Journal article
HR-pQCT reliability and accuracy of bone density and morphology properties in children
JBMR plus, Vol.9(9), ziaf106
08/01/2025
DOI: 10.1093/jbmrpl/ziaf106
PMCID: PMC12395334
PMID: 40894194
Abstract
Volumetric bone density, microarchitecture, and strength measures using high resolution peripheral quantitative computed tomography (HR-pQCT) are valuable measures of bone health in pediatrics. Our cross-sectional study evaluated bone measure reproducibility in pediatric participants using repeat HR-pQCT (XtremeCT II, Scanco Medical, Switzerland) scans of non-dominant distal tibia and radius of 30 healthy children and adolescents (7-17 yr, 47% female) by two technicians. Additionally, we examined HR-pQCT and micro-CT of twenty-six cadaveric distal tibia specimens to evaluate agreement between the modalities. All HR-pQCT scans were analyzed using manufacturer-provided software (Image Processing Language, Scanco Medical, Switzerland) and a fully automated, previously-validated, in-house algorithm, offering measures of bone micro-structure (eg, trabecular plate-rod distribution, transverse trabeculae, trabecular bone strength) currently unavailable in the manufacturer-provided software. Root-mean-squared percent coefficient of variation (RMS-%CV) assessed precision and least significant change (LSC). Intraclass correlation coefficients (ICC) using absolute-agreement, 2-way random-effects models assessed reliability. Pearson’s correlation coefficients and ICC assessed linear relationships and agreements between HR-pQCT and micro-CT, respectively. In children and adolescents, RMS-%CV of HR-pQCT-derived trabecular bone measures at distal tibia and radius ranged from 0.8-4.4 and 0.8-6.0, respectively. Most cortical bone results were in a similar range. Both computational algorithms showed ICC >0.90. RMS-%CV and LSC values were lower for tibia than radius. ICC were lower for cortical than trabecular outcomes. Most cadaveric results showed ICC > 0.83, other than trabecular bone thickness and modulus (ICC = 0.7). Pearson’s r (>0.86) suggested strong correlations for almost all parameters. HR-pQCT and micro-CT results using in-house algorithm did not differ significantly, while manufacturer-provided algorithm results showed lower yet still moderate reliability (ICC > 0.55). Reliability of the second-generation HR-pQCT in pediatric participants is excellent—better in tibia versus radius. Our results support the high reproducibility of XtremeCT II scans and thus the use of this clinical imaging modality in studies of pediatric bone health.
Details
- Title: Subtitle
- HR-pQCT reliability and accuracy of bone density and morphology properties in children
- Creators
- Roman J Shypailo - Texas Children's HospitalChadi Calarge - Baylor College of MedicinePunam K Saha - University of IowaXiaoliu ZhangXiaojie Chen - University of IowaStephanie Dinh - Baylor College of MedicineXiaofan Huang - Baylor College of MedicineBabette Zemel - Children's Hospital of PhiladelphiaFida Bacha - Texas Children's Hospital
- Resource Type
- Journal article
- Publication Details
- JBMR plus, Vol.9(9), ziaf106
- DOI
- 10.1093/jbmrpl/ziaf106
- PMID
- 40894194
- PMCID
- PMC12395334
- NLM abbreviation
- JBMR Plus
- ISSN
- 2473-4039
- eISSN
- 2473-4039
- Publisher
- Oxford University Press; OXFORD
- Grant note
- National Institutes of HealthUSDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of MedicineTexas Children's Hospital, Houston, TX, USA
This work is a publication of the USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital, Houston, TX, USA. The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. We would like to thank the Metabolic Research Unit staff, Ms. Maryse Laurent and the study coordinators who made gathering this data possible.
- Language
- English
- Electronic publication date
- 06/14/2025
- Date published
- 08/01/2025
- Academic Unit
- Electrical and Computer Engineering; Psychiatry
- Record Identifier
- 9984843244002771
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