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The effects of temperature, viscosity, and molecular size on the aluminum-27 QCT NMR of transferrins.

A number of reports in recent years have demonstrated the feasibility of detecting quadrupolar metal ions bound tightly to rather large proteins via the quadrupolar central transition (QCT) NMR approach. In this article, an in-depth investigation of several interesting properties of transferrin-bound 27Al NMR signals, namely, their dependence on temperature, viscosity, and molecular size is presented. It is shown that (1) decreasing temperature and (2) increasing viscosity by adding reagents such as glycerol and ethylene glycol perturb only the linewidths of transferrin-bound 27Al signals, and, in fact, produce a decrease in signal linewidth. These effects are in accord with quadrupolar relaxation theory, which predicts that the linewidth of the central transition of a half-integer quadrupolar nucleus should decrease with increasing correlation time of the protein under nonextreme narrowing conditions. Furthermore, it is demonstrated that these trends, which are completely opposite to those generally observed in NMR spectroscopy, can be exploited to monitor ovotransferrin half-molecule reassociation reactions. In combination with the peculiar properties of transferrin-bound quadrupolar nuclei reported in the literature to date, the phenomena described here provide the basis for understanding the conditions and experimental parameters which may facilitate the application of the QCT NMR technique to the study of other quadrupolar nuclei and proteins.

Aluminum↗

Cross-calibration of liquid and solid QCT calibration standards: corrections to the UCSF normative data.

Quantitative computed tomography (QCT) has been shown to be a precise and sensitive method for evaluating spinal bone mineral density (BMD) and skeletal response to aging and therapy. Precise and accurate determination of BMD using QCT requires a calibration standard to compensate for and reduce the effects of beam-hardening artifacts and scanner drift. The first standards were based on dipotassium hydrogen phosphate (K2HPO4) solutions. Recently, several manufacturers have developed stable solid calibration standards based on calcium hydroxyapatite (CHA) in water-equivalent plastic. Due to differences in attenuating properties of the liquid and solid standards, the calibrated BMD values obtained with each system do not agree. In order to compare and interpret the results obtained on both systems, cross-calibration measurements were performed in phantoms and patients using the University of California San Francisco (UCSF) liquid standard and the Image Analysis (IA) solid standard on the UCSF GE 9800 CT scanner. From the phantom measurements, a highly linear relationship was found between the liquid- and solid-calibrated BMD values. No influence on the cross-calibration due to simulated variations in body size or vertebral fat content was seen, though a significant difference in the cross-calibration was observed between scans acquired at 80 and 140 kVp. From the patient measurements, a linear relationship between the liquid (UCSF) and solid (IA) calibrated values was derived for GE 9800 CT scanners at 80 kVp (IA = [1.15 x UCSF] - 7.32).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Heritability of spinal trabecular volumetric bone mineral density measured by QCT in the Diabetes Heart Study.

The heritability of trabecular volumetric bone mineral density (BMD) determined by quantitative computed tomography (QCT) has not yet been reported. The purpose of this study was to investigate the heritability of BMD as determined by QCT and DXA in 124 women and 120 men (age 39-83 years, BMI 17-75, 84% type 2 diabetics) from 101 families (232 sibling pairs) in the Diabetes Heart Study. Volumetric BMD had a heritability (h2) estimate of 0.73 (SE = 0.15, P < 0.0001) at the lumbar spine and 0.71 (SE = 0.15, P < 0.0001) at the thoracic spine. Areal BMD heritability estimates were 0.56 for PA spine, 0.43 for total hip, 0.43 for femoral neck, 0.45 for distal radius, 0.42 for mid-radius, and 0.52 for whole body (all P < 0.01). After accounting for familial correlation using generalized estimating equations, volumetric BMD was inversely associated with age (r = -0.52, P < 0.0001) and duration of diabetes (r = -0.24, P < 0.01) and positively associated with body weight (r = 0.25, P < 0.01). In multivariate analysis, adjustment for age, sex, and race lowered the h2 estimates for volumetric BMD at the lumbar (h2 = 0.41, P < 0.01) and thoracic (h2 = 0.48, P < 0.001) spine, increased the h2 estimate for areal BMD at the mid radius (h2 = 0.58, P < 0.0001), and had little effect on the h2 estimate for areal BMD at other sites (h2 = 0.41-0.55, all P < 0.01). Additional adjustment for BMI, duration of diabetes, and physical activity had little effect on the h2 estimates for volumetric BMD or areal BMD except at the hip where they were lowered (h2 = 0.31-0.33, all P < 0.05). These data suggest that, like areal BMD, volumetric BMD is highly heritable and may be used in designing linkage studies to locate genes governing bone metabolism.

