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    Hans D , Barthe N , Boutroy S , Pothuaud L , Winzenrieth R , Krieg MA. 3D-analysis of cortical and trabecular bone from hip DXA is a new method for non-invasive bone structure assessment, providing separate assessment of the cortical layer and trabecular macrostructure. Utility of trabecular bone score in the evaluation of osteoporosis. INTRODUCTION:Trabecular bone score (TBS) is a textural index that evaluates bone microarchitecture of the lumbar spine. Standard bone density measurement is used to calculate and classify a patient’s risk for experiencing fracture(s), as high, moderate or low risk. TBS quantification is readily … For each finite element model, a uniaxial compression test was performed with displacement equivalent to 1% apparent strain to calculate stiffness. Cheng X, Yuan H, Cheng J, Weng X, Xu H, Gao J, Huang M, Wáng YXJ, Wu Y, Xu W, Liu L, Liu H, Huang C, Jin Z, Tian W; Bone and Joint Group of Chinese Society of Radiology, Chinese Medical Association (CMA), Musculoskeletal Radiology Society of Chinese Medical Doctors Association, Osteoporosis Group of Chinese Orthopedic Association, Bone Density Group of Chinese Society of Imaging Technology, CMA*. The inter- and intra-assay coefficients are <7% and <5%, respectively. Perimenopausal women with higher baseline levels of serum bone turnover markers and a lower trabecular bone score are at increased risk for presenting with osteopenia or osteoporosis at 5 … Low trabecular bone score (TBS) is associated with new bone formation independent of fat metaplasia on spinal MRI in patients with ankylosing spondylitis (AS), according to study results published in Scandinavian Journal of Rheumatology.. To ensure comparability with previous TBS studies, calibration of the DXA instrument at CUMC was performed using a TBS-specific phantom (medimaps). Copyright © 2017 Elsevier Inc. All rights reserved. It was developed to reflect bone microarchitecture. The ability of TBS to estimate trabecular microarchitectural texture and predict fracture risk, along with its direct measurement from DXA images, led us to investigate its potential utility in evaluating the trabecular skeleton in PHPT. Yu N , Donnan PT , Flynn RW , Murphy MJ , Smith D , Rudman A , Leese GP. Methods. The Trabecular Bone Score is a newly developed test of your bone structure that is complementary to standard bone density testing. It is a texture measurement that quantifies local variations in gray level distribution from dual-energy X-ray Absorptiometry (DXA) and is significantly correlated with three dimensional parameters of bone microarchitecture, independently of aBMD , , , . Reduced bone stiffness assessed by FEA of HRpQCT images (36, 37), as well as low TBS (15–17, 19–21), has been associated with fragility fractures in postmenopausal women. Trabecular bone score (TBS), as a tool for measurement of bone microarchitecture, represents fracture risk independently of bone density. But, is DEXA adequate for this task? Bone turnover markers (amino-terminal propeptide of type I procollagen, OC, and CTX) were at the upper range of normal, whereas serum BSAP was frankly elevated at 37.6 U/L (normal, 11.6–29.6 U/L). The reason for these discrepant findings is still not clear but is probably related to the image resolution, the DXA soft tissue correction applied, and the spectra of X-ray energies used. References. In marked contrast, TBS at the lumbar spine showed degraded microarchitecture (TBS ≤1.20) in 8 (36%) patients, partially degraded (TBS >1.20 and <1.35) in an additional 8 patients (36%), and normal values (TBS ≥ 1.35) in only 6 (27%) subjects (Figure 1, A and B). Trabecular bone, also called cancellous bone, is porous bone composed of trabeculated bone tissue. Association of Low Serum 25OHD Levels with Abnormal Bone Microarchitecture in Well-Differentiated Thyroid Cancer. In contrast, Boutroy et al (21) found significant correlations between TBS and L1–L4 aBMD (r = 0.58; P < .001) in 560 women from the OFELY cohort. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2020 May 22. 