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Precision of pQCT-measured total, trabecular and cortical bone area, content, density and estimated bone strength in
W R D Duff1, K M Björkman, C E Kawalilak
1Department of Gastroenterology, College of Medicine, University of Saskatchewan.
Insights
Peripheral quantitative computed tomography (pQCT) shows precise bone density and cortical bone measurements in children. Precision errors for bone outcomes were generally low, with age influencing tibial measurements.
Area of Science:
- Pediatric Bone Densitometry
- Skeletal Imaging Precision
- Quantitative Computed Tomography
Background:
- Accurate assessment of bone health in children is crucial for monitoring growth and identifying skeletal disorders.
- Peripheral quantitative computed tomography (pQCT) is a valuable tool for evaluating bone structure and strength in pediatric populations.
- Understanding the precision errors and least significant change values of pQCT is essential for reliable interpretation of longitudinal studies.
Purpose of the Study:
- To determine the precision errors and least significant change values for various bone outcomes at the radius and tibia using pQCT in children.
- To identify factors, such as age, that may influence the precision of pQCT measurements in pediatric bone assessment.
Main Methods:
- Duplicate pQCT scans of the radius and tibia were performed on 35 children aged 8-14 years.
- Repeatability was assessed using root-mean-squared coefficient of variation (CV%RMS) and 95% limits-of-agreement.
- Spearman's rank correlation was used to examine associations between precision errors and factors like measurement interval, age, and anthropometrics.
Main Results:
- After excluding unusable scans (6-10%), CV%RMS varied from 2% (tibia density) to 19% (distal radius trabecular content).
- Precision errors were consistent across different scan qualities, falling within 95% limits-of-agreement.
- Age showed a significant association (rho -0.4 to -0.5) with precision errors at the tibia.
Conclusions:
- pQCT measurements of bone density and cortical bone properties demonstrate high precision (CV%RMS < 5%) in children.
- The findings support the reliability of pQCT for assessing bone health in pediatric populations.
- Age is a factor to consider when interpreting tibial pQCT data in children.
Objectives:
To define pQCT precision errors, least-significant-changes, and identify associated factors for bone outcomes at the radius and tibia in children.
Methods:
We obtained duplicate radius and tibia pQCT scans from 35 children (8-14yrs). We report root-mean-squared coefficient of variation (CV%RMS) and 95% limits-of-agreement to characterize repeatability across scan quality and least-significant-changes for bone outcomes at distal (total and trabecular area, content and density; and compressive bone strength) and shaft sites (total area and content; cortical area content, density and thickness; and torsional bone strength). We used Spearman's rho to identify associations between CV% and time between measurements, child's age or anthropometrics.
Results:
After excluding unanalyzable scans (6-10% of scans per bone site), CV%RMS ranged from 4% (total density) to 19% (trabecular content) at the distal radius, 4% (cortical content) to 8% (cortical thickness) at the radius shaft, 2% (total density) to 14% (trabecular content) at the distal tibia and from 2% (cortical content) to 6% (bone strength) at the tibia shaft. Precision errors were within 95% limits-of-agreement across scan quality. Age was associated (rho -0.4 to -0.5, p⟨0.05) with CV% at the tibia.
Conclusion:
Bone density outcomes and cortical bone properties appeared most precise (CV%RMS⟨5%) in children.