Absorptiometry, Photon↗

A new set of calibration standards for estimating the fat and mineral content of vertebrae via dual energy QCT.

A new set of calibration standards has been developed for implementing a dual-energy (DE) quantitative CT technique for estimating the fat and bone content of vertebrae. The QCT technique is based upon a three-component model of bone and utilizes calibration materials that mimic those components in their X-ray attenuation properties. The three components we chose to simulate are bone (mineral plus collagen), fat and a fat-free red marrow. This choice was predicated upon our desire to employ materials that would facilitate later experimental verification of the method. The calibration standards and a set of test samples were manufactured of tissue-simulating epoxy resins. They were employed in studies of the accuracy (consistency) and precision of the technique and in a study of 21 normal postmenopausal women. Estimates of the bone and fat content of the test samples were consistent with the manufacturer's specifications to within 13 mg/ml and 7 vol%, respectively. Long-term reproducibility (coefficient of variation) for both quantities was about 3%. The average bone content of the T12-L3 vertebrae of the human subjects was 262 +/- 32 mg/ml (152 +/- 18 mg/ml calcium hydroxyapatite or mineral) and the average fat content was 63 +/- 8%. Conventional single energy (SE) QCT measurements of these vertebrae were about 23% less than the DE mineral measurements, which is consistent with the differences between SEQCT and ash content that others have determined via chemical analysis. The DE fat content is, in absolute terms, about 15% greater than values reported in the literature and may be due to an error in the assumed composition of red marrow. The true accuracy of the bone and fat estimates is to be determined in a planned human vertebral specimen study.

Bone Density↗

The European Spine Phantom--a tool for standardization and quality control in spinal bone mineral measurements by DXA and QCT.

The lack of standardization in bone mineral measurements of the lumbar spine and other skeletal sites is generally recognized as an important and unresolved issue. We report and discuss efforts at standardization and cross-calibration of DXA and QCT equipment. We have designed and tested a geometrically defined, semi-anthropomorphic phantom, the European Spine Phantom (ESP). It contains a spine insert consisting of three vertebrae of increasing bone mineral densities and thicknesses of cortical structures; the respective parameters are given in tabular form for the final phantom design. Results for cross-calibration with the ESP compare well with patient results. Measurements on the first 30 phantoms confirmed that the ESP can be manufactured with a variation of about 1%. We conclude that the ESP is suitable for daily quality assurance, cross-calibration of instruments and universal standardization. The ESP was used to establish standardized BMD (sBMD) units for DXA equipment going into effect in late 1995. Its acceptance by manufacturers as a calibration standard for DXA and QCT measurements appears imminent.

Absorptiometry, Photon↗

Type 2 diabetes is not independently associated with spinal trabecular volumetric bone mineral density measured by QCT in the Diabetes Heart Study.

The purpose of this study was to investigate the association between type 2 diabetes mellitus (DM2) and trabecular volumetric bone mineral density (vBMD) of the thoracic and lumbar spine measured by quantitative computed tomography (QCT) in 483 female (410 with DM2) and 398 male (365 with DM2) adults (age 36-86 years, BMI 16-58, 88% with DM2) in the Diabetes Heart Study. After accounting for familial correlation using generalized estimating equations (GEE), lumbar spine vBMD was positively associated with BMI (r = 0.24, P < 0.0001) and inversely associated with age (r = -0.51, P < 0.0001). In women, age-adjusted thoracic spinal vBMD (mg/ml, mean +/- SE) was higher in diabetics (147.6 +/- 2.3) compared to unaffected individuals (138.6 +/- 3.4) (P = 0.02), with age-adjusted lumbar spinal vBMD showing a similar but non-significant trend (132.9 +/- 2.1 in diabetics vs. 127.2 +/- 3.6 in unaffected individuals, P = 0.15). In contrast, in men, age-adjusted lumbar and thoracic vBMD were not different between diabetics and unaffected controls (lumbar vBMD = 125.0 +/- 1.8 in diabetics and 125.8 +/- 5.6 in unaffected individuals, P = 0.89; thoracic vBMD = 137.4 +/- 2.1 in diabetics vs. 134.2 +/- 5.5 in controls, P = 0.56). After multivariate analysis adjusting for age, sex, race, BMI, physical activity, dietary intake, smoking, and alcohol use, interaction between diabetes status and trabecular vBMD of the spine was no longer observed. In women only, age-adjusted areal BMD (determined by dual X-ray absorptiometry (DXA)) of the spine and hip were significantly higher in diabetics than non-diabetic (all P < 0.05), although the differences disappeared after additional adjustment for BMI. These data suggest that areal BMD measured by DXA and trabecular volumetric BMD measured by QCT are not associated with type 2 diabetes independently from BMI.

