The Trabecular Bone Score is computed from the antero-posterior spine DXA examination file by a software (TBS iNsight) that is provided for use as a complement to a DXA analysis. Because BMI is taken into account in the calculation of the TBS, part of the variability in HRpQCT measurements explained by TBS alone might depend on some interaction of TBS with weight. The study was performed on healthy Iranian subjects who live in urban areas of Bushehr … Differences in the quality of trabecular bone can also be recognized when HRpQCT findings are compared with histomorphometric and μCT analyses of iliac crest bone biopsy samples in PHPT. In clinical studies, TBS enhanced the ability of DXA to predict fracture risk (15–20), and in a recent study involving more than 29,000 postmenopausal women, TBS predicted osteoporotic fractures, independent of aBMD (20). Epub 2018 Feb 1. FRAX adjusted for TBS. Because of the increase in variance due to the addition of weight as a variable, TBS lost its predictive value. Several salient observations have emerged. TBS measurements were performed in the Bone Disease Unit at the University of Lausanne (Lausanne, Switzerland), using deidentified spine DXA files from scans obtained at CUMC. | The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. TBS (Trabecular Bone Score) iNsight est un paramètre de texture qui peut être appliqué aux images DXA, et qui quantifie les variations locales en niveau de gris. The Trabecular Bone Score is a rather new index obtained at the lumbar spine at the same time as a real bone mineral density. Trabecular bone score (TBS) is an indirect indicator of bone microarchitecture. The result is expressed as a Trabecular Bone Score. Because DXA does not directly measure trabecular bone and HRpQCT is not widely available, we used trabecular bone score (TBS), a novel gray-level textural analysis applied to spine DXA images, to estimate indirectly trabecular microarchitecture. Recently, the trabecular bone score (TBS) has been introduced as a novel tool for assessing bone microarchitecture. Using experimental variograms of two-dimensional (2D) projection images, TBS differentiates between three-dimensional (3D) bone structures that exhibit the same areal bone mineral density (aBMD), but different trabecular microarchitecture (13). Only 3 (14%) patients were classified as osteoporotic and 7 (32%) as osteopenic, whereas the remaining 12 (54%) subjects presented with normal L1–L4 T-scores by DXA. 2020 Dec 1;8(4):49. doi: 10.3390/medsci8040049. SEATTLE — Trabecular bone score (TBS) and HbA1c may be good predictors of incident fractures in patients with type 1 diabetes, although bone mineral density (BMD) may not be predictive, according to a new study presented at the American Society for Bone and Mineral Research (ASBMR) 2015 Annual Meeting. It was proposed to be easily used in everyday practice as a surrogate of bone strength. This finding is in contrast to high-resolution peripheral quantitative computed tomography (HRpQCT) results of abnormal trabecular microstructure and epidemiological evidence for increased overall fracture risk in PHPT. Shayganfar A, Ebrahimian S, Masjedi M, Daryaei S. J Res Med Sci. The association between type 2 diabetes and trabecular bone score (TBS) has not been clear. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Bilezikian JP , Brandi ML , Rubin M , Silverberg SJ. Results: Low BMD was detected in 19.2% of the surveyed patients with T1DM and 6.5% of … Trabecular Bone Score: A New DXA-Derived Measurement for Fracture Risk Assessment. Although the prevalence of osteoporosis at any site was 50%, the L1–L4 T-score by DXA was well above the WHO osteoporosis threshold (T-score ≤2.5) in the vast majority of subjects. The Trabecular Bone Score (TBS), a novel gray-scale textural analysis of spine DXA images, provides a quantitative estimate of trabecular microarchitecture using variograms of 2D projection images . Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. Sweden: T rabecular and cortical volumetric bone mineral density (BMD) have opposite association with coronary-artery calcium score (CACS), suggests a recent study in the journal JAMA Cardiology. For each finite element model, a uniaxial compression test was performed with displacement equivalent to 1% apparent strain to calculate stiffness. Disclosure Summary: D.H. is a co-owner of the patent for TBS. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. In contrast to 72% of patients with PHPT showing degraded or partially degraded microarchitecture by TBS, only 46% were classified as osteopenic or osteoporotic by lumbar spine T-score. Med. References. . Boutroy S , Van Rietbergen B , Sornay-Rendu E , Munoz F , Bouxsein ML , Delmas PD. Trabecular bone score. The inter- and intra-assay coefficients are <7% and <5%, respectively. Likewise, trabecular bone stiffness characterizes the mechanical competence of the trabecular bone compartment. INTRODUCTION:Trabecular bone score (TBS) is a textural index that evaluates bone microarchitecture of the lumbar spine. The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to bone microarchitecture and fracture risk. The Relationship between Health Status and Social Activity of Perimenopausal and Postmenopausal Women (Health Status