Osteoporosis Imaging Research Group
Department of Diagnostic and Interventional Radiology
Technische Universität München
Klinikum rechts der Isar
Ismaningerstr. 22, 81675 München
Phone: +49 (0) 89 4140 2621
E-mail: see Group Members
Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Bone strength primarily reflects the integration of bone density and bone quality. Bone quality refers to architecture, turnover, damage accumulation (eg, microfractures), and mineralization .
Hip, vertebral, and wrist fractures are the most common types of osteoporosis associated fractures (Figure 1). Osteoporotic fractures are associated with a reduced quality of life and especially osteoporotic vertebral and hip fractures with an increased mortality. The incidence of osteoporotic fractures and its consequential health care costs rise globally.
Figure 1: Sagittal reformation of routine abdominal MDCT with osteoporotic vertebral fracture of L1 (marked by an arrow).
Assessment of clinical risk factors and measurement of bone mineral density (BMD) are used to identify patients at high risk of osteoporotic fractures and to initiate appropriate therapy. BMD is obtained by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). The World Health Organization (WHO) operationally defines osteoporosis in postmenopausal women as BMD 2.5 SDs (T-score) below the mean for young adult women . This definition is based on DXA measurements of BMD at the lumbar spine and/ or the proximal femur.
However, this definition is problematic. Schuit et al. demonstrated in the Rotterdam-Study that only 44% of all non-vertebral fractures occurred in women with a T-score below 2.5; in men, this percentage was even lower (21%) . Thus, there is a clear need for the development of more sensitive risk assessment tools, using not only BMD, but also other predictors of fractures including parameters measuring bone quality. Using such an approach, those subjects who are at increased risk for fractures could be more accurately identified.
The Osteoporosis research group at the Section of Neuroradiology and the Department of Radiology at the Technical University Munich is focusing on the development and advancement of imaging modalities and image analysis methods, which improve the prediction of biomechanical bone strength and fracture risk. Such imaging modalities are Magnetic Resonance Imaging (MRI), multi-detector computed tomography (MDCT), high resolution peripheral quantitative computed tomography (hr-pQCT), and dark field imaging . Using these acquired image data, trabecular bone structure analysis (Figure 2), measurements of cortical bone properties, Finite Element Modeling (FEM), or bone marrow fat quantifications can be performed. Interdisciplinary collaborations with physicists and engineers working at different institutions were set up for these research purposes.
Figure 2: Micro-CT of trabecular bone cube with colour-coded visualization of a trabecular bone structure parameter (scaling index α).
(1) NIH Consensus Development Panel. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285(6):785-795.
(2) WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994; 843:1-129.
(3) Schuit SC, van der KM, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 2004; 34(1):195-202.
(4) Baum T, Karampinos DC, Liebl H, Rummeny EJ, Waldt S, Bauer JS. High-resolution bone imaging for osteoporosis diagnostics and therapy monitoring using clinical MDCT and MRI. Curr Med Chem. 2013;20(38):4844-52.
Jan S. Kirschke (Bauer), MD (jan.kirschke (at) tum.de)
Thomas Baum, MD (thomas.baum (at) tum.de)
Alexandra Gersing, MD (alexandra.gersing (at) tum.de)
Benedikt Schwaiger, MD (benedikt.schwaiger (at) tum.de)
Alexander Valentinitsch, PhD (alexander.valentinitsch (at) tum.de)
Prof. Thomas M. Link, MD (Professor of Radiology, Section Chief Musculoskeletal Radiology, Clinical Director MQIR, Department of Radiology and Biomedical Imaging, University of California San Francisco)
Christoph Räth, PhD (DLR München)
Prof. Ernst Rank, PhD (Department of Civil Engineering and Geodesy, Chair of Computation in Engineering, Technische Universität München)
Prof. Franz Pfeiffer, PhD (Physics Department, Chair of Biomedical Physics (E17), Technische Universität München)
Prof. Subburaj Karupppasamy, PhD (Engineering Product Development Pillar, Singapore University of Technology and Design)
You can contact us directly, if you would like to work with us.
German Research Foundation: DFG BA 4085/2-1, DFG BA 4906/1-1, DFG BA 4085/1-2 and DFG MU 2288 2/2
Max-Planck-Society: Tandem-Projekt Verbesserung der Diagnose von Osteoporose