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，相对低成本，准确性和可重复性使双能X射线吸收仪（DXA）成为全球使用最广泛的技术，以获得成人种群的研究和临床目的的骨测量。但是，与生长和成熟度有关的错误大大降低了小儿种群中DXA骨测量值的价值。一些研究人员发现，儿童的骨质疏松症经常被误诊为DXA扫描结果。在这方面，国际临床光密度学学会的官方立场指出，最近的建议不应根据DXA标准诊断出<20岁的受试者患有骨质疏松症。然而，人们对骨质疏松症具有童年的先例以及对儿科患者人群中对骨骼的治疗和对治疗的反应的需求的认识提高，这强调了迫切需要优化儿童DXA测量值。 该提案的具体目的是通过评估和纠正骨骼形状，骨骼大小以及脂肪和肌肉体积以及分布对儿童和年轻人轴向骨架中DXA测量的影响来提高DXA测量的准确性。椎骨密度将通过计算机断层扫描（CT）确定，儿童和成人的腰椎椎体，腹部脂肪和副肌和腹部肌肉的体积将通过磁共振成像（MRI）评估。根据从MRI和CT收集的数据，我们将能够开发和验证性别和年龄特异性公式，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设备将大大提高其骨骼测量的准确性。此外，骨骼年龄和身体检查的结果（坦纳阶段，身高，坐姿，体重，体重，BMI，腹部直径，腰围，腰围，臀部周长，腰围/髋关节和皮肤折叠的比例和皮肤折叠的测量值）与DXA值将在尝试建立哪些临床参数（S）中用于DXA Bornal orements of DXA的优化。