. Trabecular bone score (TBS) is a newly developed index for assessing trabecular bone quality and fracture risk. In fact, when TBS, aBMD, and measurements of trabecular microstructure by μCT were assessed at the same bony region, correlations of aBMD and TBS with BV/TV, Tb.N, Tb.Sp, and connectivity density were similar (13). TBS, a measurement technology readily available by DXA, shows promise in the clinical assessment of trabecular microstructure in PHPT. Curr Osteoporos Rep 9(3):112–115 . The discrepant observations by histomorphometric analysis of bone biopsy samples vis-à-vis fracture incidence in this disease suggest that HRpQCT and now TBS might be more clinically pertinent to fracture risk in PHPT. Trabecular bone score (TBS) is a texture index derived from standard lumbar spine dual energy X-ray absorptiometry (DXA) images and provides information about the underlying bone independent of the bone mineral density (BMD). A study on bone mass density using dual energy X-ray absorptiometry: Does high body mass index have protective effect on bone density in obese patients. In the milder form of primary hyperparathyroidism (PHPT), cancellous bone, represented by areal bone mineral density at the lumbar spine by dual-energy x-ray absorptiometry (DXA), is preserved. TBS in PHPT was low at 1.24, representing abnormal trabecular microstructure (normal ≥1.35). TBS and aBMD together better predicted the variability in these HRpQCT indices and whole bone stiffness than either one alone (Table 3). It was proposed to be easily used in everyday practice as a surrogate of bone strength. It was proposed to be easily used in everyday practice as a surrogate of bone strength. . The correlation of TBS with HRpQCT indices, mechanical parameters, and DXA measurements was assessed by the Pearson correlation test. Moreover, our results demonstrate that TBS has the potential to identify subjects with PHPT with abnormalities in trabecular bone not captured by lumbar spine aBMD. Trabecular bone score (TBS), as a tool for measurement of bone microarchitecture, represents fracture risk independently of bone density. . . National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Bilezikian JP , Brandi ML , Rubin M , Silverberg SJ. Trabecular bone score (TBS) is an indirect measure of bone microarchitecture that is derived from a textural analysis of pixel gray level variations in dual-energy X-ray absorptiometry (DXA) images of the lumbar vertebrae . Our aim was to assess TBS in children with inflammatory bowel diseases and to evaluate correlations with clinical, laboratory and densitometric variables. Likewise, although our results showed positive relationships between TBS and whole bone stiffness at the radius and tibia, no significant correlations between TBS and trabecular stiffness were observed either at the radius or at the tibia, even after adjustment for body weight. Although the lumbar spine and tibia are both load-bearing sites, they are subjected to different loading forces, which might explain this observation. Therefore, this cross‐sectional study investigated the association between TBS and severe periodontitis. In contrast, Boutroy et al (21) found significant correlations between TBS and L1–L4 aBMD (r = 0.58; P < .001) in 560 women from the OFELY cohort. Whereas HRpQCT has added a dimension of insight not previously seen with regard to trabecular bone in PHPT, HRpQCT is not widely available and remains so far a research tool. 2020 Jan 20;25:4. doi: 10.4103/jrms.JRMS_1066_18. The mean value of the individual measurements for L1–L4 represents the lumbar spine TBS (unitless). . Trabecular bone score (TBS) uses standard lumbar spine DXA imaging to assess bone texture inhomogeneity (that is, the number of filled versus unfilled voxels) in order to gauge bone quality and fracture risk. Significant correlations between TBS and HRpQCT indices demonstrated here indicate that TBS may serve as a valuable additional index in the assessment of skeletal microstructure in PHPT. Carter S, Lories RJ (2011) Osteoporosis: a paradox in ankylosing spondylitis. The findings of the study suggest a different role of t rabecular and cortical volumetric BMD on coronary artery calcification risk, mainly in women.. Therefore, this cross‐sectional study investigated the association between TBS and severe periodontitis. Finally, Boutroy et al (21) showed that TBS predicts osteoporotic fracture as well as lumbar spine aBMD and that TBS helps to define a subset of nonosteoporotic women at high risk for fracture. Results: Low BMD was detected in 19.2% of the surveyed patients with T1DM and 6.5% of … To this end, our aim was to assess TBS from spine DXA images in postmenopausal women with PHPT and to correlate it, for the first time, with HRpQCT measurements of volumetric bone density, skeletal microarchitecture, and bone stiffness. The trabecular bone score (TBS) is a gray‐level textural metric that can be extracted from the two‐dimensional lumbar spine dual‐energy X‐ray absorptiometry (DXA) image. 