Fractal-Based Analysis of Bone Microstructure in Crohn's Disease: A Pilot Study

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Jan 9

PMID 33419268

Citations 2

Authors

Judith Haschka

Daniel Arian Kraus

Martina Behanova

Stephanie Huber

Johann Bartko

Jakob E Schanda

Philip Meier

Arian Bahrami

Shahin Zandieh

Jochen Zwerina

Roland Kocijan

Affiliations

Soon will be listed here.

Abstract

Crohn's disease (CD) is associated with bone loss and increased fracture risk. TX-Analyzer™ is a new fractal-based technique to evaluate bone microarchitecture based on conventional radiographs. The aim of the present study was to evaluate the TX-Analyzer™ of the thoracic and lumbar spine in CD patients and healthy controls (CO) and to correlate the parameters to standard imaging techniques. 39 CD patients and 39 age- and sex-matched CO were analyzed. Demographic parameters were comparable between CD and CO. Bone structure value (BSV), bone variance value (BVV) and bone entropy value (BEV) were measured at the vertebral bodies of T7 to L4 out of lateral radiographs. Bone mineral density (BMD) and trabecular bone score (TBS) by dual energy X-ray absorptiometry (DXA) were compared to TX parameters. BSV and BVV of the thoracic spine of CD were higher compared to controls, with no difference in BEV. Patients were further divided into subgroups according to the presence of a history of glucocorticoid treatment, disease duration > 15 years and bowel resection. BEV was significantly lower in CD patients with these prevalent risk factors, with no differences in BMD at all sites. Additionally, TBS was reduced in patients with a history of glucocorticoid treatment. Despite a not severely pronounced bone loss in this population, impaired bone quality in CD patients with well-known risk factors for systemic bone loss was assessed by TX-Analyzer™.

Citing Articles

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References

Hoffmann P, Krisam J, Kasperk C, Gauss A . Prevalence, Risk Factors and Course of Osteoporosis in Patients with Crohn's Disease at a Tertiary Referral Center. J Clin Med. 2019; 8(12). PMC: 6947604. DOI: 10.3390/jcm8122178. View

Pentland A . Fractal-based description of natural scenes. IEEE Trans Pattern Anal Mach Intell. 2012; 6(6):661-74. DOI: 10.1109/tpami.1984.4767591. View

Adami G, Saag K . Glucocorticoid-induced osteoporosis: 2019 concise clinical review. Osteoporos Int. 2019; 30(6):1145-1156. DOI: 10.1007/s00198-019-04906-x. View

Shannon C . The mathematical theory of communication. 1963. MD Comput. 1997; 14(4):306-17. View

Orwoll E, Oviatt S, Mann T . The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. J Clin Endocrinol Metab. 1990; 70(4):1202-7. DOI: 10.1210/jcem-70-4-1202. View

Targownik L, Bernstein C, Nugent Z, Johansson H, Oden A, McCloskey E . Inflammatory bowel disease and the risk of fracture after controlling for FRAX. J Bone Miner Res. 2012; 28(5):1007-13. DOI: 10.1002/jbmr.1848. View

Caligiuri P, Giger M, Favus M . Multifractal radiographic analysis of osteoporosis. Med Phys. 1994; 21(4):503-8. DOI: 10.1118/1.597390. View

Dempster D . Bone histomorphometry in glucocorticoid-induced osteoporosis. J Bone Miner Res. 1989; 4(2):137-41. DOI: 10.1002/jbmr.5650040202. View

Greenspan S, Myers E . Classification of osteoporosis in the elderly is dependent on site-specific analysis. Calcif Tissue Int. 1996; 58(6):409-14. DOI: 10.1007/BF02509439. View

10.

Targownik L, Bernstein C, Nugent Z, Leslie W . Inflammatory bowel disease has a small effect on bone mineral density and risk for osteoporosis. Clin Gastroenterol Hepatol. 2012; 11(3):278-85. DOI: 10.1016/j.cgh.2012.10.022. View

11.

Oostlander A, Bravenboer N, Sohl E, Holzmann P, van der Woude C, Dijkstra G . Histomorphometric analysis reveals reduced bone mass and bone formation in patients with quiescent Crohn's disease. Gastroenterology. 2010; 140(1):116-23. DOI: 10.1053/j.gastro.2010.09.007. View

12.

Dalle Carbonare L, Arlot M, Chavassieux P, Roux J, Portero N, Meunier P . Comparison of trabecular bone microarchitecture and remodeling in glucocorticoid-induced and postmenopausal osteoporosis. J Bone Miner Res. 2001; 16(1):97-103. DOI: 10.1359/jbmr.2001.16.1.97. View

13.

Bartko J, Reichardt B, Kocijan R, Klaushofer K, Zwerina J, Behanova M . Inflammatory Bowel Disease: A Nationwide Study of Hip Fracture and Mortality Risk After Hip Fracture. J Crohns Colitis. 2020; 14(9):1256-1263. DOI: 10.1093/ecco-jcc/jjaa052. View

14.

Suzuki Y, Ichikawa Y, Saito E, Homma M . Importance of increased urinary calcium excretion in the development of secondary hyperparathyroidism of patients under glucocorticoid therapy. Metabolism. 1983; 32(2):151-6. DOI: 10.1016/0026-0495(83)90221-4. View

15.

Dufour R, Winzenrieth R, Heraud A, Hans D, Mehsen N . Generation and validation of a normative, age-specific reference curve for lumbar spine trabecular bone score (TBS) in French women. Osteoporos Int. 2013; 24(11):2837-46. DOI: 10.1007/s00198-013-2384-8. View

16.

Nehrer S, Ljuhar R, Steindl P, Simon R, Maurer D, Ljuhar D . Automated Knee Osteoarthritis Assessment Increases Physicians' Agreement Rate and Accuracy: Data from the Osteoarthritis Initiative. Cartilage. 2019; 13(1_suppl):957S-965S. PMC: 8808932. DOI: 10.1177/1947603519888793. View

17.

Pothuaud L, Lespessailles E, Harba R, Jennane R, Royant V, Eynard E . Fractal analysis of trabecular bone texture on radiographs: discriminant value in postmenopausal osteoporosis. Osteoporos Int. 1999; 8(6):618-25. DOI: 10.1007/s001980050108. View

18.

Lundahl T, Ohley W, Kay S, SIFFERT R . Fractional brownian motion: a maximum likelihood estimator and its application to image texture. IEEE Trans Med Imaging. 1986; 5(3):152-61. DOI: 10.1109/TMI.1986.4307764. View

19.

Benhamou C, Poupon S, Lespessailles E, Loiseau S, Jennane R, Siroux V . Fractal analysis of radiographic trabecular bone texture and bone mineral density: two complementary parameters related to osteoporotic fractures. J Bone Miner Res. 2001; 16(4):697-704. DOI: 10.1359/jbmr.2001.16.4.697. View

20.

Haschka J, Hirschmann S, Kleyer A, Englbrecht M, Faustini F, Simon D . High-resolution Quantitative Computed Tomography Demonstrates Structural Defects in Cortical and Trabecular Bone in IBD Patients. J Crohns Colitis. 2016; 10(5):532-40. PMC: 4957457. DOI: 10.1093/ecco-jcc/jjw012. View