Adult↗

[The comparative measurement of the bone marrow dose in quantitative computed tomography (QCT), dual-photon radiography (DPX) and conventional x-rays of the LS].

One of the issues in the discussion on the best method for measuring the bone mineral content is the relevance of the applied dose. We used highly sensitive thermoluminescent dosimeters (TLD) to directly compare bone marrow doses in a human phantom. DPX gave a bone marrow dose in the lumbar spine of 4 mu Gy, in QCT the dose corrected to the same amount of irradiated marrow was about 1 mGy. This value is in the same range as conventional a.p. plus lateral view x-rays of the lumbar spine. Corrected to the total body dose, the QCT dose is as low as 10% of the yearly background irradiation. It should therefore be radiobiologically irrelevant.

Absorptiometry, Photon↗

Significance of QCT bone mineral density and its standard deviation as parameters to evaluate osteoporosis.

OBJECTIVE: A study using quantitative CT (QCT) of the spine was carried out to determine whether the standard deviation (SD) of the bone mineral density (BMD) within a given region of interest (ROI) could be used as a parameter to evaluate osteoporosis. MATERIALS AND METHODS: A low dose single energy protocol was used. The elliptical ROIs inside the trabecular bone of the vertebral bodies T12-L3 were analyzed for four patient groups: Group 1, 52 healthy premenopausal women (age 41 +/- 2 years); group 2, 119 healthy early postmenopausal women (53 +/- 4 years); group 3, 45 postmenopausal relatively healthy women (age 65 +/- 5 years); group 4, 26 osteoporotic women (age 67 +/- 5 years). Average group mean BMD values and their coefficients of variation (CV = SD/BMD) were calculated. The t values, percent decrements, z-scores, and analysis of variance (ANOVA) served to compare capabilities of the BMD and the CV to discriminate groups pairwise using all possible group combinations. RESULTS: The use of z-scores and percent decrements gave ambivalent and mostly insignificant results. The CV performed better than BMD in separating group pairs (1,3), (1,4), (2,3), and (2,4), but BMD was superior for group pairs (1,2) and (3,4). Using SD as an independent variable in addition to age and BMD in the ANOVA did not significantly change r2 or the standard error of the estimate. The t test showed highly significant better discriminatory capabilities for BMD compared to CV> CONCLUSION: The results of our study did not indicate a significant potential of the BMD SD as measured in trabecular single energy low dose spinal QCT to improve the discriminatory capabilities of BMD for a separation of osteoporotic from nonosteoporotic subjects.

Adult↗

New QCT analysis approach shows the importance of fall orientation on femoral neck strength.

UNLABELLED: The influence of fall orientation on femur strength has important implications for understanding hip fracture risk. A new image analysis technique showed that the strength of the femoral neck in 37 males varied significantly along the neck axis and that bending strength varied by a factor of up to 2.8 for different loading directions. INTRODUCTION: Osteoporosis is associated with decreased BMD and increased hip fracture risk, but it is unclear whether specific osteoporotic changes in the proximal femur lead to a more vulnerable overall structure. Nonhomogeneous beam theory, which is used to determine the mechanical response of composite structures to applied loads, can be used along with QCT to estimate the resistance of the femoral neck to axial forces and bending moments. MATERIALS AND METHODS: The bending moment [My(theta)] sufficient to induce yielding within femoral neck sections was estimated for a range of bending orientations (theta) using in vivo QCT images of 37 male (mean age, 73 years; range, 65-87 years) femora. Volumetric BMD, axial stiffness, average moment at yield (M(y,avg)), maximum and minimum moment at yield (M(y,max) and M(y,min)), bone strength index (BSI), stress-strain index (SSI), and density-weighted moments of resistance (Rx and Ry) were also computed. Differences among the proximal, mid-, and distal neck regions were detected using ANOVA. RESULTS: My(theta) was found to vary by as much as a factor of 2.8 for different bending directions. Axial stiffness, M(y,avg), M(y,max), M(y,min), BSI, and Rx differed significantly between all femoral neck regions, with an overall trend of increasing axial stiffness and bending strength when moving from the proximal neck to the distal neck. Mean axial stiffness increased 62% between the proximal and distal neck, and mean M(y,avg) increased 53% between the proximal and distal neck. CONCLUSIONS: The results of this study show that femoral neck strength strongly depends on both fall orientation and location along the neck axis. Compressive yielding in the superior portion of the femoral neck is expected to initiate fracture in a fall to the side.

