Language
English
Publication Date
9-1-2025
Journal
JBMR Plus
DOI
10.1093/jbmrpl/ziaf106
PMID
40894194
PMCID
PMC12395334
PubMedCentral® Posted Date
6-14-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Volumetric bone density, microarchitecture, and strength measures using HR-pQCT are valuable measures of bone health in pediatrics. Our cross-sectional study evaluated bone measure reproducibility in pediatric participants using repeat HR-pQCT (XtremeCT II, Scanco Medical) scans of non-dominant distal tibia and radius of 30 healthy children and adolescents (7-17 yr, 47% female) by 2 technicians. Additionally, we examined HR-pQCT and micro-CT of 26 cadaveric distal tibia specimens to evaluate agreement between the modalities. All HR-pQCT scans were analyzed using manufacturer-provided software (Image Processing Language, Scanco Medical) and a fully automated, previously validated, in-house algorithm, offering measures of bone microstructure (eg, trabecular plate-rod distribution, transverse trabeculae, trabecular bone strength) currently unavailable in the manufacturer-provided software. Root-mean-squared percent coefficient of variation (RMS-%CV) assessed precision and least significant change. Intraclass correlation coefficients (ICCs) using absolute-agreement, 2-way random-effects models assessed reliability. Pearson’s correlation coefficients and ICC assessed linear relationships and agreements between HR-pQCT and micro-CT, respectively. In children and adolescents, RMS-%CV of HR-pQCT-derived trabecular bone measures at distal tibia and radius ranged from 0.8-4.4 to 0.8-6.0, respectively. Most cortical bone results were in a similar range. Both computational algorithms showed ICC > 0.90. RMS-%CV and least significant change values were lower for tibia than radius. ICCs were lower for cortical than trabecular outcomes. Most cadaveric results showed ICC > 0.83, other than trabecular bone thickness and modulus (ICC = 0.7). Pearson’s r (>0.86) suggested strong correlations for almost all parameters. HR-pQCT and micro-CT results using in-house algorithm did not differ significantly, while manufacturer-provided algorithm results showed lower yet still moderate reliability (ICC > 0.55). Reliability of the second-generation HR-pQCT in pediatric participants is excellent—better in tibia vs radius. Our results support the high reproducibility of XtremeCT II scans and thus the use of this clinical imaging modality in studies of pediatric bone health.
Keywords
HR-pQCT, accuracy, reliability, children, adolescent, bone morphology
Published Open-Access
yes
Recommended Citation
Shypailo, Roman J; Calarge, Chadi; Saha, Punam K; et al., "High-Resolution Peripheral Quantitative Computed Tomography Reliability and Accuracy of Bone Density and Morphology Properties in Children" (2025). Faculty and Staff Publications. 5776.
https://digitalcommons.library.tmc.edu/baylor_docs/5776