Virtual bone biopsy: time-lapse high-resolution peripheral quantitative computed tomography provides noninvasive...

Area of Science:

• Orthopedics and Bone Biology
• Medical Imaging and Diagnostics
• Endocrinology and Cardiovascular Health

Background:

• Skeletal complications are significant in chronic endocrine and cardiovascular diseases.
• Comprehensive patient-specific skeletal assessment is crucial for understanding disease mechanisms and guiding treatment.
• High-resolution peripheral quantitative computed tomography (HR-pQCT) provides detailed in vivo bone analysis.

Purpose of the Study:

• To introduce and advocate for the broader implementation of time-lapse HR-pQCT for comprehensive skeletal assessment.
• To highlight the capability of time-lapse HR-pQCT in evaluating bone remodeling dynamics, density, geometry, microarchitecture, and biomechanics.
• To position time-lapse HR-pQCT as a reliable, noninvasive 'virtual bone biopsy'.

Main Methods:

• Utilizing time-lapse analysis integrated with HR-pQCT to track voxel-level bone changes over time.
• Longitudinal monitoring of bone remodeling processes noninvasively.
• In vivo skeletal assessment validated in preclinical studies and recently applied in clinical settings.

Main Results:

• Time-lapse HR-pQCT has demonstrated feasibility in assessing bone turnover in patients with chronic kidney disease.
• Clinical studies show its utility in mapping bone gain/loss in response to treatments and mechanical loading.
• Preclinical validation of time-lapse analysis for in vivo skeletal assessment has existed for two decades.

Conclusions:

• Time-lapse HR-pQCT enables comprehensive evaluation and longitudinal monitoring of skeletal parameters.
• Broader implementation is recommended, contingent upon rigorous validation and methodological optimization.
• This technique offers a reliable, noninvasive approach to skeletal assessment and monitoring.