Precision and intersite correlation of bone densitometry at the radius, tibia and femur with peripheral quantitative CT

Objective. To compare the in situ precision of peripheral quantitative CT (pQCT) at the radius, tibia and femur, and to analyze the intersite correlation, in order to determine whether measurements at the lower extremity reproduce results at the radius or are of additional informative value. Design and material. pQCT measurements were performed in 86 elderly cadavers (mean age 80.5 years) at trabecular and cortical locations in the radius, tibia and femur, determining densitometric (bone mineral content and density) as well as geometric parameters (cross-sectional area, cortical thickness, polar moment of inertia and others). In 14 cadavers, repeated measurements were obtained at all sites on four different days. Results and conclusions. At cortical sites, the precision for the densitometric and geometric variables ranged from 0.4% to 4.3%, and was similar for the radius, tibia and femur. At trabecular locations, the reproducibility of the density measurements ranged from 1.8% to 2.5% at the radius, and from 3.2% to 5.9% at the femur and tibia. The intersite correlation of the total bone mineral content ranged from 0.87 and 0.97 at cortical sites, and from 0.63 to 0.85 at trabecular locations. The trabecular density showed a higher similarity between the tibia and femur (r=0.68-0.78) than between the radius and the lower extremity (r=0.41-0.45). The results demonstrate a substantial heterogeneity of trabecular bone in elderly individuals and advocate measurements directly at the site of clinical or scientific interest.