and Social Relationships in Menopause). Noteworthy conclusions of this study of postmenopausal women with PHPT, therefore, are that TBS may help to identify structural abnormalities in trabecular bone and that conventional DXA assessment is insufficient for this purpose. Moreover, our results demonstrate that TBS has the potential to identify subjects with PHPT with abnormalities in trabecular bone not captured by lumbar spine aBMD. Methods. The trabecular bone score (TBS) is a gray‐level textural metric that can be extracted from the two‐dimensional lumbar spine dual‐energy X‐ray absorptiometry (DXA) image. Statistical analysis was performed using SAS (version 9.2; SAS Institute, Inc, Cary, North Carolina). This finding is not surprising, because cortical and trabecular compartments are both affected in PHPT, leading to strong correlations between measurements of trabecular and cortical microarchitecture and density, even among HRpQCT indices (eg, correlation between Tb.N and Ct.Th at the radius: r = 0.667; P = .001). Even though these studies did not involve patients with PHPT, our findings suggest that low TBS may be related with decreased bone stiffness, and consequently, fracture risk, also in PHPT. Although we did not have a healthy control group, there is robust experience with normative datasets that have already defined normal values for this technology. The result is expressed as a Trabecular Bone Score. The trabecular bone score (TBS) a grayscale measurement of texture which is derived from the evaluation of the experimental variogram obtained from the Dual-energy X-ray Absorptiometry (DXA) images, is a relatively new tool to evaluate bone microarchitecture . Moreover, because TBS is assessed on 2D projection images, it is not likely that TBS analyzes purely trabecular bone. These findings, however, are not consistent with recent observations using technologies that have greater resolving power than DXA, such as high-resolution peripheral quantitative computed tomography (HRpQCT) in which trabecular microarchitectural deficits are seen (6, 7). However, HRpQCT indices of trabecular microarchitecture and stiffness were better predicted by L1–L4 aBMD, and the combination of TBS and L1–L4 aBMD was only slightly better in predicting their variance. Keywords: osteoporosis, trabecular bone score (TBS), bone mineral density (BMD), autoimmune diseases (AD), bone loss. To this end, our aim was to assess TBS from spine DXA images in postmenopausal women with PHPT and to correlate it, for the first time, with HRpQCT measurements of volumetric bone density, skeletal microarchitecture, and bone stiffness. A 3-year study, Trabecular bone score (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism, Effects of anti-resorptive agents on trabecular bone score (TBS) in older women, Copyright © 2013 by The Endocrine Society, Slit2 regulation of hyaluronan & cytokine synthesis in fibrocytes in thyroid associated ophthalmopathy, Testosterone Replacement Therapy added to Intensive Lifestyle Intervention in Older Men with Obesity and Hypogonadism, Anti-Müllerian hormone levels in adolescence in relation to long-term follow-up for presence of polycystic ovary syndrome, Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy, Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning, The Journal of Clinical Endocrinology & Metabolism, About The Journal of Clinical Endocrinology & Metabolism, Receive exclusive offers and updates from Oxford Academic, Abnormalities in Cortical Bone, Trabecular Plates, and Stiffness in Postmenopausal Women Treated With Glucocorticoids, Bariatric Surgery Results in Cortical Bone Loss, TBS (Trabecular Bone Score) and Diabetes-Related Fracture Risk. Bone texture; Dual-energy X-ray absorptiometry; Fracture; Osteoporosis; Trabecular bone score. TBS analysis is readily available from the lumbar spine DXA image without the need for further imaging or expensive instrumentation. Whereas HRpQCT has added a dimension of insight not previously seen with regard to trabecular bone in PHPT, HRpQCT is not widely available and remains so far a research tool. TBS is a measure of bone texture which correlates to bone microarchitecture. TBS iNsight™ software installs on existing DXA scanners. . . Citation: Ruaro B, Casabella A, Paolino S, Alessandri E, Patané M, Gotelli E, Sulli A and Cutolo M (2020) Trabecular Bone Score and Bone Quality in Systemic Lupus Erythematosus Patients. This study has limitations. Significant correlations between TBS and HRpQCT indices demonstrated here indicate that TBS may serve as a valuable additional index in the assessment of skeletal microstructure in PHPT. Stein EM , Silva BC , Boutroy S , et al. Our study has important strengths. TBS in PHPT was low at 1.24, representing abnormal trabecular microstructure (normal ≥1.35). Attention: TBS values are accurate only for patients (women and men) with a BMI in the range [15 – 37 kg/m²] Individuals with fracture risk assessed since April 15, 2015 . Finally, Boutroy et al (21) showed that TBS predicts osteoporotic fracture as well as lumbar spine aBMD and that TBS helps to define a subset of nonosteoporotic women at high risk for fracture. The mean value of the individual measurements for L1–L4 represents the lumbar spine TBS (unitless). Subjects were eligible for inclusion if they had well-characterized PHPT (elevated serum calcium and elevated or inappropriately normal PTH levels). Significant correlations between TBS and 3D direct measurements of trabecular microstructure were previously observed in human cadaver bone specimens (vertebrae, femur, and radius) (12, 13). Med. The trabecular bone score (TBS) is a novel texture parameter that evaluates pixel gray-level variations in the spine DXA image and is related to bone microarchitecture and fracture risk, providing information independent of BMD (22– 25). Physical performance during the menopausal transition and the role of physical activity. Exclusion criteria included bisphosphonate or glucocorticoid use within the past 2 years, a history of Cushing syndrome, uncontrolled thyroid disease, malabsorption syndrome, significant liver disease, creatinine clearance <30 mL/min, and any chronic disorders of mineral metabolism such as Paget disease or osteogenesis imperfecta. This was a cross-sectional study conducted in a referral center. The trabecular bone score (TBS) is a gray-level textural metric that can be extracted from the two-dimensional lumbar spine dual-energy X-ray absorptiometry (DXA) image. Hansen et al (6) have also observed similar structural deficits at the distal radius in PHPT. The pivotal TBS study showed significant relationships between TBS evaluated from 2D projection images directly derived from 3D μCT reconstruction and direct 3D measurements of trabecular microarchitecture by μCT (12). INTRODUCTION:Trabecular bone score (TBS) is a textural index that evaluates bone microarchitecture of the lumbar spine. The positive relationship between TBS and whole bone stiffness assessed by FEA of HRpQCT images suggests that, in PHPT, low TBS may also indicate increased fracture risk. The correlation of TBS with HRpQCT indices, mechanical parameters, and DXA measurements was assessed by the Pearson correlation test. The results of this study show, for the first time, significant correlations between TBS and HRpQCT measurements of volumetric densities, skeletal microarchitecture, and bone stiffness at the radius and tibia in a group of postmenopausal women with PHPT. By HRpQCT, both trabecular and cortical compartments are abnormal at the radius and tibia in postmenopausal women with PHPT. It was proposed to be easily used in everyday practice as a surrogate of bone strength. Trabecular Bone Score . The aim of this study was to estimate the reference values of TBS in both genders among the Iranian population to evaluate osteoporotic fractures in the future. There are no studies assessing whether trabecular bone score characterizes bone quality in kidney transplant recipients. Image analysis has been validated and detailed elsewhere (24–27). In this study, the researchers aimed to evaluate the association between TBS and new bone formation independently of fatty lesions on spinal MRI, both … Search for other works by this author on: The study of hyperparathyroidism at the Massachusetts General Hospital, The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years, A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery, Primary hyperparathyroidism: new concepts in clinical, densitometric and biochemical features, Skeletal disease in primary hyperparathyroidism, Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT, Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women, Primary hyperparathyroidism and the risk of fracture: a population-based study, Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism, Increased mortality and morbidity in mild primary hyperparathyroid patients. TBS was significantly correlated with tibia HRpQCT with regard to volumetric densities, Ct.Th, BV/TV, and whole bone stiffness. Trabecular bone, also called cancellous bone, is porous bone composed of trabeculated bone tissue. Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. Boutroy S , Hans D , Sornay-Rendu E , Vilayphiou N , Winzenrieth R , Chapurlat R. Lamy O , Krieg MA , Stoll D , Aubry-Rozier B , Metzger M , Hans D. Vasic J , Gojkovic F , Petranova T , et al. Epub 2017 Jul 19. high-resolution peripheral quantitative computed tomography, standard deviation of trabecular separation. Although the lumbar spine and tibia are both load-bearing sites, they are subjected to different loading forces, which might explain this observation. 2020 Aug;137:115451. doi: 10.1016/j.bone.2020.115451. Rubin MR , Bilezikian JP , McMahon DJ , et al. Stein EM , Liu XS , Nickolas TL , et al. Trabecular bone, also called cancellous bone, is porous bone composed of trabeculated bone tissue. . Trabecular bone score and transilial bone trabecular histomorphometry in type 1 diabetes and healthy controls. Using linear regression analysis, variations in HRpQCT measurements of volumetric density were better predicted by the combination of TBS and L1–L4 aBMD than by either one alone. This meta-analysis showed that compared with controls, diabetic patients had a lower trabecular bone score (TBS) than non-diabetic individuals, suggesting that TBS can be a useful measurement for the assessment of fracture risk in diabetic patients. . Studies in cadaveric bones have shown significant correlations between TBS and 3D trabecular