Improving the Accuracy of Pediatric DXA Bone Studies

提高儿科 DXA 骨骼研究的准确性

• 批准号: 6956901
• 负责人: VICENTE GILSANZ
• 金额: $ 41.32万
• 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/6956901
• 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(申请人提供)：可用性、易用性、相对较低的成本、准确性和重复性使双能X射线骨密度仪(DXA)成为全球最广泛使用的技术，可在成人人群中获得用于研究和临床的骨测量。然而，与生长和成熟度相关的误差极大地降低了DXA骨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被误诊为DXA扫描结果的继发性疾病。在这方面，国际临床密度学会的官方立场表明，其最近的建议是，20岁的受试者不应根据DXA标准被诊断为骨质疏松症。然而，越来越多的人意识到骨质疏松症在儿童时期就有其先兆，儿科患者群体对骨获取和治疗反应的检查的需求强调了优化儿童DXA测量的迫切需要。 这项建议的具体目的是通过评估和校正骨形状、骨大小、脂肪和肌肉体积和分布对儿童和年轻人轴骨DXA测量的影响来提高DXA测量的准确性。脊椎骨密度将通过计算机断层扫描(CT)确定，腰椎椎体、腹部脂肪、棘旁和腹部肌肉的体积将通过磁共振成像(MRI)进行评估。基于从MRI和CT收集的数据，我们将能够开发和验证性别和年龄特定的公式，这些公式将纠正骨大小和身体成分对DXA测量的影响。将这些校正因子纳入现有和未来的DXA设备将极大地提高其骨测量的准确性。此外，还将研究骨龄结果与体格检查(Tanner分期、身高、坐高、体重、体重指数、腹径、腰围、臀围、腰臀比和皮褶测量值)和DXA值之间的关系，以确定哪个临床参数(S)可以用于DXA骨测量的优化。