Best Performance Parameters of HR‐pQCT to Predict Fragility Fracture: Systematic Review and Meta‐Analysis
Abstract
Osteoporosis is a systemic skeletal disease characterized by low bone mass and bone structural deterioration that may result in fragility fractures. Use of bone imaging modalities to accurately predict fragility fractures is always an important issue, yet the current gold standard of dual‐energy X‐ray absorptiometry (DXA) for diagnosis of osteoporosis cannot fully satisfy this purpose. The latest high‐resolution peripheral quantitative computed tomography (HR‐pQCT) is a three‐dimensional (3D) imaging device to measure not only volumetric bone density, but also the bone microarchitecture in a noninvasive manner that may provide a better fracture prediction power. This systematic review and meta‐analysis was designed to investigate which HR‐pQCT parameters at the distal radius and/or distal tibia could best predict fragility fractures. A systematic literature search was conducted in Embase, PubMed, and Web of Science with relevant keywords by two independent reviewers. Original clinical studies using HR‐pQCT to predict fragility fractures with available full text in English were included. Information was extracted from the included studies for further review. In total, 25 articles were included for the systematic review, and 16 articles for meta‐analysis. HR‐pQCT was shown to significantly predict incident fractures and/or major osteoporotic fractures (MOFs). Of all the HR‐pQCT parameters, our meta‐analysis revealed that cortical volumetric bone mineral density (Ct.vBMD),…
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Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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