21 Therefore, TBS was chosen in this … The purpose of this study was to assess TBS from spine DXA images in relation to HRpQCT indices and bone stiffness in radius and tibia in PHPT. The trabecular bone score (TBS) is a textural measurement derived from lumbar spine d ual-energy X-ray absorptiometry (DXA) images. Because BMI is taken into account in the calculation of the TBS, part of the variability in HRpQCT measurements explained by TBS alone might depend on some interaction of TBS with weight. It can be found at the ends of long bones like the femur, where the bone is actually not solid but is full of holes connected by thin rods and plates of bone tissue. Shayganfar A, Ebrahimian S, Masjedi M, Daryaei S. J Res Med Sci. This work was supported by the National Institutes of Health (Grants R01 DK32333 and R01 AR051376) and by the Brazilian National Council of Technological and Scientific Development (to B.C.S.). At the tibia, correlations between TBS and Tb.N, Tb.Sp, or Tb.Sp.SD became significant only after adjustment for body weight, a surrogate for biomechanical loading. . Univariate or Multivariate Linear Regression Analysis to Predict the Variability in HRpQCT Indices and Mechanical Parameters. The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. Results on Trabecular Bone Score (TBS) in these patients are lacking. . 2017 Mar;46(1):153-180. doi: 10.1016/j.ecl.2016.09.005. Trabecular bone score (TBS), a novel tool in the evaluation of osteoporosis is an indirect indicator of bone microarchitecture. The trabecular bone score (TBS) is a gray‐level textural metric that can be extracted from the two‐dimensional lumbar spine dual‐energy X‐ray absorptiometry (DXA) image. A Spanish case-control study, Bone mineral density (BMD) combined with the trabecular bone score (TBS) significantly improves the identification of women at high risk of fracture: the SEMOF Cohort Study [abstract], Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study, Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study, What is the performance in vertebral fracture discrimination by bone mineral density (BMD), micro-architecture estimation (TBS), body mass index (BMI) and FRAX in stand-alone or combined approaches: The OsteoLaus Study [abstract], Spine micro-architecture estimation (TBS) discriminates major osteoporotic fracture from controls equally well than site matched BMD and independently: the Eastern Europe TBS study [abstract], In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography, Comparison of 2D and 3D bone microarchitecture evaluation at the femoral neck, among postmenopausal women with hip fracture or hip osteoarthritis, Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment, High-resolution peripheral quantitative computed tomography can assess microstructural and mechanical properties of human distal tibial bone, Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method, Primary hyperparathyroidism: iliac crest trabecular bone volume, structure, remodeling, and balance evaluated by histomorphometric methods, Preserved three-dimensional cancellous bone structure in mild primary hyperparathyroidism, Bone structure in postmenopausal hyperparathyroid, osteoporotic, and normal women, Maintenance of cancellous bone connectivity in primary hyperparathyroidism: trabecular strut analysis, The histomorphometry of bone in primary hyperparathyroidism: preservation of cancellous bone structure, Assessment of trabecular and cortical architecture and mechanical competence of bone by high-resolution peripheral computed tomography: comparison with transiliac bone biopsy, Accuracy of high-resolution peripheral quantitative computed tomography for measurement of bone quality, Finite element analysis based on in vivo HR-pQCT images of the distal radius is associated with wrist fracture in postmenopausal women, Abnormal microarchitecture and reduced stiffness at the radius and tibia in postmenopausal women with fractures, Identification of rheumatoid arthritis patients with vertebral fractures using bone mineral density and trabecular bone score, TBS (trabecular bone score) and diabetes-related fracture risk, Bone quality, as measured by trabecular bone score in patients with adrenal incidentalomas with and without subclinical hypercortisolism, Effects of zoledronate versus placebo on spine bone mineral density (BMD) and microarchitecture assessed by the trabecular bone score (TBS) in postmenopausal women with osteoporosis. Trabecular bone score (TBS) is complementary to conventional BMD as a marker for bone quality in patients with glucocorticoid induced osteoporosis. For example, two In contrast, the trabecular bone score is a novel and widely available tool that uses