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

描述（由申请人提供）：在过去十年中，定量计算机断层扫描（QCT）和体积定量计算机断层扫描（vQCT）图像已成为中央骨骼皮质和小梁骨密度、骨几何形状和整体骨强度定量信息的重要来源。使用新部署的高分辨率外周QCT （HR-pQCT）扫描仪，可以获得外周骨骼的骨室微结构和强度。虽然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)在多中心环境中无缝应用它们的能力；（ii）通过迄今为止所做的队列研究和药理学试验的“苹果对苹果”比较，提取病理生理学和治疗效果的基本信息的能力，这一过程受到多种扫描仪类型和图像分析平台的使用的阻碍。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标准化的vQCT和HR-pQCT采集指标，并提供标准化的骨骼密度和结构指标，为多队列研究和临床试验之间的直接比较提供基础。这项工作将在UCSF进行，由Lang博士和Burghardt博士共同指导，在梅奥诊所进行，由UCI的Khosla博士和Keyak博士领导。本研究计划具体目标如下：具体目标1：制定标准，使多中心研究中的QCT和HRpQCT采集和分析标准化。具体目标2：开发vQCT的开源图像分析指标，作为NIH支持的插件程序，如MIPAV。

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.