ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017
Operator variability in scan positioning is a major component of HR-pQCT precision error and is reduced by standardized training.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Article
- High-resolution peripheral quantitative computed tomography reliability and accuracy of bone density and morphology properties in children.JBMR plus · 2025Article
- Diabetes Risk Factors and Bone Microarchitecture as Assessed by High-Resolution Peripheral Quantitative Computed Tomography in Adults With Long-standing Type 1 Diabetes.Diabetes care · 2024Article
- Deep Convolutional Neural Networks Provide Motion Grading for High-Resolution Peripheral Quantitative Computed Tomography of the Scaphoid.Diagnostics (Basel, Switzerland) · 2024Article
- Microvascular disease not type 2 diabetes is associated with increased cortical porosity: A study of cortical bone microstructure and intracortical vessel characteristics.Bone reports · 2024Article
- Recommendations for High-resolution Peripheral Quantitative Computed Tomography Assessment of Bone Density, Microarchitecture, and Strength in Pediatric Populations.Current osteoporosis reports · 2023Review
- Validation of High-Resolution peripheral Quantitative Computed Tomography-Derived Achilles Tendon Properties Against Diagnostic Ultrasound.Journal of musculoskeletal & neuronal interactions · 2022Article
- Bone Microarchitecture and Strength in Long-Standing Type 1 Diabetes.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Cortical Bone Loss Following Gastric Bypass Surgery Is Not Primarily Endocortical.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Using 3D image registration to maximize the reproducibility of longitudinal bone strength assessment by HR-pQCT and finite element analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Longitudinal Evolution of Bone Microarchitecture and Bone Strength in Type 2 Diabetic Postmenopausal Women With and Without History of Fragility Fractures-A 5-Year Follow-Up Study Using High Resolution Peripheral Quantitative Computed Tomography.Frontiers in endocrinology · 2021Article
- Comparative Anesthesia Effect of Brachial Plexus Block Based on Smart Electronic Medical Ultrasound-Guided Positioning and Traditional Anatomical Positioning.Journal of healthcare engineering · 2021Article
- Longitudinal bone microarchitectural changes are best detected using image registration.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Guidelines for the assessment of bone density and microarchitecture in vivo using high-resolution peripheral quantitative computed tomography.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018Article
- Reliability of HR-pQCT Derived Cortical Bone Structural Parameters When Using Uncorrected Instead of Corrected Automatically Generated Endocortical Contours in a Cross-Sectional Study: The Maastricht Study.Calcified tissue international · 2018Observational
- Article
- Weight loss in men in late life and bone strength and microarchitecture: a prospective study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Article
- Effects of Gastric Bypass Surgery on Bone Mass and Microarchitecture Occur Early and Particularly Impact Postmenopausal Women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018Article
- Changes in the distributions of fluorine-18-labelled fluoro-2-deoxy-d-glucose accumulation into tongue-related muscles after dissection in patients with tongue cancer.Dento maxillo facial radiology · 2017Article
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19 authors.
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Abstract
In this study, we determined that operator positioning precision contributes significant measurement error in high-resolution peripheral quantitative computed tomography (HR-pQCT). Moreover, we developed software to quantify intra- and inter-operator variability and demonstrated that standard positioning training (now available as a web-based application) can significantly reduce inter-operator variability.
introductionHR-pQCT is increasingly used to assess bone quality, fracture risk, and anti-fracture interventions. The contribution of the operator has not been adequately accounted in measurement precision. Operators acquire a 2D projection ("scout view image") and define the region to be scanned by positioning a "reference line" on a standard anatomical landmark. In this study, we (i) evaluated the contribution of positioning variability to in vivo measurement precision, (ii) measured intra- and inter-operator positioning variability, and (iii) tested if custom training software led to superior reproducibility in new operators compared to experienced operators.
methodsTo evaluate the operator in vivo measurement precision, we compared precision errors calculated in 64 co-registered and non-co-registered scan-rescan images. To quantify operator variability, we developed software that simulates the positioning process of the scanner's software. Eight experienced operators positioned reference lines on scout view images designed to test intra- and inter-operator reproducibility. Finally, we developed modules for training and evaluation of reference line positioning. We enrolled six new operators to participate in a common training, followed by the same reproducibility experiments performed by the experienced group.
resultsIn vivo precision errors were up to threefold greater (Tt.BMD and Ct.Th) when variability in scan positioning was included. The inter-operator precision errors were significantly greater than the short-term intra-operator precision (p < 0.001). New trained operators achieved comparable intra-operator reproducibility to experienced operators and lower inter-operator reproducibility (p < 0.001). Precision errors were significantly greater for the radius than for the tibia.
conclusionOperator reference line positioning contributes significantly to in vivo measurement precision and is significantly greater for multi-operator datasets. Inter-operator variability can be significantly reduced using a systematic training platform, now available online ( http://webapps.radiology.ucsf.edu/refline/ ).
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