X-Ray Scattering Bone Densitometry

描述（由申请人提供）：骨质疏松症是美国老龄化人口面临的严重公共卫生问题。在过去的几十年里，在骨质疏松症的诊断和治疗方面取得了重大进展，但也存在争议。直到最近，骨筛查是不准确的，骨折风险难以计算。提出了一种测量骨密度（BMD）的新诊断技术，用于骨质疏松症和其他骨病的诊断和治疗过程监测（评估）。基于传统相干康普顿散射比（CCSR）的小角度前向向后散射和小角度前向散射对透射辐射的简单而稳健的测量，克服了以往CCSR的辐射剂量大、系统成本高、检测时间长等局限性，提供了高质量的体内BMD测量。在放射学和其他骨诊断技术中，CCSR被认为是一种更优越、更敏感的测定骨密度的方法，无需逐案校准。与目前的黄金标准技术双能x射线吸收测定法（DEXA）相比，它还有几个优势。CCSR的独特之处在于，它提供了定量和直接的体积骨密度（单位为mg/cm3），即“真实”密度，而从DEXA获得的面积骨密度（单位为mg/cm2）产生了高度不确定的体积密度。CCSR的另一个重要优点是，它已被准确地应用于体内小梁骨，以产生小梁骨矿物质密度（TBMD），这在某些DEXA应用中很难从皮质骨中分离出来。由于骨小梁是骨骼中代谢最活跃的部分，在严重骨折（如髋关节和脊柱骨折）中会限制骨强度，因此测定体积TBMD对于骨质疏松症和其他代谢性骨病的诊断和治疗至关重要。尽管CCSR具有潜力和前景，但它只在体内应用于跟骨，使用的是过时的配置。本文所采用的新方法将证明基于ccsr的设备不仅具有高灵敏度和准确性，而且在临床上具有实用性和实用性，可以满足当前和未来骨质疏松症评估和管理的需求。

DESCRIPTION (provided by applicant): Osteoporosis is a serious public health problem faced by an aging US population. In past decades, there has been significant progress, as well as controversy, in the diagnosis and treatment of osteoporosis. Until recently, bone screening was inaccurate and fracture risk was difficult to calculate. A new diagnostic technique of measuring bone mineral density (BMD) for diagnosis and monitoring the course of treatment (assessment) of osteoporosis and other bone diseases is proposed. The simple and robust measurements of small-angle forward-to-backward scattering and small angle forward scattering-to-transmitted radiation, based on the use of the conventional Coherent to Compton Scattering Ratio (CCSR), can offer a high quality in-vivo measurement of BMD by overcoming prior CCSR limitations, such as high radiation dosage, high system cost and long examining time. Among radiological and other bone diagnostic technologies, CCSR is considered to be a superior and more sensitive method for BMD determination without the need for a case by case calibration. It also has several advantages over the current gold standard technology, Dual-energy X-ray Absorptiometry (DEXA). CCSR is unique in that it provides a quantitative and direct determination of volumetric BMD (in mg/cm3), the "true" density, while the areal BMD (in mg/cm2) that is obtained from DEXA, yields a highly uncertain volumetric density. Another important advantage of CCSR is that it has been accurately applied to trabecular bone in-vivo to yield Trabecular Bone Mineral Density (TBMD) which can be difficult to isolate from cortical bone in some applications of DEXA. Since trabecular bone is the most metabolically active component of the skeleton and can limit bone strength in serious fractures such as those of the hip and spine, the determination of volumetric TBMD is crucial for diagnosis and monitoring of the treatment of osteoporosis and other metabolic bone diseases. Despite the potential and promise of CCSR, it has only been applied in-vivo to the calcaneus using an obsolete configuration. The new approach used in this proposal, will demonstrate that a CCSR-based device is not only highly sensitive and accurate, but also clinically practical and useful to meet the current and future demands of osteoporosis assessment and management.