EX VIVO VALIDATION OF IMAGE-BASED BIOMARKER OF PEDAL BONE QUALITY

描述（由申请人提供）：足部截肢是昂贵且普遍的，特别是在患有糖尿病、神经病变和血管疾病的老年人中。截肢的途径包括骨折、结构畸形、缺血性血管病变和溃疡。对骨骼并发症的晚认识延误了可以防止截肢的干预措施。该建议具有重要意义，因为它将确定基于图像的足部骨质量和数量指标，这些指标是高危人群足部截肢的早期预测指标。本拨款申请的目的是测试基于图像的踏板骨质量和数量指标，作为人类第二跖骨和第二楔形骨骨折强度的预测指标。在目标1中，pi将使用力学测试测试基于图像的脚骨强度指标。在目标2中，他们将比较基于体积定量计算机断层扫描（vQCT）图像的测量方法与microCT的参考标准。PIs提出了一项基于图像的足部骨质量和数量测量的新研究，来自老年糖尿病患者的截肢和尸体足。他们将使用显微ct衍生的骨质量和数量指标进行多元回归分析，以预测全骨单调的最终骨折力。期望预测骨折的最佳模型将包括一个或多个骨质量指标。为了测试这些测量的临床相关性，pi将微ct测量值与骨切除前获得的类似vqct衍生测量值进行比较。这个应用程序将继续一个由临床、图像、工程科学家和外科医生组成的多专业团队的成功合作，他们专注于开发和评估基于图像的生物标志物，以提高对导致截肢的神经病变和血管病变引起的足部骨并发症的识别。

DESCRIPTION (provided by applicant): Foot amputation is costly and prevalent, especially in older adults with diabetes, neuropathy, and vascular disease. The pathway to amputation includes fracture, structural deformities, ischemic vasculopathy and ulceration. Late recognition of bony complications delays interventions that could prevent amputation. This proposal is significant as it will identify image-based indices of pedal bone quality and quantity that are eary prognosticators of foot amputation in high-risk populations. The objective of this grant application is to test image-based measures of pedal bone quality and quantity as predictors of fracture strength in human 2nd metatarsals and 2nd cuneiforms. In Aim 1 the PIs will test image-based indices of pedal bone strength using mechanical testing. In Aim 2 they will compare volumetric quantitative computed tomography (vQCT) image-based measures to the reference standard of microCT. The PIs propose a novel study of image-based pedal bone quality and quantity measures from amputated and cadaver feet of advanced age with diabetes. They will perform multiple regression analysis using microCT-derived bone quality and quantity indices to predict whole-bone monotonic ultimate fracture force. The expectation is that the best model to predict bone fracture will include one or more bone quality indices. To test the clinical relevance of these measures the PIs compare microCT measures to similar vQCT-derived measures obtained prior to bone excision. This application will continue successful collaborations of a multi-professional team of clinical, image, engineering scientists and surgeons who have focused their expertise on developing and assessing image-based biomarkers to improve the recognition of neuropathy- and vasculopathy-induced bony complications of the foot that lead to amputation.