gray-scale variograms of the spine image from dual-energy x-ray absorptiometry to assess trabecular quality. TBS® performs a gray level analysis (textures) on the DEXA images to determine bone integrity. Please enter the Trabecular Bone Score to compute the ten year probability of fracture adjusted for TBS. Liu XS , Zhang XH , Sekhon KK , et al. The findings of the study suggest a different role of t rabecular and cortical volumetric BMD on coronary artery calcification risk, mainly in women.. Structure. The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. These findings, however, are not consistent with recent observations using technologies that have greater resolving power than DXA, such as high-resolution peripheral quantitative computed tomography (HRpQCT) in which trabecular microarchitectural deficits are seen (6, 7). The Relationship between Health Status and Social Activity of Perimenopausal and Postmenopausal Women (Health Status and Social Relationships in Menopause). Roux JP , Wegrzyn J , Boutroy S , Bouxsein M , Hans D , Chapurlat R. Pothuaud L , Barthe N , Krieg MA , Mehsen N , Carceller P , Hans D. Rabier B , Heraud A , Grand-Lenoir C , Winzenrieth R , Hans D. Winzenrieth R , Dufour R , Pothuaud L , Hans D. Del Rio LM , Winzenrieth R , Cormier C , Di Gregorio S. Popp A , Meer S , Krieg MA , Perrelet R , Hans D , Lippuner K. Hans D , Goertzen AL , Krieg MA , Leslie WD. TBS predicts osteoporotic fractures independently of BMD 3,4. In clinical studies, TBS enhanced the ability of DXA to predict fracture risk (15–20), and in a recent study involving more than 29,000 postmenopausal women, TBS predicted osteoporotic fractures, independent of aBMD (20). Trabecular bone score (TBS) is a texture index derived from standard lumbar spine dual energy X-ray absorptiometry (DXA) images and provides information about the underlying bone independent of the bone mineral density (BMD). To this end, our aim was to assess TBS from spine DXA images in postmenopausal women with PHPT and to correlate it, for the first time, with HRpQCT measurements of volumetric bone density, skeletal microarchitecture, and bone stiffness. Curr Opin Rheumatol 30(2):137–143. These more recent findings by HRpQCT and FEA are consistent with epidemiological evidence of increased fracture risk at both vertebral and nonvertebral sites in PHPT (8–11). Wang R, Ward MM (2018) Epidemiology of axial spondyloarthritis: an update. Trabecular bone score (TBS) uses standard lumbar spine DXA imaging to assess bone texture inhomogeneity (that is, the number of filled versus unfilled voxels) in order to gauge bone quality and fracture risk. Trabecular bone score (TBS) is a newly developed index for assessing trabecular bone quality and fracture risk. Our aim was to assess TBS in children with inflammatory bowel diseases and to evaluate correlations with clinical, laboratory and densitometric variables. Although both cortical and trabecular bone are abnormal when assessed by HRpQCT at the radius and tibia, histomorphometry and μCT studies of iliac crest biopsy samples show that trabecular bone volume, number, separation, and connectivity are either preserved or increased in PHPT (29–33). 2020 Aug;137:115451. doi: 10.1016/j.bone.2020.115451. Article Google Scholar 3. Baseline Characteristics of 22 Subjects With PHPT. At the radius, TBS explained 25% and 21% of the variance in Tb.N and Tb.Sp, respectively, with a slight increase in the degree of variance explained by the combination of TBS with L1–L4 aBMD compared with L1–L4 aBMD alone (Table 3). Because Tb.Sp and Tb.Sp.SD did not follow a normal distribution, they were log-transformed before analysis. Silverberg SJ , Shane E , Jacobs TP , Siris E , Bilezikian JP. It was proposed to be easily used in everyday practice as a surrogate of bone strength. A 3-year study, Trabecular bone score (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism, Effects of anti-resorptive agents on trabecular bone score (TBS) in older women, Copyright © 2013 by The Endocrine Society, Slit2 regulation of hyaluronan & cytokine synthesis in fibrocytes in thyroid associated ophthalmopathy, Testosterone Replacement Therapy added to Intensive Lifestyle Intervention in Older Men with Obesity and Hypogonadism, Anti-Müllerian hormone levels in adolescence in relation to long-term follow-up for presence of polycystic ovary syndrome, Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy, Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning, The Journal of Clinical Endocrinology & Metabolism, About The Journal of Clinical Endocrinology & Metabolism, Receive exclusive offers and updates from Oxford Academic, Abnormalities in Cortical Bone, Trabecular Plates, and Stiffness in Postmenopausal Women Treated With Glucocorticoids, Bariatric Surgery Results in Cortical Bone Loss, TBS (Trabecular Bone Score) and Diabetes-Related Fracture Risk. Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. The trabecular bone score (TBS) a grayscale measurement of texture which is derived from the evaluation of the experimental variogram obtained from the Dual-energy X-ray Absorptiometry (DXA) images, is a relatively new tool to evaluate bone microarchitecture . This site needs JavaScript to work properly. aBMD by DXA was measured at the lumbar spine (L1–L4), total hip, femoral neck, and nondominant forearm (ultradistal [UD] radius and one-third radius) using a Discovery A dual-energy X-ray absorptiometer (Hologic Inc; Bedford, Massachusetts). As reported previously (22, 41), we observed modest or no correlation between TBS and aBMD at all sites. A procedure to generate TBS-adjusted FRAX probabilities has become available with the resultant predicted fracture risks shown to be more accurate than the standard FRAX tool. Using cutoff points previously reported as having the best sensitivity and specificity in terms of fracture risk (19–23), we showed that 36% of patients with PHPT had degraded microarchitecture (TBS ≤1.20), an additional 36% had partially degraded microarchitecture (TBS >1.20 and <1.35), and only 27% had normal TBS values (TBS ≥1.35). TBS was evaluated by determining the variogram of the trabecular bone projected image, calculated as the sum of the squared gray-level differences between pixels at a specific distance and angle. Subjects were eligible for inclusion if they had well-characterized PHPT (elevated serum calcium and elevated or inappropriately normal PTH levels). At the tibia, TBS was a poor predictor of the variance in HRpQCT measurements of trabecular microarchitecture. Numerous studies have examined the relationship between TBS and fracture risk and have shown that lower TBS values are associated with increased risk for major osteoporotic fracture in postmenopausal women and older men, with this result being independent of BMD values and other clinical risk factors. TBS can then be used to refine the fracture risk. In fact, when TBS, aBMD, and measurements of trabecular microstructure by μCT were assessed at the same bony region, correlations of aBMD and TBS with BV/TV, Tb.N, Tb.Sp, and connectivity density were similar (13). Methods . . Oxford University Press is a department of the University of Oxford. The other authors have nothing to disclose. With use of an extensively calibrated dataset based on more than 35,000 women, normal and abnormal scores have been established: TBS ≤1.2 defines degraded microarchitecture, TBS between 1.20 and 1.35 is partially degraded microarchitecture, and TBS ≥1.35 is considered normal (19–23). The findings of the study suggest a different role of t rabecular and cortical volumetric BMD on coronary artery calcification risk, mainly in women.. Sweden: T rabecular and cortical volumetric bone mineral density (BMD) have opposite association with coronary-artery calcium score (CACS), suggests a recent study in the journal JAMA Cardiology. Studies in cadaveric bones have shown significant correlations between TBS and 3D trabecular microarchitecture measurements by microcomputed tomography (μCT) (12–14). Bone mineral density (BMD) was taken as a quantitative assessment and trabecular bone score (TBS) was used as qualitatively parameter.). Curr Opin Rheumatol. Serum total calcium (normal, 8.4–10.2 mg/dL) and albumin were measured using standard methods (Quest Diagnostics, Madison, New Jersey), and calcium values were corrected for albumin concentration <4 g/dL. Several salient observations have emerged. TBS is important because about one-half of people who break bones do not have a bone density that is classified as osteoporosis. . For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Significant correlations between TBS and HRpQCT indices demonstrated here indicate that TBS may serve as a valuable additional index in the assessment of skeletal microstructure in PHPT. TBS (Trabecular Bone Score) iNsight est un paramètre de texture qui peut être appliqué aux images DXA, et qui quantifie les variations locales en niveau de gris. Parisien M , Mellish RW , Silverberg SJ , et al. The poor correlation between TBS and aBMD at the lumbar spine, despite the fact that both evaluate the same region of bone, implies that these measurements are at least partially independent of each other. It was proposed to be easily used in everyday practice as a surrogate of bone strength. 