A systematic review and meta-analysis of pediatric normative peripheral quantitative computed tomography data

Area of Science:

• Orthopedics
• Radiology
• Pediatrics

Background:

• Peripheral-quantitative computed tomography (pQCT) offers advanced 3D bone geometry and compartment analysis, presenting an alternative to dual-energy X-ray absorptiometry (DXA).
• pQCT's utility in pediatric bone health assessment requires further investigation due to variability in data acquisition and reporting.

Purpose of the Study:

• To systematically review and summarize pQCT image acquisition methods in pediatric populations (up to age 20).
• To aggregate existing normative pQCT data for children, adolescents, and young adults.

Main Methods:

• A comprehensive literature search was performed in MEDLINE and EMBASE (1947-2020).
• Article quality was assessed using STARD and USPSTF criteria.
• A meta-analysis included seven studies with 2134 participants, focusing on seven pQCT parameters from the radius and tibia.

Main Results:

• Significant variability in normative pQCT data was observed due to non-standardized acquisition parameters, age groups, and scan sites.
• While study designs were generally good, only 38.9% of primary papers met a 'good' STARD quality score.
• Specific trabecular volumetric bone mineral density (vBMD) values were reported for various age and sex groups, but data aggregation was limited.

Conclusions:

• Insufficient evidence currently supports the routine clinical use of pQCT in pediatrics.
• Systematic derivation of normative pediatric pQCT data and standardized clinical guidelines are essential for its adoption beyond research settings.