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Updated: Mar 25, 2026
Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
Published on: September 8, 2023
Histomorphometric and microarchitectural analyses using the 2 mm bone marrow trephine in metastatic breast cancer
M Fralick1, N Bouganim2, R Kremer2
1Department of Internal Medicine, University of Toronto, Toronto, Canada.
Background:
Bone-targeted agents are widely used for the treatment of osteoporosis, the prevention of cancer-therapy induced bone loss, and for reducing the risk of skeletal related events in patients with metastatic disease. Despite widespread use, relatively little is known about the in vivo effect of these agents on bone homeostasis, bone quality, and bone architecture in humans. Traditionally bone quality has been assessed using a transiliac bone biopsy with a 7 mm "Bordier" core needle. We examined the possibility of using a 2 mm "Jamshidi" core needle as a more practical and less invasive method to assess bone turnover and potentially other tumor effects.
Methods:
A pilot study on the feasibility of assessing bone quality and microarchitecture and tumor invasion using a 2 mm bone marrow trephine was conducted. Patients underwent a posterior trans-iliac trephine biopsy and bone marrow aspirate. Samples were analyzed for bone microarchitecture, bone density, and histomorphometry. The study plan was to accrue three patients with advanced breast cancer to assess the feasibility of the study before enrolling more patients.
Results:
The procedure was well tolerated. The sample quality was excellent to analyze bone trabecular microarchitecture using both microCT and histomorphometry. Intense osteoclastic activity was observed in a patient with extensive tumor burden in bone despite intravenous bisphosphonate therapy.
Discussion:
Given the success of this study for assessing bone microarchitecture, bone density, and histomorphometry assessment using a 2 mm needle the study will be expanded beyond these initial three patients for longitudinal assessment of bone-targeted therapy.
Insights
A new 2mm needle biopsy technique effectively assesses bone quality and microarchitecture in patients undergoing bone-targeted therapies. This less invasive method allows for detailed analysis of bone homeostasis and treatment effects.
Area of Science:
- Oncology
- Orthopedics
- Pharmacology
Background:
- Bone-targeted agents are crucial for osteoporosis, cancer bone loss, and metastatic disease.
- In vivo effects on human bone homeostasis, quality, and architecture remain poorly understood.
- Traditional 7mm transiliac biopsies are invasive; a less invasive 2mm needle biopsy was explored.
Purpose of the Study:
- To evaluate the feasibility of using a 2mm core needle for assessing bone quality and microarchitecture.
- To determine if this method can assess bone turnover and tumor effects in vivo.
- To establish a less invasive alternative to traditional bone biopsy techniques.
Main Methods:
- A pilot study utilized a 2mm posterior trans-iliac trephine biopsy and bone marrow aspirate.
- Samples were analyzed for bone microarchitecture, bone density, and histomorphometry.
- The initial phase focused on three advanced breast cancer patients to assess feasibility.
Main Results:
- The 2mm needle biopsy procedure was well-tolerated by patients.
- Excellent sample quality was achieved for microCT and histomorphometry analysis of bone microarchitecture.
- Intense osteoclastic activity was noted in a patient with high bone tumor burden, despite bisphosphonate treatment.
Conclusions:
- The 2mm needle biopsy is a successful and practical method for assessing bone microarchitecture, density, and histomorphometry.
- This less invasive technique enables longitudinal assessment of bone-targeted therapies.
- The study's success warrants expansion for further investigation into bone homeostasis and treatment efficacy.
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