The CT scanner table height was set to the center of the greater trochanter. Patient data were evaluated with QCT-Pro software v4.1.3 with the QCT-Pro Bone Investigational Toolkit v2.0 (BIT) (Mindways Software,Austin,USA)
and also with Real Intage Lumacaftor mw visualization software (KGT,Tokyo,Japan) based on 3D DICOM data to provide fusion functions and several geometrical measurements. All measurements were analyzed by a radiologist (M. Ito) blinded to treatment group assignment. The exact 3D rotation of the femur and the threshold setting for defining the bone contours appeared to be the two most critical steps for achieving accuracy and reproducibility in the automated procedures performed by QCT-Pro. The outer cortical BMD thresholds had to be adapted individually for each scan. The femoral neck axis was identified visually and also automatically with the “Optimize FN Axis” algorithm. QCT-Pro
BIT processing was then performed with a fixed bone threshold for cortical separation set to 350 mg/cm3 for all patients and visits. This application was used to measure hip axis length (HAL), femoral neck angle (FNA), and neck width. vBMD, cross-sectional area (CSA), and cross-sectional bone mass of the femoral neck (total, cortical, and trabecular region), as well as cortical thickness and cortical perimeter were also measured. Trabecular parameters in each subject were calculated based on the total and cortical parameters. Biomechanical properties were also derived from the cross-sectional parameters of the femoral neck. This comprehensive image data visualization software based on 3D DICOM data selleck screening library provides fusion functions and several geometrical measurements. For bone analysis of the femoral shaft, this software was used for fusion of 3D images from baseline and images at 144 weeks to define the same regions of interest. The software was then used to measure the
outer perimeter, inner perimeter, bone area, cortical bone density, and cross-sectional moment of inertia (CSMI) of the femoral shaft. The cross-sectional femoral neck data were derived on the basis of the geometrical axis to calculate volumetric total BMD (total vBMD; mg/cm3), cortical Protirelin BMD (cortical vBMD; mg/cm3), trabecular BMD (trabecular vBMD; mg/cm3), total CSA (cm2), cortical CSA (cm2), trabecular CSA (cm2), total bone mass (g), cortical bone mass (g), and trabecular bone mass (g). Cortical thickness (mm) and cortical perimeter (mm) were also derived. These parameters were all calculated with QCT-Pro. Because biomechanical parameters were determined on the principal axis, the cross-sectional moment of inertia (CSMI; mm4), the section modulus (SM; mm3), and buckling ratio (BR) were calculated from bone density and geometrical data. The CSMI is defined by the integration of products of incremental cross-sectional area and the square of their distance from the center of mass (centroid).