2017. It is a simple, rapid and reproducible method that seamlessly integrates into your workflow and estimates fracture risk based on determination of bone texture. This is the first clinical study to report significant correlations between TBS and direct measurements of trabecular microstructure by HRpQCT. Exclusion criteria included bisphosphonate or glucocorticoid use within the past 2 years, a history of Cushing syndrome, uncontrolled thyroid disease, malabsorption syndrome, significant liver disease, creatinine clearance <30 mL/min, and any chronic disorders of mineral metabolism such as Paget disease or osteogenesis imperfecta. Nevertheless, there may be a tendency for higher correlations between these 2 indices when Hologic scanners (21, 42) as opposed to GE Lunar DXA devices (20, 43) are used. The addition of weight in the model increased the total variance in HRpQCT measurements, and TBS was no longer distinctly associated with HRpQCT indices when body weight was included in the analyses. The Trabecular Bone Score is a newly developed test of your bone structure that is complementary to standard bone density testing. Thangavelu T, Silverman E, Akhter MP, Lyden E, Recker RR, Graeff-Armas LA. Z–score of −2.0 or less was regarded as «low bone mineral density». To ensure comparability with previous TBS studies, calibration of the DXA instrument at CUMC was performed using a TBS-specific phantom (medimaps). . It is a textural index that evaluates pixel gray-level variations in the lumbar spine DXA (dual energy X-ray absorptiometry) image. These results also need to be followed up with a larger number of patients along with 2 groups of hyperparathyroid subjects we have yet to study, namely men and premenopausal women. Trabecular bone score (TBS) is a texture parameter related to bone microarchitecture that provides skeletal information that is not captured from the BMD measurement 2. Methods . NLM Trabecular Bone Score (TBS) shows great value in improving fracture risk prediction of primary and secondary osteoporosis within daily clinical routine in conjunction with DXA BMD.That is particularly true with diseases in Endocrinology such as Diabetes, Acromegaly, Chronic Kidney Disease (CKD), and Hyperparathyroidism.. Trabecular Bone Score (TBS) in Chronic Kidney Disease (CKD): Because of the relatively small number of subjects, we could not evaluate any association between TBS and fracture risk in PHPT. Dusceac said trabecular bone score correlated with lumbar spine BMD in hemodialysis patients (r=0.382; P = .001) and controls (r=0.36; P = .002) … 2020 Aug;137:115451. doi: 10.1016/j.bone.2020.115451. Likewise, Romagnoli et al (42) recently showed that TBS values were lower in subjects with mild PHPT than in aged-matched healthy control subjects, despite similar lumbar spine aBMDs by DXA (42). Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by hypercalcemia and elevated or inappropriately normal levels of PTH. Trabecular bone score (TBS), a gray‐level texture measure derived from lumbar spine (LS) dual‐energy X‐ray absorptiometry (DXA) images, improves fracture risk prediction beyond that provided by the combination of bone mineral density (BMD) by DXA and clinical risk factors. NIH At the tibia, correlations were observed between TBS and volumetric densities, cortical thickness, trabecular bone volume, and whole bone stiffness. Perimenopausal women with higher baseline levels of serum bone turnover markers and a lower trabecular bone score are at increased risk for presenting with osteopenia or osteoporosis at 5 … Stein EM , Liu XS , Nickolas TL , et al. . Boutroy S , Van Rietbergen B , Sornay-Rendu E , Munoz F , Bouxsein ML , Delmas PD. Despite the fact that TBS estimates trabecular microarchitecture, our results also revealed positive correlations between TBS and Ct.vBMD and Ct.Th at the radius and tibia. TBS has the major clinical advantage of being readily available from images of DXA, a test routinely performed in PHPT. The Parathyroid Epidemiology and Audit Research Study (PEARS), Fractures in patients with primary hyperparathyroidism: nationwide follow-up study