Accidental Falls↗

[Clinical evaluation of age-related changes of bone mineral content of cortical and trabecular bones by dual energy QCT].

The potential capability of a new dual energy (DE) quantitative computed tomography (QCT) method, 4-equation 4-unknown method (DEQCT4E-4U), was evaluated for estimation of bone mineral density (BMD) as well as bone mineral content/cm width (BMC) in trabecular bone of lumbar vertebrae. Cortical BMD and BMC were also estimated by the single energy QCT method (SEQCT 80 kVp) and the age-related change of cortical BMD and the cortical BMC/trabecular BMC ratio was also studied. The result indicated that the estimation of the BMD combining analysis of BMC in trabecular bone obtained by the present method provides further knowledge concerning vertebral trabecular bone mineral status. The profiles of the age-related changes of the cortical BMD and cortical BMC/trabecular BMC ratio in females were markedly different from those in males. These results indicated that our method combining analysis of BMC (BMD) of cortical bone and trabecular bone was also found to provide valuable information to evaluate the vertebral bone mineral status.

Absorptiometry, Photon↗

In vivo high resolution 3D-QCT of the human forearm.

In vivo examinations of bone microarchitecture have become available recently through high resolution computed tomography (3D-QCT) and magnetic resonance imaging. The spatial resolution of the resulting images, however, is not sufficient to depict individual trabeculae in their true shape. Nevertheless, structural indices such as relative bone volume, trabecular number, mean thickness and mean separation can be extracted with the help of a ridge detection algorithm. Precision of the procedure is of the order of 1%, accuracy is ascertained using a micro-CT based calibration. In this work we report first results of time serial examinations. Eighteen healthy postmenopausal women (no HRT) were measured at months 0, 6, and 12, and the temporal changes were analyzed. Examination site was the distal radius. The above mentioned structural indices, the average densities and the thickness of the cortical shell were determined. Of the 18 women 6 showed no significant bone loss of any kind, 5 lost primarily cancellous bone, 4 lost primarily cortical bone, and 3 had a substantial loss of cortical as well as cancellous bone. We conclude that even in a homogenous group such as postmenopausal women, there are considerable differences in the reason why bone is weakened and that high resolution 3D-QCT allows to differentiate between various types of bone loss.

Bone Density↗

Measurement of bone mineral density (BMD) with quantitative computed tomography (QCT) in postmenopausal osteoporosis: effect of estrogen.

UNLABELLED: To determine the efficacy of the estrogen replacement therapy (ERT) on the bone mineral density (BMD) measured with quantitative computed tomography (QCT) in postmenopausal osteoporosis 16 women aged 46-72 were examined. They were divided into two groups: 8 women treated with conjugated estrogens (Group I) and 8 who did not received ERT (Group II). In all 16 patients the serum hormonal concentrations (LH, FSH and estradiol) were measured with radioimmunological methods. The bone densitometry was performed in all of them using the single-energy computed tomography (QCT) with the computer Picker 1200. Bone mineral density was measured in three lumbar vertebra (L1-L3) and expressed in milligrams K2HPO4 per ml. The bone mineral density (BMD) was statistically significantly higher in the estrogen treated group (Group I) in every vertebra compared with that of controls (Group II). The serum FSH concentration was statistically significantly lower in the ERT group (Group I) and a statistically significant correlation between FSH level and average BMD (Lmean) was present. IN CONCLUSION: 1. the ERT is very efficacious in preventing bone loss in postmenopausal women; 2. measurement of BMD in lumbar vertebra L1 or L3 may be a sufficiently reliable and accurate, cost-effective and time-saving method of screening for osteoporosis; 3. the serum FSH determination seems to be useful in monitoring of the estrogen therapy for postmenopausal osteoporosis.

Aged↗

[Clinical application of skeletal scintigraphy and quantitative computed tomography (QCT) to osteoarthritis of the knee].

Skeletal scintigraphy and QCT were performed to determine changes of subchondral bone tissues in osteoarthritis of the knee and findings were compared with plain X-ray findings, knee pain and femoro-tibial angle. Results on blood pool study were especially related to pain. Results on delayed study using single photon emission computed tomography revealed high uptake on the medial side of the femur and tibia parallel to plain X-rays and pain. The QCT value was slightly decreased as osteoarthritic changes progressed without a significant change. In addition, delayed study in cases with previous surgical intervention by high tibial osteotomy revealed a lower uptake on the medial side of the femur and tibia. When skeletal scintigraphy accurately reflects blood flow through the subchondral bone tissues and is closely related to morbidity and pain, this modality is valuable in analysis of signs and symptoms as well as postoperative outcome.

