A single site, multi-operator precision study for second-generation HR-pQCT

Area of Science:

• Orthopedics and Bone Imaging
• Medical Physics
• Radiological Sciences

Background:

• High-resolution peripheral quantitative computed tomography (HR-pQCT) is increasingly used for bone dynamics research.
• Existing HR-pQCT precision data often rely on older technology and limited operator/population diversity.
• Ensuring reproducibility is vital for longitudinal HR-pQCT studies.

Purpose of the Study:

• To investigate the influence of operator characteristics and participant demographics on HR-pQCT measurement precision.
• To establish reference values for scan-rescan precision in a standardized academic imaging center.
• To assess the impact of technologist variability on HR-pQCT outcomes.

Main Methods:

• 45 adult participants underwent same-day repeat HR-pQCT scans of the distal tibia and radius.
• Three imaging technologists acquired 15 scan pairs each, with standardized post-processing.
• Statistical modeling analyzed the effects of technologists and participant demographics (age, sex, BMI).

Main Results:

• Root-mean-square coefficients of variation were ≤1.3% for bone mineral density and <2% for area measures.
• Trabecular microarchitecture precision ranged from 1.14% to 2.82%.
• Cortical thickness precision was ≤1.99%, while cortical porosity precision was higher (20.90-24.66%).
• No significant differences in precision were found based on technologist or participant demographics.
• Image quality scores did not impact precision outcomes.

Conclusions:

• Standardized technologist training yields consistent HR-pQCT scan-rescan precision across operators.
• These findings provide reference values for least significant change in HR-pQCT parameters.
• The study supports the reliability of HR-pQCT for longitudinal bone research with standardized protocols.