Novel Imaging Modalities in Osteoporosis Diagnosis and Risk Stratification

Abstract

Purpose of review: Two hundred million individuals worldwide are diagnosed with osteoporosis, and every year, approximately 8.9 million experience a fracture. There is an opportunity with new diagnostic technology to enhance risk stratification of osteoporosis to improve patient outcomes. The current standard for osteoporosis diagnosis includes an areal bone mineral density (aBMD) T-score derived from a dual-energy X-ray absorptiometry (DXA) scan. However, aBMD does not account for bone quality, resulting in some individuals at risk for fracture not being identified. This review article will explore the potential of novel imaging technologies in osteoporosis diagnosis and risk stratification. Recent findings: Several novel imaging technologies have had success identifying those at risk for fracture and measuring treatment effectiveness. These include trabecular bone score (TBS), high-resolution peripheral quantitative computed tomography (HR-pQCT), peripheral quantitative computed tomography (pQCT), magnetic resonance imaging (MRI), and quantitative ultrasound (QUS). Recently, TBS has been incorporated into fracture risk prediction. Summary: While these imaging modalities show promise, further investigation is necessary to determine accuracy and reliability in osteoporosis diagnostics and fracture risk stratification before clinical integration is possible.Copyright © 2018, Springer International Publishing AG, part of Springer Nature.