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.