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Bone tissue forms the internal skeleton of vertebrate animals, providing structure to the body.
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Updated: Feb 8, 2026

Outer-Boundary Assisted Segmentation and Quantification of Trabecular Bones by an Imagej Plugin
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Increasing soft tissue thickness does not affect trabecular bone score reproducibility: a phantom study.

Carmelo Messina1,2, Alessandro Poloni3, Vito Chianca4

  • 1Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. carmelomessina.md@gmail.com.

Endocrine
|June 28, 2018
PubMed
Summary
This summary is machine-generated.

Trabecular Bone Score (TBS) assessment is reliable even with increased soft tissue. This study found that TBS reproducibility was not significantly affected by soft tissue thickness, unlike bone mineral density (BMD).

Keywords:
Dual energy X-ray absorptiometryPhantomPrecisionReproducibilityTrabecular bone score

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Area of Science:

  • Osteoporosis research
  • Medical imaging analysis

Background:

  • Trabecular Bone Score (TBS) assesses bone microarchitecture using lumbar spine (LS) dual-energy X-ray absorptiometry.
  • Soft tissue thickness can artifactually reduce TBS values, potentially impacting diagnostic accuracy.

Purpose of the Study:

  • To evaluate the impact of simulated soft tissue thickness on TBS and bone mineral density (BMD) reproducibility.
  • To compare the influence of soft tissue on TBS versus BMD measurements using a phantom model.

Main Methods:

  • A Hologic spine phantom was scanned using a QDR-Discovery W densitometer.
  • Fresh pork rind layers (5 mm) simulated soft tissues, applied in thicknesses of 0, 1, 3, and 6 cm.
  • BMD and TBS reproducibility were assessed across different scan modes (fast array, array, high definition) by calculating the least significant change.

Main Results:

  • Both BMD and TBS reproducibility slightly decreased with increasing soft tissue thickness.
  • BMD reproducibility showed a statistically significant decrease only in the high-definition (HD) modality.
  • TBS reproducibility was consistently slightly lower than BMD but remained robust, ranging from 97.4% to 98.8% across conditions.

Conclusions:

  • TBS reproducibility is not significantly affected by up to 6 cm of soft tissue thickness.
  • TBS measurements appear less influenced by soft tissue (fat) compared to BMD measurements.
  • TBS remains a reliable indicator of bone microarchitecture even in the presence of varying soft tissue depths.