Aged↗

Bone mineral and other bone components in vertebrae evaluated by QCT and MRI.

To evaluate the usefulness of assessing bone components using magnetic resonance imaging (MRI), the contributions of bone components, including mineral, fat and collagen, to bone mineral density (BMD) and T1 relaxation time (T1) were studied using phantoms. Excised human vertebrae were also evaluated by quantitative computed tomography (QCT) and MRI. T1 was shortened with increasing quantities of fat and collagen. In water, T1 was significantly affected by bone density, while in oil, T1 became slightly longer as bone density increased. The presence of fat and collagen caused under- and overestimations of BMD, respectively. There was good correlation between T1 and BMD in osteoporotic vertebrae and the vertebrae with long T1 showed an increased content of hematopoietic marrow and/or abnormally increased bone mineral. It was concluded that the experimental data showed that MRI can contribute to the assessment of bone quality.

Adipose Tissue↗

Cortical mineral content of the radius assessed by peripheral QCT predicts compressive strength on biomechanical testing.

Our aim was to evaluate the role of cortical bone in resistance to compression in the human radius. Thirty-three left cadaver forearms were scanned on an XCT 960 Stratec CT scanner. Cortical density and cortical thickness were measured at the junction of the middle and distal third of the radius. Subsequently, 2-cm-high cylindrical specimens, centrated on the level of the CT slice, were cut. After removal of the endosteal trabecular bone, the specimens were submitted to compressive testing, using an Instron machine, and load deformation curves were obtained. Maximal stress (load corrected for cross-sectional area) showed a significant relationship with the density (r = 0.78) as well as with the thickness (r = 0.74) of the cortex. The closest correlation involved the maximal load and the mineral content of the cortex specimens (r = 0.87). We conclude that the mineral content of these radius cortex specimens, measured using peripheral QCT, predicts their compressive strength on biomechanical testing.

Aged↗

[Peripheral quantitative computed tomography for bone mineral measurement using a new special QCT-scanner. Methodology, normal values, comparison with manifest osteoporosis].

Some years ago we designed a special purpose gamma-ray QCT scanner for bone mineral measurements at the forearm. Currently, the first commercially built scanners (Stratec SCT 900) are being tested and clinically evaluated. The scanner uses an 125I photon source with a multidetector translate rotate fan beam geometry and newly developed semiconductor crystals. Quantification of trabecular bone and total bone at a standardized radial cross section gives an in-vivo reproducibility of less than 1%, which is superior compared to all other bone mineral measurement techniques. In-vitro reproducibility is between 0.2 and 0.4%, measured with calibration phantoms. The high in vivo reproducibility is ensured by automatic contour finding algorithms to determine the bone mass within a forearm cross sectional slice. A number of healthy men (n = 201) and women (n = 400) were examined to obtain a reference population for comparison to patients with generalized bone disease. We compared 182 osteoporotic females with healthy subjects. The high precision of the device and the high sensitivity of the measurement site considering changes of trabecular bone mass provide a very powerful means for monitoring bone mineral loss or changes due to therapy, as well as high diagnostic sensitivity.

Adult↗

Peripheral QCT: a low-risk procedure to identify women predisposed to osteoporosis.

A low-risk procedure is described for the precise quantitation of changes of trabecular and cortical bone density at peripheral measuring sites. The method is based on quantitative computed tomography (QCT). Bone parameters are calculated for a sample volume common to all examinations of a patient. This is achieved by matching stacks of tomograms according to the cross sectional area of the bone measured. With the help of a special-purpose CT system the described procedure enables a reproducibility for trabecular and cortical bone parameters of 0.3% (1 SD) at a local radiation dose of 0.1 mSv (10 mrem). The method was used to assess the individual changes in bone density of 39 perimenopausal women during an observation period of 2 to 3 years. The results are grouped according to their menstrual state. Regularly menstruating women experience minute or no changes in bone density. After menopause the interindividual differences are considerable: some women lose bone excessively, others remain relatively stable. The frequency distribution of the rate of bone loss appears to be bimodal. Hence women can be classified in fast losers and slow losers. We conclude that the rate of bone loss may be most helpful in the identification of those women predisposed to osteoporosis.

Disease Susceptibility↗