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Two methods for osteoporotic VF assessment on lateral spine radiographs, the Genant semiquantitative (GSQ) technique and a modified algorithm-based qualitative (mABQ) approach were compared.
Osteoporotic vertebral
fracture (VF) is considered a fracture of one or more vertebrae and related to
the high rates of mortality and morbidity as well. This raises the importance
of diagnosis as soon as possible. The study reflects the different method's
efficacy and anticipates modified algorithm-based qualitative (mABQ) approach
as a leading approach for vertebral fracture (VF) management.
Two methods for
osteoporotic VF assessment on lateral spine radiographs, the Genant
semiquantitative (GSQ) technique and a modified algorithm-based qualitative
(mABQ) approach were compared.
1771 men and 4465 women
aged ≥50 years from the Canadian Multicentre Osteoporosis Study with available
X-ray images at baseline were evaluated. 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 compared 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 L1 to L4 bone mineral density (BMD)
(-0.065 g/cm2 [-0.087 to -0.042]), femoral neck BMD (-0.051 g/cm2 [-0.065 to
-0.036]), and total hip BMD (-0.059 g/cm2 [-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]).
The study concluded that
defining VF by mABQ is preferred to the use of GSQ for clinical assessments.
J Bone Miner Res. 2017 Jul 19.
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).
Lentle BC et al.
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