Improving the Accuracy of Pediatric DXA Bone Studies

提高儿科 DXA 骨骼研究的准确性

• 批准号: 7119235
• 负责人: VICENTE GILSANZ
• 金额: $ 40.37万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-05 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7119235
• 关键词: adolescence (12-20); bioimaging /biomedical imaging; body composition; bone density; bone development; bone imaging /visualization /scanning; clinical research; computed axial tomography; diagnosis design /evaluation; diagnosis quality /standard; early diagnosis; gender difference; human subject; magnetic resonance imaging; middle childhood (6-11); musculoskeletal disorder diagnosis; osteoporosis; photon absorptiometry; reproductive development

DESCRIPTION (provided by applicant): Availability, ease of use, relative low cost, accuracy and reproducibility have made dual energy x-ray absorptiometry (DXA) the most widely used technique worldwide to obtain bone measurements for both research and clinical purposes in adult populations. However, errors related to growth and maturity greatly diminish the value of DXA bone measurements in pediatric populations. Several investigators have found that osteoporosis in children is frequently misdiagnosed secondary to results from DXA scans. In this regard, the official position of the International Society for Clinical Densitometry states its recent recommendations that subjects <20 years of age should not be diagnosed with osteoporosis based on DXA criteria. Nevertheless, the increased awareness that osteoporosis has its antecedents in childhood and the demand for examinations of bone acquisition and response to therapy in pediatric patient populations stress the urgent need to optimize DXA measurements for children. The specific aims of this proposal are to improve the accuracy of DXA measurements by assessing and correcting for the influence of bone shape, bone size, and fat and muscle volume and distribution on DXA measurements in the axial skeleton of children and young adults. Vertebral bone density will be determined by computed tomography (CT), and the volumes of the lumbar vertebral bodies, abdominal fat and paraspinous and abdominal musculature in children and adults will be assessed by magnetic resonance imaging (MRI). Based on the data collected from MRI and CT, we will be able to develop and validate sex- and age-specific formulas that will correct for the influence that bone size and body composition has on DXA measurements. The incorporation of these correction factors into current and future DXA equipment will greatly improve the accuracy of their bone measurements. In addition, the relationships between outcomes from bone age and physical examinations (Tanner stage, height, sitting height, weight, BMI, abdominal diameter, waist circumference, hip circumference, waist/hip ratio and skin fold measurements) and DXA values will be examined in an attempt to establish which clinical parameter(s) can be used in the optimization of DXA bone measurements.

描述（由申请人提供）：可用性、易用性、相对较低的成本、准确性和可重复性使双能 X 射线吸收测定法 (DXA) 成为全球最广泛使用的技术，用于获取成年人群研究和临床目的的骨测量。然而，与生长和成熟相关的误差极大地降低了 DXA 骨骼测量在儿科人群中的价值。一些研究人员发现，儿童骨质疏松症经常因 DXA 扫描结果而被误诊。对此，国际临床密度测量学会的官方立场表明其最近的建议，即年龄<20岁的受试者不应根据DXA标准诊断为骨质疏松症。然而，人们越来越认识到骨质疏松症在儿童时期有其前因，以及对儿童患者群体骨获取和治疗反应进行检查的需求，都强调迫切需要优化儿童 DXA 测量。 该提案的具体目标是通过评估和校正骨骼形状、骨骼大小以及脂肪和肌肉体积和分布对儿童和年轻人中轴骨骼 DXA 测量的影响来提高 DXA 测量的准确性。将通过计算机断层扫描 (CT) 确定椎骨密度，并通过磁共振成像 (MRI) 评估儿童和成人的腰椎椎体、腹部脂肪以及棘旁和腹部肌肉组织的体积。根据 MRI 和 CT 收集的数据，我们将能够开发和验证特定性别和年龄的公式，以纠正骨骼大小和身体成分对 DXA 测量的影响。将这些校正因子纳入当前和未来的 DXA 设备将大大提高骨骼测量的准确性。此外，还将检查骨龄和体检结果（Tanner 分期、身高、坐高、体重、BMI、腹径、腰围、臀围、腰臀比和皮褶测量）和 DXA 值之间的关系试图确定哪些临床参数可用于优化 DXA 骨测量。