Bone quality by vQCT and HR-pQCT: translation to multi-center clinical research

描述(申请人提供)：在过去的十年中，定量计算机断层扫描(QCT)和体积定量CT(VQCT)图像已经成为关于中央骨骼的皮质和松质骨密度、骨几何形状和整体骨强度的重要定量信息来源。使用新部署的高分辨率外周QCT(HR-pQCT)扫描仪可以获得周围骨骼中的间隔性骨骼微结构和强度。尽管这些方法被广泛使用，但它们作为临床研究工具的内在价值将取决于两个主要因素：(I)在多中心设置中无缝使用它们的能力，以及(Ii)通过对迄今已完成的队列研究和药理学试验进行“苹果对苹果”比较来提取关于病理生理学和治疗有效性的基本信息的能力，这一过程因使用多种类型的扫描仪和图像分析平台而受到阻碍。为了解决这两个基本问题，我们提出了一个创新的研究计划，为未来的多中心研究建立vQCT和HR-pQCT采集的标准化指标，并提供标准化的骨密度和结构指标，为多个队列研究和临床试验的直接比较提供基础。这项工作将在加州大学旧金山分校的朗博士和伯格哈特博士的共同指导下进行，并在UCI的科斯拉博士和基亚克博士的领导下在梅奥诊所进行。这项研究计划体现在以下具体目标中：具体目标1：制定衡量标准，以标准化多中心研究中QCT和HRpQCT的采集和分析。具体目标2：为vQCT开发开源图像分析指标，并将其作为NIH支持的项目(如MIPAV)的插件。

DESCRIPTION (provided by applicant): Over the last decade, quantitative computed tomography (QCT) and volumetric QCT (vQCT) images have become important sources of quantitative information on cortical and trabecular bone density, bone geometry and whole bone strength in the central skeleton. Compartmental bone micro-architecture and strength in the peripheral skeleton are being obtained using newly deployed high-resolution peripheral QCT (HR-pQCT) scanners. Although these approaches are in wide use, their inherent value as clinical research tools will depend on two major factors: (i) the ability to seamlessly employ them in the multi-center setting and (ii) the ability to distill fundamental information on pathophysiology and treatment efficacy through "apples to apples" comparisons of the cohort studies and pharmacologic trials done thus far, a process hindered by the use of multiple scanner types and image analysis platforms. To address these two basic issues, we propose an innovative research program to establish metrics for standardization of vQCT and HR-pQCT acquisitions for future multi-center studies, as well as to provide standardized skeletal density and structural metrics to provide a basis for direct comparison across multiple cohort studies and clinical trials. This work will be carried out at UCSF under the joint direction of Drs Lang and Burghardt and at the Mayo Clinic under the leadership of Dr. Khosla and Dr. Keyak at UCI. This research program is embodied in the following specific aims: Specific Aim 1: Development of metrics to standardize QCT and HRpQCT acquisitions and analysis in multicenter studies. Specific Aim 2: Development of open-source image analysis metrics for vQCT incorporated as a plug-in NIH supported programs such as MIPAV.