Osteoporosis Clinical Trial
Official title:
Parameters Derived From DXA-based Structural Engineering Models of the Proximal Femur as a Biomarker for Hip Fracture Prediction.
The study aims to determine the efficacy and best methods for predicting hip fractures and diagnosing post-menopausal osteoporosis using three dimensional structural engineering models (SEMs) of proximal femoral bone produced using a Hologic Discovery duel-energy x-ray absorptiometry scanner and Hologic's new 3D Hip(TM) software in comparison to three dimensional SEMs produced using quantitative computed tomography - the current gold standard.
Bone mineral density (BMD) measurements by dual-energy x-ray absorptiometry (DXA) have been
available to the clinician for the past 20 years and their use forms the basis of current
clinical practice guidelines. The measurements are very useful, but they could be improved
upon by taking into account the third dimension of bone (depth) and the distribution of
mineral within bone. The value of a diagnostic test depends greatly on the strength of
association of the measurement with the outcome. If we find that our new approach
strengthens the ability of hip DXA measurements to predict fracture then we will have a
greatly improved diagnostic test and so can better identify those patients we should treat.
Further, such a test would allow better evaluation of new therapies for osteoporosis,
particularly those that may alter bone geometry, including anabolic agents such as
teriparatide.
Patients attending for study visits will complete a basic questionnaire to collect
information on their bone health and lifestyle (the current Metabolic Bone Centre standard
questionnaire). Patients will also undergo DXA scans of their hips on a Hologic Discovery
DXA machine using a new 3D imaging technique called '3D HipTM'. Hologic will process 3D
HipTM scans and provide us with volumetric dataset of the scans before they provide us with
a high performance PC and software for us to do the process on-site. They have already
installed the software upgrade and necessary hardware to our Discovery densitometry system
to enhance the 3D HipTM capability. Patients will attend for a CT scan of their hip at the
medical imaging department of the Northern General Hosptial as per standard practice.
50 postmenopausal women who have recently suffered a hip fracture will be recruited to the
study. 50 postmenopausal age matched controls will also be recruited. Subjects will give
informed consent and a study visit will be arranged for them to attend for a DXA scan and a
CT scan. At the study visit basic demographic data and a brief medical history will be
collected on study specific Case Report Forms (CRF).
The intended outcomes of the study are 1) To establish the diagnostic accuracy for hip
fracture of the 3D HipTM and SEMs derived from the 3D HipTM, and to determine how much
better the 3D HipTM is over the traditional 2D DXA in a case controlled study. 2) To compare
three dimensional SEMs of the proximal femur derived from 3D Hip(TM) against simulated SEMs
derived using quantitative computed tomography.
;
Observational Model: Case Control, Time Perspective: Prospective
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