Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry

Uemura, Keisuke; Otake, Yoshito; Tamura, Kazunori; Higuchi, Ryo; Kono, Sotaro; Mae, Hirokazu; Takashima, Kazuma; Okada, Seiji; Sugano, Nobuhiko; Hamada, Hidetoshi

doi:https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1

Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry

Uemura, Keisuke; Otake, Yoshito; Tamura, Kazunori et al.

Bone and Joint Research, 2025, 14(10), 850-859

アクセス数:18件（2026-02-15 23:45 集計）

固定URL: https://hdl.handle.net/11094/103666

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タイトル	Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry
著者	NRID 1000070871367 1000070871367 ORCID 0000-0002-9245-1743 0000-0002-9245-1743 researchmap permalink keisukeuemura keisukeuemura Scopus Author ID 57203910709 57203910709 著者名 Uemura, Keisuke
	NRID 1000080349563 1000080349563 著者名 Otake, Yoshito
	著者名 Tamura, Kazunori
	著者名 Higuchi, Ryo
	ORCID 0009-0008-8393-2781 0009-0008-8393-2781 著者名 Kono, Sotaro
	NRID 1000060978261 1000060978261 ORCID 0009-0000-4617-0409 0009-0000-4617-0409 著者名 Mae, Hirokazu
	NRID 1000010964801 1000010964801 researchmap permalink tk-sm tk-sm 著者名 Takashima, Kazuma
	NRID 1000030448435 1000030448435 ORCID 0000-0002-5107-8209 0000-0002-5107-8209 researchmap permalink okadaseiji okadaseiji Scopus Author ID 35079139100 35079139100 著者名 Okada, Seiji
	NRID 1000070273620 1000070273620 researchmap permalink read0185092 read0185092 Scopus Author ID 7101688414 7101688414 著者名 Sugano, Nobuhiko
	NRID 1000090778705 1000090778705 ORCID 0000-0003-3652-9400 0000-0003-3652-9400 researchmap permalink x_y_z x_y_z Scopus Author ID 55917324800 55917324800 著者名 Hamada, Hidetoshi
内容	Uemura K., Otake Y., Tamura K., et al. Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry. Bone and Joint Research 14, 850 (2025); https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1.
抄録	Aims After total hip arthroplasty (THA), dual-energy x-ray absorptiometry (DXA) is used as necessary to assess the bone mineral density (BMD) in the Gruen zones around the femoral stem implants. Although periprosthetic BMD may serve as a potential indicator for evaluating stress adaptive remodelling and stem fixation, several factors can introduce measurement errors. Therefore, an automated method was applied using quantitative CT, verified for the total hip with correlation coefficient > 0.9, for BMD assessment in the Gruen zones. Methods This was a retrospective analysis of 71 hips from 58 participants (9 male and 49 female) who underwent THA using the same taper-wedge type stem. Preoperative and postoperative CT scans were acquired alongside DXA measurements of the Gruen zones. A deep-learning method was used to measure BMD in the Gruen zones from preoperative CT images by embedding the stem position information acquired from postoperative CT images through iterative closest point registration. CT images were rotated to the neutral position and were projected anteroposteriorly to generate a digitally reconstructed radiograph to measure the BMD at each zone (CT-aBMD). Correlations between CT-aBMD and DXA measurements were assessed for each zone. Results The correlations between CT-aBMD and DXA measurements for zones 1 to 7 were 0.924, 0.783, 0.817, 0.921, 0.731, 0.847, and 0.677, respectively (p < 0.001 for all). Conclusion Our results based on CT analysis suggest that DXA is generally reliable for assessing BMD in the Gruen zones. However, caution may be advised for zones 5 and 7 because of limited correlations. As zone 7 plays a crucial role in stem fixation, during longitudinal evaluation of post-THA stress adaptive remodelling, we recommend ensuring cautious interpretation and consistent BMD measurements using the image attached to the DXA report. It is imperative to calculate the least significant change for accurate BMD evaluation.
出版者	British Editorial Society of Bone and Joint Surgery
収録物名	Bone and Joint Research
巻(号)	14(10)
ページ	850-859
刊行年月	2025-10-07
言語	英語
ハンドルURL	https://hdl.handle.net/11094/103666
eISSN	20463758
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Bone and Joint Research. 2025, 14(10), p. 850-859
DC.title	Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry
DC.creator	Uemura, Keisuke
	Otake, Yoshito
	Tamura, Kazunori
	Higuchi, Ryo
	Kono, Sotaro
	Mae, Hirokazu
	Takashima, Kazuma
	Okada, Seiji
	Sugano, Nobuhiko
	Hamada, Hidetoshi
DC.publisher	British Editorial Society of Bone and Joint Surgery
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-10-07
DC.identifier	https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1
DC.description	Uemura K., Otake Y., Tamura K., et al. Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry. Bone and Joint Research 14, 850 (2025); https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1.
DCTERMS.abstract	Aims After total hip arthroplasty (THA), dual-energy x-ray absorptiometry (DXA) is used as necessary to assess the bone mineral density (BMD) in the Gruen zones around the femoral stem implants. Although periprosthetic BMD may serve as a potential indicator for evaluating stress adaptive remodelling and stem fixation, several factors can introduce measurement errors. Therefore, an automated method was applied using quantitative CT, verified for the total hip with correlation coefficient > 0.9, for BMD assessment in the Gruen zones. Methods This was a retrospective analysis of 71 hips from 58 participants (9 male and 49 female) who underwent THA using the same taper-wedge type stem. Preoperative and postoperative CT scans were acquired alongside DXA measurements of the Gruen zones. A deep-learning method was used to measure BMD in the Gruen zones from preoperative CT images by embedding the stem position information acquired from postoperative CT images through iterative closest point registration. CT images were rotated to the neutral position and were projected anteroposteriorly to generate a digitally reconstructed radiograph to measure the BMD at each zone (CT-aBMD). Correlations between CT-aBMD and DXA measurements were assessed for each zone. Results The correlations between CT-aBMD and DXA measurements for zones 1 to 7 were 0.924, 0.783, 0.817, 0.921, 0.731, 0.847, and 0.677, respectively (p < 0.001 for all). Conclusion Our results based on CT analysis suggest that DXA is generally reliable for assessing BMD in the Gruen zones. However, caution may be advised for zones 5 and 7 because of limited correlations. As zone 7 plays a crucial role in stem fixation, during longitudinal evaluation of post-THA stress adaptive remodelling, we recommend ensuring cautious interpretation and consistent BMD measurements using the image attached to the DXA report. It is imperative to calculate the least significant change for accurate BMD evaluation.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	103666
citation_title	Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry
citation_author	Uemura, Keisuke
	Otake, Yoshito
	Tamura, Kazunori
	Higuchi, Ryo
	Kono, Sotaro
	Mae, Hirokazu
	Takashima, Kazuma
	Okada, Seiji
	Sugano, Nobuhiko
	Hamada, Hidetoshi
citation_publisher	British Editorial Society of Bone and Joint Surgery
citation_language	英語
citation_date	2025-10-07
citation_journal_title	Bone and Joint Research
citation_volume	14
citation_issue	10
citation_firstpage	850
citation_lastpage	859
citation_doi	https://doi.org/10.1302/2046-3758.1410.BJR-2025-0036.R1
citation_public_url	https://hdl.handle.net/11094/103666

Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry

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