Seeking: Accurate measurement techniques for deep-bone density and structure

We are seeking a clinically useful technology with enough sensitivity to assess the microstructure of “spongy” bone that is found in the marrow cavities of whole bones. However, this technology must be for skeletal sites surrounded by layers of soft tissues, such as the spine and the hip. Soft tissue interferes with conventional imaging and using a more accessible area — for example, the wrist or the ankle of limbs — as a proxy for the less accessible skeletal regions, will not be accurate. A non-radioactive technology is strongly preferred.

The structural arrangement of tiny bones (the trabecular microarchitecture) that are found in the marrow cavity of whole bones is difficult to image. Trying to image the trabecular microarchitecture of the spine or the hip is complicated because of the noise produced by surrounding soft tissue. Studies have reported profound changes to the bone marrow compartments of the hip and spine under certain stresses and conditions.

Unlike commonly recognized bone diseases such as osteoporosis, the skeletal changes we have observed are targeted to specific sites of the skeleton. This suggests that the factors — that cause the bone mineral loss we are seeing — do not circulate through the body, but are local to the affected skeletal site — the spine and hip in particular. In other words, measurements conducted at a site at the periphery of the skeleton may not reflect or predict changes at a site located more centrally in the skeleton.

Technologies have emerged for the assessment of the trabecular microarchitecture of bone structures. These high-resolution methods, however, are being developed for peripheral skeletal sites (wrist and ankle) because bones are closer to the surface and the signal can be detected better (greater “signal to noise”) than for bones surrounded by layers of soft tissue. A similar, high-resolution technology is desired to measure trabecular bone microarchitecture for sites of the central skeleton, such as hip and spine, because there are pronounced changes in total bone mass and whole bone structure occurring at these sites and a disruption in trabecular microstructure is suspected as well.

We would like to come up with a method that can non-invasively assess the microarchitecture of deep-seated central skeletal bones, and provide data that can be correlated or translated to bone strength. With this knowledge, we can monitor changes in bone microarchitecture for sites such as the hip and spine and identify a person at high risk for fracture in order to intervene with a course of therapy.

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