microarchitecture measurements by microcomputed tomography (μCT) (12–14). However, part of this correlation was partially confounded with age. TBS is important because about one-half of people who break bones do not have a bone density that is classified as osteoporosis. Breban S , Briot K , Kolta S , et al. Trabecular Bone Score (TBS) Trabecular Bone Score (TBS) is measured from a lumbar spine DXA image and thus no extra scan is required. How does TBS benefit patients? Because trabecular microstructure can differ significantly among different anatomical sites, it is possible that these weak relationships are explained by the comparison of a method that estimates trabecular microarchitecture at the lumbar spine (TBS) with a technology that measures trabecular microstructure and stiffness at the radius and tibia (HRpQCT). Utility of trabecular bone score in the evaluation of osteoporosis. TBS quantification is readily … Serum total calcium (normal, 8.4–10.2 mg/dL) and albumin were measured using standard methods (Quest Diagnostics, Madison, New Jersey), and calcium values were corrected for albumin concentration <4 g/dL. Trabecular Bone Score (TBS®) by Medimaps is a fracture risk predictor using DEXA as a source. In contrast, Boutroy et al (21) found significant correlations between TBS and L1–L4 aBMD (r = 0.58; P < .001) in 560 women from the OFELY cohort. Using AP spine data obtained during routine DXA exams, TBS iNsight™ produces a clinically significant 1,2 fracture risk parameter. NLM The trabecular bone score (TBS) is a gray‐level textural metric that can be extracted from the two‐dimensional lumbar spine dual‐energy X‐ray absorptiometry (DXA) image. Site-matched spine TBS parameters were extracted from the DXA image using TBS iNsight software (version 1.9; medimaps, Geneva, Switzerland). Front. Most patients with PHPT (77%) were asymptomatic. The Trabecular Bone Score is a rather new index obtained at the lumbar spine at the same time as a real bone mineral density. Parisien M , Mellish RW , Silverberg SJ , et al. Red bone marrow, where all the blood cells are made, fills the space between the trabecular pores. 23 TBS is a bone texture parameter that quantifies cancellous bone microarchitecture, which is key in determining bone strength and resistance to fracture, by computing raw data from a dual energy X‐ray absorptiometry (DXA) image of the lumbar spine. Therefore, this cross‐sectional study investigated the association between TBS and severe periodontitis. It is a texture measurement that quantifies local variations in gray level distribution from dual-energy X-ray Absorptiometry (DXA) and is significantly correlated with three dimensional parameters of bone microarchitecture, independently of aBMD , , , . Trabecular bone score (TBS) is a newly developed index for assessing trabecular bone quality and fracture risk. The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. Bone tissue was assumed to have an isotropic linear material property with a Young modulus of 15 GPa and a Poisson ratio of 0.3. Whole bone stiffness was defined as the reaction force divided by the applied displacement. HHS Curr Opin Endocrinol Diabetes Obes. 2017 Jul-Sep;20(3):334-345. doi: 10.1016/j.jocd.2017.06.019. Likewise, a recent ex vivo study on 16 human vertebrae showed a positive relationship between TBS assessed in L3 and mechanically measured bone stiffness of the same vertebra (14). El Maghraoui A (2004) Osteoporosis and ankylosing spondylitis. TBS was evaluated by determining the variogram of the trabecular bone projected image, calculated as the sum of the squared gray-level differences between pixels at a specific distance and angle. Romagnoli E , Cipriani C , Nofroni I , et al. Unlike regular XR, in which it’s possible to assess the trabecular structure, DEXA’s low radiation is not enough for trabeculae differentiation. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Volumetric bone mineral density (vBMD) and microarchitecture were measured at the nondominant distal radius and tibia using the HRpQCT system (voxel size 82 μm, XtremeCT; Scanco Medical AG, Brüttisellen, Switzerland) at CUMC, as described previously (24). Oxford University Press is a department of the University of Oxford. Clipboard, Search History, and several other advanced features are temporarily unavailable. | The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. TBS iNsight est dérivé de l’évaluation du variogramme, expérimentale, obtenue à partir des niveaux de gris de l’ image DXA . 2017 Dec;24(6):402-410. doi: 10.1097/MED.0000000000000365. Significant correlations remained after adjustment for body weight (Table 2 and Figure 2). Trabecular bone score (TBS) is an indirect measure of bone microarchitecture that is derived from a textural analysis of pixel gray level variations in dual-energy X-ray absorptiometry (DXA) images of the lumbar vertebrae . TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Krueger D., Fidler E., Libber J., Aubry-Rozier B, Hans D, Binkley N. Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. Trabecular bone score (TBS) uses standard lumbar spine DXA imaging to assess bone texture inhomogeneity (that is, the number of filled versus unfilled voxels) in order to gauge bone quality and fracture risk.