I Fogelman

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..The aim of this study was to show that skeletal ratios, such as length of femur to height, could be accurately measured from a DXA (dual energy X-ray absorptiometry) image...

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..The most important question, however, is irrespective of whether a lesion is seen on x-ray, CT, or bone scan and irrespective of lytic of blastic morphology: if the FDG-PET study is negative, what is the clinical relevance of that lesion?..

..In conclusion, these results demonstrate a positive effect of HRT on SOS measurements at the radius and tibia and BMD measurements of the lumbar spine...

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..5 mg daily prevents bone loss in the lumbar spine and femoral neck over 8 years and adherence to treatment is high. The greater bone density compared with untreated women would be expected to reduce the risk of bone fractures...

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..6, -3.0, -3.0 and -2.2 and for osteopenia of -1.4, -1.6, -2.3, and -1.4, for the radius, tibia, phalanx and metatarsal, respectively, were recommended...

..We conclude that MXA precision is generally poorer than that of MRX and that the presence of vertebral deformities has a more pronounced effect on MXA precision than on MRX precision...

..6 standard deviation higher than their US counterparts...

..The inconsistencies of the imaging system used for this study demonstrate that further development is required before it will be possible to show improvements in long-term precision...

..Weight changes up to 5 kg had little effect on precision...

..VXA may prove useful in the clinical evaluation of patients at risk of osteoporosis as an adjunct to BMD scans or in the selection of subjects for osteoporosis-related clinical trials...

..029). Our data suggest a link between imbalances in bone turnover and arterial stiffness in pre-dialysis CKD. Longitudinal studies are needed to evaluate the clinical usefulness of these bone turnover markers as predictors of CVD in CKD...

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..61, -1.94 and -1.90 for Sahara BUA, SOS and estimated heel BMD respectively and -1.45 and -2.10 for DTU BUA and SOS respectively Additional studies are needed to determine suitable T-score thresholds for other commercial QUS devices...

..However, the widely accepted threshold of a T-score of less than -2.5 for the definition of osteoporosis may need modifying for the interpretation of QUS scans...

..In particular, total hip BMD appears to be as effective as femoral neck BMD for detecting response to treatment in the femur in the setting of a clinical trial or similar research study...

..2 ng/mL (p < 0.05) in the withdrawal group, but was unchanged in the controls. No change was seen in CTx. Corticosteroid withdrawal in renal transplant recipients results in an increase in BMD with a corresponding increase in serum OC...

..However, these increases were not clinically significant. In conclusion, the combination of axial BMD and calcaneal QUS measurements did not significantly improve fracture discrimination compared with either method alone...

..In conclusion, addition of PTH(1-84) to stable HT produced marked increases in lumbar spine BMD and may represent an additional approach to the treatment of PMO women receiving HT...

..We have compared 18FDG PET with 99mTc MDP bone scintigraphy in patients with skeletal metastases from breast cancer and have analyzed the data in subgroups based on radiographic characteristics of lesions...

..However, comparable data could probably be obtained by using 99mTc-MDP if methods for single photon emission computed tomography (SPECT) quantitation were improved...

..However, obesity may have an adverse effect on precision errors in individual patients and particular care is necessary to ensure reproducible patient positioning for femur scans...

..027). Our data suggest that the Wnt pathway may play a role in CKD-MBD. Prospective studies are required to establish the clinical relevance of sclerostin and DKK1 as serological markers in CKD...

..In conclusion, calcaneal QUS can discriminate between women with and those without fracture at the wrist or at sites other than the spine, hip, or forearm as well as axial DXA measurements of BMD can...

..Independent confirmation is needed, but our results suggest there are reliable alternatives to plain radiography in the early assessment of response of bone metastases to treatment...

..In symptomatic osteoporotic patients the bone scan may be helpful in elucidating the etiology of back pain and can impact on patient management...

..2%). BMI and BMD had little or no effect on precision. We conclude that optimal results are obtained by the acquisition of both SE and HD scans. However, for rapid assessment by trained operators SE scans alone offer almost equal utility...

