Imaging of trabecular bone structure in osteoporosis

Osteoporosis is a metabolic bone disorder that is characterized by reduced bone mass and a deterioration of bone structure which results in an increas ed risk. Since the disease is preventable, diagnostic techniques are of maj or importance. Standard techniques determine bone mineral density, whereas some of the newer techniques focus on trabecular structure. This article re views structure analysis techniques in the diagnosis of osteoporosis. Imagi ng techniques applied to the assessment of trabecular bone structure includ e conventional radiography, magnification radiography, high-resolution CT ( HRCT) and high-resolution MR imaging (HRMRI). The best results were obtaine d using high-resolution tomographic techniques. The highest spatial resolut ions in vivo were achieved using HRMRI. The most common texture analysis te chniques that have been used are morphological parameters (analogous to bon e histomorphometry). Fractal dimension, co-occurrence matrices, mathematica l filter techniques and autocorrelation functions are more complex techniqu es. Most of the studies evaluating structure analysis show that texture par ameters and bone mineral density both predict bone strength and osteoporoti c fractures, and that combining both techniques yields the best results in the diagnosis of osteoporosis.