3D Imaging Bone Quality: Bench to Bedside

Abstract Introduction Measuring the health of bone is important for understanding the pathogenesis, progression, diagnosis and treatment outcomes for fragility. At present the most common method for measuring bone health in a clinical setting is to assess skeletal mass. The current gold standard is dualenergy X-ray absorptiometry (DXA) which models bones as 2D objects and measures areal bone mineral density (BMD). However, BMD only accounts for 50% of bone strength and the technique ignores other important factors such as cortical geometry and trabecular architecture, which are also significant contributors. Consequently a new concept of ‘bone quality’ has developed the material and structural basis of bone strength and fragility. As yet though, a suitable non-invasive method has not been developed for measuring quality in living patients. The aim of this paper is to discuss how bone quality might be visualised, quantified and applied in a clinical setting. Discussion The most useful imaging techniques are likely to be clinical-CT and MRI. Both modalities have been used successfully to characterise bone macro-structure in 3D e.g. volume fraction and orientation. More recently in vivo systems with high 3D Imaging Bone Quality: Bench to Bedside