Does high-resolution computed tomography image analysis of distal radius provide information independent of bone mass?

The study aimed to investigated the usefulness of computed tomography (CT) image analysis of the distal radius for comparing two groups of postmenopausal women matched for age and bone mineral density at both the lumbar spine and femoral neck. The first group consisted of 16 women with at least one vertebral fracture, and the second consisted also of 16 women without disease affecting bone mass or bone metabolism. Eight slices were selected in each patient: four consecutive coronal slices and four consecutive axial slices, Bone texture was analyzed using structural methods leading to the measurement of 24 features. Most of the structural variables were derived from histomorphometric parameters and were measured after segmentation from a binary or a skeletonized image. Nine variables were significantly different between the two groups on axial slices: valley number, valley surface area, apparent bent: volume/tissue volume (BV/TV), apparent trabecular separation, apparent trabecular number, trabecular bone pattern factor, trabecular skeletal length, node count, and node-to-node strut count. Also, four variables were significantly different between women with osteoporosis and control subjects on coronal slices: apparent BV/TV, trabecular partition, node-to-node strut count, and terminus-to-terminus strut count. In conclusion. this preliminary study suggests that bone texture analysis could yield additional data on bone mass that could explain bone strength and therefore could be used for improving the prediction of fracture risk.