ArticlePloS one2020
Artificial neural network analysis of bone quality DXA parameters response to teriparatide in fractured osteoporotic patients.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Artificial intelligence for predicting the risk of bone fragility fractures in osteoporosis.European radiology experimental · 2025Review
- Application of artificial intelligence in osteoporosis: a review.Frontiers in medicine · 2025Review
- DXA-derived lumbar bone strain index corrected for kyphosis is associated with vertebral fractures and trabecular bone score in acromegaly.Endocrine · 2024Article
- DXA beyond bone mineral density and the REMS technique: new insights for current radiologists practice.La Radiologia medica · 2024Review
- Generation and Validation of Normative, Age-Specific Reference Curves for Bone Strain Index in Women.Diagnostics (Basel, Switzerland) · 2024Article
- Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study.Bone reports · 2023Article
- New Horizons: Artificial Intelligence Tools for Managing Osteoporosis.The Journal of clinical endocrinology and metabolism · 2023Article
- Bone Strain Index: preliminary distributional characteristics in a population of women with normal bone mass, osteopenia and osteoporosis.La Radiologia medica · 2022Article
- Osteosarcopenia-The Role of Dual-Energy X-ray Absorptiometry (DXA) in Diagnostics.Journal of clinical medicine · 2022Review
- The Bone Strain Index: An Innovative Dual X-ray Absorptiometry Bone Strength Index and Its Helpfulness in Clinical Medicine.Journal of clinical medicine · 2022Review
- Bone Strain Index predicts fragility fracture in osteoporotic women: an artificial intelligence-based study.European radiology experimental · 2021Article
- DXA-Based Bone Strain Index: A New Tool to Evaluate Bone Quality in Primary Hyperparathyroidism.The Journal of clinical endocrinology and metabolism · 2021Article
- Bone strain index as a predictor of further vertebral fracture in osteoporotic women: An artificial intelligence-based analysis.PloS one · 2021Article
- Prediction of osteoporotic fragility re-fracture with lumbar spine DXA-based derived bone strain index: a multicenter validation study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index.Frontiers in medicine · 2020Review
- Hip Structural Analysis and Bone Strain Index in Clinical Practice: Their Utility Beyond BMD.Indian journal of endocrinology and metabolismReview
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Teriparatide is a bone-forming therapy for osteoporosis that increases bone quantity and texture, with uncertain action on bone geometry. No data are available regarding its influence on bone strain. To investigate teriparatide action on parameters of bone quantity and quality and on Bone Strain Index (BSI), also derived from DXA lumbar scan, based on the mathematical model finite element method. Forty osteoporotic patients with fractures were studied before and after two years of daily subcutaneous 20 mcg of teriparatide with dual X-ray photon absorptiometry to assess bone mineral density (BMD), hip structural analysis (HSA), trabecular bone score (TBS), BSI. Spine deformity index (SDI) was calculated from spine X-ray. Shapiro-Wilks, Wilcoxon and Student's t test were used for classical statistical analysis. Auto Contractive Map was used for Artificial Neural Network Analysis (ANNs). In the entire population, the ameliorations after therapy regarded BSI (-13.9%), TBS (5.08%), BMD (8.36%). HSA parameters of femoral shaft showed a worsening. Dividing patients into responders (BMD increase >10%) and non-responders, the first presented TBS and BSI ameliorations (11.87% and -25.46%, respectively). Non-responders presented an amelioration of BSI only, but less than in the other subgroup (-6.57%). ANNs maps reflect the mentioned bone quality improvements. Teriparatide appears to ameliorate not only BMD and TBS, but also BSI, suggesting an increase of bone strength that may explain the known reduction in fracture risk, not simply justified by BMD increase. BSI appears to be a sensitive index of TPD effect. ANNs appears to be a valid tool to investigate complex clinical systems.
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