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，骨质疏松症的诊断和治疗取得了重大进展，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。提出了一种新的骨密度（BMD）测量诊断技术，用于骨质疏松症和其他骨骼疾病的诊断和治疗过程的监测（评估）。基于传统的相干-康普顿散射比（CCSR），小角度前向-后向散射和小角度前向-透射散射的简单可靠的测量方法，克服了CCSR的辐射剂量高、系统成本高和检查时间长等局限性，可以提供高质量的骨密度活体测量。在放射学和其他骨诊断技术中，CCSR被认为是一种上级和更灵敏的骨密度测定方法，无需逐个校准。与目前的黄金标准技术双能X射线吸收测定法（DEXA）相比，它也有几个优点。CCSR的独特之处在于它提供了体积BMD（mg/cm 3）的定量和直接测定，即“真实”密度，而从DEXA获得的面积BMD（mg/cm 2）产生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骨小梁，以产生骨小梁矿物质密度（TBMD），在DEXA的某些应用中，骨小梁矿物质密度（TBMD）可能难以与皮质骨分离。由于骨小梁是骨骼中最具代谢活性的成分，并且可以限制严重骨折（如髋关节和脊柱骨折）中的骨强度，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监测至关重要。尽管CCSR具有潜力和前景，但它仅使用过时的配置在体内应用于跟骨。本提案中使用的新方法将证明，基于CCSR的设备不仅具有高度灵敏度和准确性，而且在临床上实用且有用，可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.