2017 Jul-Sep;20(3):334-345. doi: 10.1016/j.jocd.2017.06.019. It is a textural index that evaluates pixel gray-level variations in the lumbar spine DXA (dual energy X-ray absorptiometry) image. TBS has the major clinical advantage of being readily available from images of DXA, a test routinely performed in PHPT. The mean TBS of the whole group was 1.24, markedly below the normal threshold (≥1.35). Curr Opin Endocrinol Diabetes Obes. It can be found at the ends of long bones like the femur, where the bone is actually not solid but is full of holes connected by thin rods and plates of bone tissue. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Silverberg SJ , Shane E , de la Cruz L , et al. Krueger D., Fidler E., Libber J., Aubry-Rozier B, Hans D, Binkley N. Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. SEATTLE — Trabecular bone score (TBS) and HbA1c may be good predictors of incident fractures in patients with type 1 diabetes, although bone mineral density (BMD) may not be predictive, according to a new study presented at the American Society for Bone and Mineral Research (ASBMR) 2015 Annual Meeting. Statistical analysis was performed using SAS (version 9.2; SAS Institute, Inc, Cary, North Carolina). Trabecular bone score (TBS), as a tool for measurement of bone microarchitecture, represents fracture risk independently of bone density. Red bone marrow, where all the blood cells are made, fills the space between the trabecular pores. Boutroy S , Bouxsein ML , Munoz F , Delmas PD. Using experimental variograms of two-dimensional (2D) projection images, TBS differentiates between three-dimensional (3D) bone structures that exhibit the same areal bone mineral density (aBMD), but different trabecular microarchitecture (13). The reference ranges in premenopausal women for OC, BSAP, and CTX were, respectively, 8.4 to 33.9 ng/mL, 11.6 to 29.6 U/L, and 0.112 to 0.738 ng/mL. Search for other works by this author on: The study of hyperparathyroidism at the Massachusetts General Hospital, The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years, A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery, Primary hyperparathyroidism: new concepts in clinical, densitometric and biochemical features, Skeletal disease in primary hyperparathyroidism, Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT, Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women, Primary hyperparathyroidism and the risk of fracture: a population-based study, Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism, Increased mortality and morbidity in mild primary hyperparathyroid patients. Linear regression analyses, without and with adjustment for weight, were applied to estimate the variability in HRpQCT and biomechanical parameters when TBS, aBMD at the lumbar spine, or the combination of both was used as the explanatory variable. The following indices were evaluated at the distal radius and tibia: total area and total vBMD, cortical vBMD (Ct.vBMD), and trabecular vBMD (Tb.vBMD); cortical thickness (Ct.Th); trabecular bone volume (BV/TV); trabecular number (Tb.N); trabecular thickness (Tb.Th); trabecular separation (Tb.Sp); and standard deviation of trabecular separation (Tb.Sp.SD), a parameter reflecting the heterogeneity of the trabecular network. At the tibia, correlations were observed between TBS and volumetric densities, cortical thickness, trabecular bone volume, and whole bone stiffness. Twenty-two postmenopausal women with PHPT were recruited from Columbia University Medical Center (CUMC). Among the 29 women screened, 1 was excluded because of her premenopausal status and 6 were excluded because of a history of bisphosphonate use within 2 years before study. The Trabecular Bone Score is computed from the antero-posterior spine DXA examination file by a software (TBS iNsight) that is provided for use as a complement to a DXA analysis.

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