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..The high positive predictive value suggests that those with a positive scan must undergo further investigation, while the 100% negative predictive value means those with no FDG uptake can safely be spared further invasive investigations..

..Tibolone was well tolerated. CONCLUSION: Tibolone 2.5 mg daily maintains its beneficial effects on bone loss over 10 years, while remaining well tolerated...

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..In view of the data showing the rapid transport of (18)F-fluoride across the red cell membrane, bone kinetic data for (18)F are more accurately reported as whole-blood clearance rather than plasma clearance...

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..What impact can the expanding range of treatments make on the growing and costly burden of osteoporosis?..

..degree of consistency among different methods? Finally, does it matter if the imperfect correlation among different types of measurement results in different patients being selected for treatment on the basis of different techniques?..

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..78, P < 0.001). FGF-23 is increased by intermittent PTH(1-34). This is related to early changes in P1NP, suggesting that the skeletal effects of PTH may involve FGF-23. Further studies are required to elucidate this...

..We conclude that in a randomized study the effects of weight change can be corrected and total body DXA can give useful information about the response to treatment across the whole skeleton...

..A possible role for the use of the hypoxia selective tracer 18F-fluoromisonidazole in skeletal infection also exists. This article summarizes the current role of PET in the skeleton with regard to these tracers and diseases...

..C-reactive protein (CRP) and serum phosphate correlated with FGF-23. A significant association was seen between FGF-23 and BMD at the hip...

..Nevertheless, prospective studies with large patient groups will be essential to define the exact diagnostic role of FCH and DOPA PET in different clinical settings...

..Data in men are lacking. The aim was to investigate the relationship between circulating concentrations of Inh B and Act A and FSH/LH/testosterone (T) and their contribution to bone mineral density (BMD) in a male population...

..Bone metabolism at the spine remained stable following discontinuation of alendronate and risedronate at 1 year but increased in the hip in the alendronate group only...

..The results confirm that the fraction of free 99mTc-MDP varies with time and shows significant differences between individuals, which are dependent on GFR and K(bone) amongst other factors...

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..4 microSv/h. These figures compare with a natural background radiation in the United Kingdom of 7 microSv/d. In conclusion the radiation doses from forearm pDXA to both patients and operator were found to be truly trivial...

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..Provided revised diagnostic criteria are adopted for QUS, similar proportions of postmenopausal women are identified as osteopenic or osteoporotic as with BMD...

..A patient with an unusual pattern of disease is presented together with quantitative assessment of the tracer kinetics pre- and posttreatment...

..The data also suggest that, in contrast to E(2), RAL may exert its anti-resorptive actions, at least in part, via the RANKL/OPG pathway. Further in vivo studies are required to confirm this...

..Vitamin D supplementation was found to have no effect on BMD...

..However, when new therapies are first introduced, follow-up scans have a useful role in building up the physician's experience and confidence...

..In this review we discuss the efficacy of radiological and radionuclide techniques in the assessment of diabetic foot infection...

..However, estimates of wall thickening from echocardiography cannot be used interchangeably with those derived from gated myocardial perfusion SPECT...

..This review article discusses the evidence for these and other advantages of central DXA, including its role in the new WHO algorithm for treating patients on the basis of individual fracture risk...

..AccuDEXA measurements could, therefore, provide an alternative method for identifying individuals with low bone mass, provided care is taken in interpreting T-scores, perhaps, through the use of device-specific thresholds...

..This study has demonstrated that the relationship between regional bone turnover measured directly at the lumbar spine with changes in BMD is similar to that seen for global skeletal bone turnover using biochemical markers...

..18)F-PET may aid in our understanding of the importance of bone perfusion in osteoporosis and differences in regional bone turnover with disease and in response to therapy...

..This latter correction will be required for the interpretation of future DXA scans in patients who have discontinued strontium ranelate treatment...

..In this study, the dependence of Tc-MDP protein binding on total plasma clearance (Ktotal) and serum albumin concentration was investigated using data from two groups of patients...

