ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Cone beam computed tomography reveals altered trabecular bone structure in acromegaly
Andrea Giustina 1 , Gherardo Mazziotti 1 , Michele Maddalo 2 , Filippo Maffezzoni 1 , Stefano Frara 1 , Ivan Zorza 2 , Pierantonio Soldini 2 , Francesco Doglietto 3 & Roberto Maroldi 2
1Endocrinology, University of Brescia, Brescia, Italy; 2Radiology, University of Brescia, Brescia, Italy; 3Neurosurgery, University of Brescia, Brescia, Italy.
Over the last years, there has been evidence that acromegaly may cause skeletal fragility with high risk of vertebral fractures. The diagnostic approach to this complication is still a matter of uncertainty, since DXA measurement of bone mineral density (BMD) does not provide reliable information on fracture risk in acromegaly. The cone beam computed tomography (CBCT) technique offers three-dimensional images for the radiographed area with the advantage to use non-dedicated equipments as compared to the peripheral Quantitative Computed Tomography. The aim of this study was to investigate whether a non-dedicated CBCT system may provide information on the skeletal abnormalities caused by acromegaly. Twenty-two patients with acromegaly (12 females, ten males; mean age 62 years, range 25–72) and 16 healthy control subjects (six females and ten males; mean age 59 years, range 25–68) were studied using high resolution CBCT system (Newtom 5G; QR, Verona, Italy) at the distal radius. All acromegaly patients were also evaluated for DXA BMD at lumbar spine, total hip, femoral neck and distal radius. Patients with acromegaly showed lower trabecular bone volume fraction (BV/TV) (P=0.001) and mean trabecular thickness (Th.mean) (P=0.001) and greater mean trabecular separation (Sp.mean) (P=0.01), without significant difference in cortical thickness (P=0.47) as compared to the control subjects. In acromegaly patients, the duration of active disease significantly correlated with BV/TV (r: −0.69; P=0.001), Th.mean (r: −0.46; P=0.05) and Sp.mean (r: 0.47; P=0.04). In acromegaly patients, the BMD at distal radius significantly correlated with cortical thickness (r=0.56; P=0.007), whereas the BMD at either skeletal site was not significantly correlated with the trabecular parameters. In acromegaly patients, the distal radius CBCT reveals significant alterations of physiological trabecular bone structure which may be responsible for their high risk of fragility fractures even in the presence of normal BMD.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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