Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 33(4), 569-579, 2017
Comparative Analysis of the Radiology of Osteoporotic Vertebral Fractures in Women and Men: Cross-Sectional and Longitudinal Observations from the Canadian Multicentre Osteoporosis Study (CaMos)
Brian C Lentle, Claudie Berger, Linda Probyn, Jacques P Brown, Lisa Langsetmo, Ben Fine, Kevin Lian, Arvind K Shergill, Jacques Trollip, Stuart Jackson, William D Leslie, Jerilynn C Prior, Stephanie M Kaiser, David A Hanley, Jonathan D Adachi, Tanveer Towheed, K Shawn Davison, Angela M Cheung, David Goltzman
We compared two methods for osteoporotic vertebral fracture (VF) assessment on lateral spine radiographs, the Genant semiquantitative (GSQ) technique and a modified algorithm-based qualitative (mABQ) approach. We evaluated 4465 women and 1771 men aged ≥50 years from the Canadian Multicentre Osteoporosis Study with available X-ray images at baseline. Observer agreement was lowest for grade 1 VFs determined by GSQ. Among physician readers, agreement was greater for VFs diagnosed by mABQ (ranging from 0.62 [95% confidence interval (CI) 0.00-1.00] to 0.88 [0.76-1.00]) than by GSQ (ranging from 0.38 [0.17-0.60] to 0.69 [0.54-0.85]). GSQ VF prevalence (16.4% [95% CI 15.4-17.4]) and incidence (10.2/1000 person-years [9.2; 11.2]) were higher than with the mABQ method (prevalence 6.7% [6.1-7.4] and incidence 6.3/1000 person-years [5.5-7.1]). Women had more prevalent and incident VFs relative to men as defined by mABQ but not as defined by GSQ. Prevalent GSQ VFs were predominantly found in the mid-thoracic spine, whereas prevalent mABQ and incident VFs by both methods co-localized to the junction of the thoracic and lumbar spine. Prevalent mABQ VFs compared with GSQ VFs were more highly associated with reduced adjusted L(1) to L(4) bone mineral density (BMD) (-0.065 g/cm(2) [-0.087 to -0.042]), femoral neck BMD (-0.051 g/cm(2) [-0.065 to -0.036]), and total hip BMD (-0.059 g/cm(2) [-0.076 to -0.041]). Prevalent mABQ VFs compared with prevalent GSQ were also more highly associated with incident VF by GSQ (odds ratio [OR] = 3.3 [2.2-5.0]), incident VF by mABQ (9.0 [5.3-15.3]), and incident non-vertebral major osteoporotic fractures (1.9 [1.2-3.0]). Grade 1 mABQ VFs, but not grade 1 GSQ VFs, were associated with incident non-vertebral major osteoporotic fractures (OR = 3.0 [1.4-6.5]). We conclude that defining VF by mABQ is preferred to the use of GSQ for clinical assessments.
osteoporotic vertebral fracture assessment Genant semiquantitative vs algorithm-based qualitative, Prior JC osteoporosis vertebral fracture radiology, Canadian Multicentre Osteoporosis Study CaMos vertebral fractures, modified algorithm-based qualitative mABQ vertebral fracture diagnosis, vertebral fracture sex differences bone mineral density, GSQ vs mABQ vertebral fracture prevalence incidence, cross-sectional longitudinal vertebral fracture assessment radiology, bone mineral density femoral neck lumbar spine fracture risk, osteoporotic vertebral fracture men women comparative analysis, vertebral fracture grading methods observer agreement reliability
PMID 28722766 28722766 DOI 10.1002/jbmr.3222 10.1002/jbmr.3222
Cite this article
Lentle, B. C., Berger, C., Probyn, L., Brown, J. P., Langsetmo, L., Fine, B., Lian, K., Shergill, A. K., Trollip, J., Jackson, S., Leslie, W. D., Prior, J. C., Kaiser, S. M., Hanley, D. A., Adachi, J. D., Towheed, T., Davison, K. S., Cheung, A. M., Goltzman, D., & CaMos Research Group (2018). Comparative Analysis of the Radiology of Osteoporotic Vertebral Fractures in Women and Men: Cross-Sectional and Longitudinal Observations from the Canadian Multicentre Osteoporosis Study (CaMos). Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 33(4), 569-579. https://doi.org/10.1002/jbmr.3222
Lentle BC, Berger C, Probyn L, Brown JP, Langsetmo L, Fine B, et al. Comparative Analysis of the Radiology of Osteoporotic Vertebral Fractures in Women and Men: Cross-Sectional and Longitudinal Observations from the Canadian Multicentre Osteoporosis Study (CaMos). J Bone Miner Res. 2018;33(4):569-579. doi:10.1002/jbmr.3222
Lentle, B. C., et al. "Comparative Analysis of the Radiology of Osteoporotic Vertebral Fractures in Women and Men: Cross-Sectional and Longitudinal Observations from the Canadian Multicentre Osteoporosis Study (CaMos)." Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, vol. 33, no. 4, 2018, pp. 569-579.
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