ABSTRACT

Objective:

In this study we aimed to investigate whether there is a difference in osteoporosis detection rates with dual energy x-ray absorbsiometry (DXA) and Quantitative Computed Tomography (QCT) and relationship between bone-related biochemical markers.

Methods:

34 postmenopausal women who admitted to Physical Medicine and Rehabilitation Clinic with complaints of dorsalgia. Lumbar and thoracal X-rays were obtained in all patients. Bone mineral density measurements were performed with DXA and QCT. Therefore, osteoporosis and osteopenia rates were detected. Serum levels of calcium, phosphorus, bone-spesific alkaline phosphatase (BAP), osteocalcin, parathormone, calcitonin and 25-OH vitamin D3 were measured.

Results:

The mean age of patients was 63.44+9.34 years. L2-L4 vertebrae T-score in 6/34 (17.64%) patients and Femoral neck T-score in 3/34 (8.82%) patients were <2.5 in DXA evaluation. With QCT evaluation, L2-L4 vertebrae T-score in 31/34 (91.1%) patients and femoral neck T-score in 2/34 (5.88%) patients were <2.5. Osteoporosis detection rates were higher with QCT compared to DXA and it was found statistically significant (p<0.005). Statistically significant relationship was found between lumbar and femur T scores of bone mineral density and calcitonin (p<0.005).

Conclusion:

Osteoporosis detection rates were higher with QCT compared to DXA. QCT seems to be more valuable to detect osteoporosis.

Keywords: Dual Energy x-ray Absorbsiometry, Quantitative Computed Tomography, osteoporosis

References

Sindel D, Gula G.Osteoporozda kemik mineral yoğunluğunun değerlendirilmesi. Türk Osteoporoz Dergisi 2015;21:23-9.

National Osteoporosis Foundation (NOF). Clinician’s guide to prevention and treatment of osteoporosis. Available from: www. nof.org; 2014.

World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. Geneva, World Health Organization, 1994. WHO Technical Report Series, No. 843.

Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137-41.

Genant HK, Engelke K, Prevrhal S. Advanced CT bone imaging in osteoporosis. Rheumatology (Oxford) 2008;4:9-16.

Glendenning P. Markers of Bone Turnover for the Prediction of Fracture Risk and Monitoring of Osteoporosis Treatment: A Need for International Reference Standards. Osteoporos Int 2011;22:391-420.

Eryavuz M. Osteoporozda ayrıcı tanı. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Osteoporoz Sempozyumu 1999;51-56.

Cheng X, Wang L, Wang Q, Ma Y, Su Y, Li K. Validation of quantitative computed tomography-derived areal bone mineral density with dual energy X-ray absorptiometry in an elderly Chinese population. Chinese Med Journal 2014;127: 1445-49.

Engelke K, Adams JE, Armbrecht G, Augat P, Bogado CE, Bouxsein ML, Felsenberg D, Ito M, Prevrhal S, Hans DB, Lewiecki EM.Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: the 2007 ISCD Official Positions. Journal of Clin Densitom 2008; 11: 1: 123–162.

American College of Radiology, “ACR Practice Guideline for the Performance of Quantitative Computed Tomography (QCT) Bone Densitometry (Resolution 33),” Reston, Va, USA, 2008, http://www.acr.org/~/media/ACR/Documents/PGTS/ guidelines/QCT.pdf

Günaydın R, Olmez N, Kaya T, Dirim Vidinli B, Memiş A. Ortopedik Vertebra Fraktürlerinde Risk Faktörleri. Osteoporoz Dünyasından 2002;3:105-109.

Demirbağ Kabayel D, Doğan D. Osteoporozun Değerlendirilmesinde Kantitatif Bilgisayarlı Tomografi ve Manyetik Rezonans Görüntüleme’nin Kullanımı. Turkiye Klinikleri J Orthop & Traumatol-Special Topics 2015;8: 2: 22-28.

Erdem HR. Osteoporozda tanı yöntemleri. Turkiye Klinikleri JPM&R-Special Topics 2012; 5: 6-10.

Lewiecki EM. Osteoporotic fracture risk assessment. Available from: www.uptodate.com. Last updated: April 17, 2013.

Sindel D. Osteoporozda görüntüleme yöntemlerinde gelişmeler. Turk J Phys Med Rehab Osteoporoz Özel Sayısı. 2009; 2: 50-61.

Li N, Li XM, Xu L, Sun WJ, Cheng, XG, Tian W. Comparison of QCT and DXA:Osteoporosis Detection Rates in Postmenopausal Women. Int J Endocrinol. 2013,895474: 1-5

Yu W, Gluer CC, Fuerst T, Grampp S, Li J, Lu Y, Genant HK. Influence of degenerative joint disease on spinal bone mineral measurements in postmenopausal women. Calcif Tissue Int 1995;57:3:169-174.

Greenspan SL, Von Stetten E, Emond SK, Jones L, Parker RA. Instant vertebral assessment: a noninvasive dual X-ray absorptiometry technique to avoid misclassification and clinical mismanagement of osteoporosis. Journal of Clin Densitom 2001:4; 373–380.

Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men (RACGP) http://www. racgp.org. au/guidelines/musculoskeletaldiseases/osteoporosis (Updated on Feb2010).

Akçay Yalbuzdağ Ş, Sarıfakıoğlu B, Şengül İ, Çetin N. Yeni Tanı Alan Postmenopozal Osteoporozda Kemik Döngüsü Belirteçleri Kırık Riski ile İlişkili midir? Kesitsel, Klinik Çalışma. Turk J Osteoporos 2015;21:2:58-62.

Garmero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, Muller C, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res 1996;11:1531-1538.

Taşcıoğlu F. Öner C. Armagan O. Postmenopozal Osteoporoz Tedavisinde Sürekli ve Intermitan Kalsitonun Uygulamalarinin Etkinligi. Turk J Osteoporos 2002;8: 1: 9-14.

Robert D. Tiegs RD, Jean Jacques Body JJ, Wahner HW, Barta J, Riggs BL. Hunter Heath H III. Calcitonin Secretion in Postmenopausal Osteoporosis. N Engl J Med 1985;312:1097-1100.

Chesnut CH 3rd, Baylink DJ, Sisom K, Nelp WB, Roos BA. Basal plasma immunoreactive calcitonin in postmenopausal osteoporosis. Metabolism 1980;29;6:559-562.

Taggart HM, Chesnut CH 3rd, Ivey JL, Baylink DJ, Sisom K, Huber MB, Roos BA. Deficient calcitonin response to calcium stimulation in postmenopausal osteoporosis? Lancet 1982;1;8270:475-478.

Tekin Y, Erkin Bozdemir A, Barutçuoğlu B.Osteoporoz Tanısında Kullanılan Biyokimyasal Göstergeler. Türk Klinik Biyokimya Derg 2005;3(2):73-83.

Assessment of Dual-Energy X-Ray Absorptiometry (DXA) and Quantitative Computed Tomography (QCT) Methods with Biochemical Markers in Lumbar and Femoral Osteoporosis Diagnosis

ABSTRACT

References