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..We also discuss the recently published clinical guidelines that incorporate the FRAX fracture risk assessment in decisions about patient treatment...

..01). These findings suggest that decreased BMD is associated with arterial calcification and stiffening and raise the possibility that OPG is a marker of arterial stiffening, independent of any association with BMD...

..The main PET parameter of interest, termed K(i), reflects regional bone metabolism. The aim of this study was to compare the long-term precision of (18)F-fluoride PET with that of biochemical markers of bone turnover assessed over 6 mo...

..Replication and further fine mapping of this region is ongoing to determine potential genes influencing bone size and diseases affecting bone...

..3 y) before participation in a clinical trial of an osteoporosis therapy. The aim was to compare the consistency and accuracy of the 3 methods before their use in evaluating the subjects' response to treatment...

..This review discusses the evidence for these and other clinical aspects of DXA scanning, including its role in the new WHO algorithm for treating patients on the basis of their individual fracture risk...

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..This is the first study showing a direct metabolic effect of TPTD at different skeletal sites in vivo, as measured by tracer kinetics...

..This review discusses the evidence for these and other clinical aspects of DXA scanning, including its role in the new WHO algorithm for treating patients on the basis of their individual fracture risk...

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..We used clinical trial data and a model of long-term strontium kinetics to estimate the effect of past strontium treatment on future BMD measurements...

..In this study we evaluated their use to quantify bone turnover in women receiving antiresorptive therapy compared with that of untreated control subjects...

..This study used a bivariate gaussian model to examine the effect of combining two different BMD measurements. The results show that, in practice, there is little benefit unless the measurements are completely unrelated...

..It was concluded that equating estimates of absolute fracture risk for different types of scan should not be used as the basis of deriving equivalent T-scores for interpreting peripheral measurements...

..Genetic influences were found for all SOS and BMD measurements. A combination of shared and unique genetic influences was found to control BMD and SOS at the radius...

..05]. Serum osteocalcin increased at 12 months in group 2 ( P=0.01). Dietary improvement in elderly women with low BMI is associated with a reduction in bone resorption with a small but "net" positive effect on bone formation...

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..However, in general, the results from these devices cannot be interpreted using the WHO definition of osteoporosis, and until there is a consensus over establishing an equivalent threshold, their use is premature...

..More recently, positron emission tomography (PET) scanning has been found to be helpful in the more difficult cases...

..As a result, conventional measurements of GFR using (51)Cr-EDTA overestimate the true renal clearance of tracer by approximately 10%...

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..The net plasma clearance of fluoride to bone mineral reflecting osteoblastic activity decreased significantly after therapy...

..Lower values of regional bone formation activity at the lumbar spine were seen in osteoporotic women, whereas global markers of bone formation were significantly increased...

..BMD was correlated with body mass index but there was no correlation with prolactin. BMD was not correlated with prolactin levels and showed no clinically significant reduction. The low BMD in black males warrants further investigation...

..We conclude that use of forearm BMD alone with a modified T-score threshold of -2.1 would save the need for spine and hip DXA scans and identify only slightly fewer fracture cases for treatment...

..Overall, this study points to BMD correlation as an important factor in explaining the ability of measurements made at distant sites to predict fracture risk...

..The aim of this study was to validate the accuracy of the AUC method by comparing K(bone) values obtained by that method with those obtained by gamma-camera imaging...

..2% (7.5-11.8) for standardised uptake values, 11.7% (9.5-14.9) for plasma clearance measurements using the Patlak method and 14.5% (11.7-18.5) for plasma clearance measurements using the Hawkins three-compartment model...

..The lesion was removed with complete relief of pain...

..The MXA phantom appears to be a useful tool for documenting the stability of the mechanical instruments and for checking the long-term consistency of operator precision...

..131I is an important therapeutic tool. FDG-PET is useful in certain cases, especially for finding metastases and monitoring response to therapy...

..Today, scans to measure bone mineral density are seen as having an essential role in the evaluation of patients at risk of osteoporosis...