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Potential sources of quantification error when retrospectively assessing metacarpal bone loss from historical radiographs by using digital X-ray radiogrammetry: an experimental study
Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Sectra Imtec AB, Linköping, Sweden.ORCID-id: 0000-0002-3486-796X
Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping.ORCID-id: 0000-0002-9446-6981
2014 (Engelska)Ingår i: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 17, nr 1, s. 104-108Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

During the past 15 yr, digital X-ray radiogrammetry (DXR) has been used to measure metacarpal bone mineral density (BMD). BMD is often measured in existing cohorts where X-ray images were not acquired in accordance with the DXR imaging protocol (DIP). The purpose of the present study was to analyze how deviations from DIP in historical radiographs may affect the reproducibility of DXR-BMD measurements. Cadaver hand phantoms were used to conduct repeat measurements of deviations from DIP with respect to voltage, exposure, lateral displacement, supination, combination of lateral displacement and supination or rotation, extension of the wrist, and edge enhancement. Direct digital radiography (Aristos; Siemens Healthcare, Erlangen, Germany) was used for image acquisition and dxr-online (Sectra, Linkoping, Sweden) for DXR-BMD measurements. The influence of the tested deviations from DIP ranged from 0 to 32.5 mg/cm(2) (0-6.8%). On repetition with the same specimen, none of the deviations resulted in a within-specimen reproducibility error greater than 2 mg/cm(2) (0.4%, equivalent to a T-score of 0.042). Among the tested deviations, all except tube voltage had a magnitude greater than the normal measurement noise for the technique and must therefore be considered when planning a study based on historical images.

Ort, förlag, år, upplaga, sidor
Elsevier, 2014. Vol. 17, nr 1, s. 104-108
Nyckelord [en]
Bone mineral density; digital X-ray radiogrammetry; osteoporosis; rheumatoid arthritis
Nationell ämneskategori
Radiologi och bildbehandling
Identifikatorer
URN: urn:nbn:se:liu:diva-105587DOI: 10.1016/j.jocd.2013.04.002ISI: 000331598300018PubMedID: 23664111OAI: oai:DiVA.org:liu-105587DiVA, id: diva2:708721
Tillgänglig från: 2014-03-28 Skapad: 2014-03-27 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
Ingår i avhandling
1. Automatic image analysis for decision support in rheumatoid arthritis and osteoporosis
Öppna denna publikation i ny flik eller fönster >>Automatic image analysis for decision support in rheumatoid arthritis and osteoporosis
2015 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Low-energy trauma and fragility fractures represent a major public health problem. The societal cost of the fragility fractures that occurred in Sweden 2010 has been estimated at €4 billion.

In rheumatoid arthritis (RA), patient outcomes have improved greatly in recent years. However, the therapeutic decision making is still hampered by a lack of effective validated biomarkers. The cost of RA in Sweden 2010 has been estimated at €600 million, of which biologic drugs was €180 million.

Digital X-ray radiogrammetry (DXR) is a method to measure bone mineral density (BMD) in the metacarpals of the hand. It can be applied opportunistically in several workflows where a person is already at an X-ray machine, including fracture repositioning follow up, mammography screening and hand imaging in RA. This thesis explored DXR-BMD as a marker to identify individuals who would benefit from anti-osteoporotic treatment, change rate of DXR-BMD as a biomarker in RA and under what conditions historical X-ray images can be used to estimate DXR-BMD. An automated method for measurement of joint space width in metacarpophalangeal and interphalangeal joints was also developed and evaluated as a biomarker in RA.

Low DXR-BMD was predictive for hip fractures and predicted fragility fractures to a comparable degree as other BMD measurement sites. Rapid decrease of DXR-BMD was a strong and independent predictor for progression of radiographic damage in RA when manual radiographic progression scores were not available. Change of metacarpal joint space width was a statistically significant but weak predictor of joint space narrowing score progression. Guidelines and considerations for use of historical X-ray radiographs for DXR-BMD measurements in clinical trials have been developed and published.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2015. s. 57
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1433
Nyckelord
Osteoporosis, rheumatoid arthritis, digital X-ray radiogrammetry, joint space width, bone densitometry
Nationell ämneskategori
Medicinsk bildbehandling
Identifikatorer
urn:nbn:se:liu:diva-113680 (URN)10.3384/diss.diva-113680 (DOI)978-91-7519-170-6 (ISBN)
Disputation
2015-03-13, Wrannesalen, CMIV, Campus US, Linköpings universitet, Linköping, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2015-01-28 Skapad: 2015-01-28 Senast uppdaterad: 2019-11-15Bibliografiskt granskad

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Potential sources of quantification error when retrospectively assessing metacarpal bone loss from historical radiographs by using digital X-ray radiogrammetry: an experimental study(496 kB)243 nedladdningar
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