of 1.7% with 1 cm thickness of interposed soft tissue using high definition (HD)-mode
Summary
Bone strain index (BSI) is a tool measuring bone strain, derived from dual x-ray photon absorptiometry. Osteoporosis is defined as a skeletal condition characterised by reduced bone strength, due to an impaired bone mass and compromised microarchitecture that cause an increased risk of non-traumatic fragility fractures [1]. Dual x-ray photon absorptiometry (DXA) is considered the gold standard method for the diagnosis of reduced bone mass and for its follow-up [4]. Bone mineral density (BMD) is the most relevant parameter of bone load resistance and is calculated as bone mineral content on area (g/cm). Bone mineral density (BMD) is the most relevant parameter of bone load resistance and is calculated as bone mineral content on area (g/cm2) It is expressed by T-score and Messina et al European Radiology Experimental
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