of 1201 patients, Correlations between grey-level variations in 2D projection images (TBS) and 3D microarchitecture: applications in the study of human trabecular bone microarchitecture, Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae, The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex-vivo study [published online March 2013], Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study, A multicentre, retrospective case-control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): analysing the odds of vertebral fracture, A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture, Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? A Menopause Strategies-Finding Lasting Answers for Symptoms and Health (MsFLASH) Investigation of Self-Reported Menopausal Palpitation Distress. 2017 Dec;24(6):402-410. doi: 10.1097/MED.0000000000000365. Trabecular bone score (TBS) is a texture index derived from standard lumbar spine dual energy X-ray absorptiometry (DXA) images and provides information about the underlying bone independent of the bone mineral density (BMD). This finding is not surprising, because cortical and trabecular compartments are both affected in PHPT, leading to strong correlations between measurements of trabecular and cortical microarchitecture and density, even among HRpQCT indices (eg, correlation between Tb.N and Ct.Th at the radius: r = 0.667; P = .001). Stein EM , Silva BC , Boutroy S , et al. Trabecular bone score (TBS; expressed as Z-scores) in control subjects and in all patients with primary hyperparathyroidism (PHPT) at baseline, in 20 surgically treated patients with PHPT at baseline and after a 24-month follow-up and in 10 conservatively followed up patients with PHPT at baseline and after 24 months. TBS measurements were performed in the Bone Disease Unit at the University of Lausanne (Lausanne, Switzerland), using deidentified spine DXA files from scans obtained at CUMC. Med. Yun HJ, Ryoo SR, Kim JE, Choi YJ, Park I, Shin GT, Kim H, Jeong JC. However, part of this correlation was partially confounded with age. Romagnoli E , Cipriani C , Nofroni I , et al. . Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. Leslie WD, Shevroja E, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D. Osteoporos Int. Volumetric bone mineral density (vBMD) and microarchitecture were measured at the nondominant distal radius and tibia using the HRpQCT system (voxel size 82 μm, XtremeCT; Scanco Medical AG, Brüttisellen, Switzerland) at CUMC, as described previously (24). Patients with MGUS have increased cortical porosity and decreased bone strength as measured by HRpQCT imaging. TBS iNsight est dérivé de l’évaluation du variogramme, expérimentale, obtenue à partir des niveaux de gris de l’ image DXA . Chatswood Densitometry, with our partner site at St Vincents Clinic, were first to introduce TBS to Australia. For each finite element model, a uniaxial compression test was performed with displacement equivalent to 1% apparent strain to calculate stiffness. 2020 Jul 25;21(1):299. doi: 10.1186/s12882-020-01944-0. FEA was performed to estimate whole bone and trabecular stiffness by converting whole bone and trabecular HRpQCT images into finite element models. Wang R, Ward MM (2018) Epidemiology of axial spondyloarthritis: an update. Shevroja E, Lamy O, Kohlmeier L, Koromani F, Rivadeneira F, Hans D. J Clin Densitom. Roux JP , Wegrzyn J , Boutroy S , Bouxsein M , Hans D , Chapurlat R. Pothuaud L , Barthe N , Krieg MA , Mehsen N , Carceller P , Hans D. Rabier B , Heraud A , Grand-Lenoir C , Winzenrieth R , Hans D. Winzenrieth R , Dufour R , Pothuaud L , Hans D. Del Rio LM , Winzenrieth R , Cormier C , Di Gregorio S. Popp A , Meer S , Krieg MA , Perrelet R , Hans D , Lippuner K. Hans D , Goertzen AL , Krieg MA , Leslie WD. In contrast, the trabecular bone score is a novel and widely available tool that uses gray-scale variograms of the spine image from dual-energy x-ray absorptiometry to assess trabecular quality. For example, two Citation: Ruaro B, Casabella A, Paolino S, Alessandri E, Patané M, Gotelli E, Sulli A and Cutolo M (2020) Trabecular Bone Score and Bone Quality in Systemic Lupus Erythematosus Patients. Trabecular bone, also called cancellous bone, is porous bone composed of trabeculated bone tissue. Hawkins Carranza F, Guadalix Iglesias S, De Mingo Dominguez ML, Allo Miguel G, Arroba CM, Alvares BL, Martínez Diaz-Guerra G. Med Sci (Basel). The purpose of this study was to assess TBS from spine DXA images in relation to HRpQCT indices and bone stiffness in radius and tibia in PHPT. Risk-equivalent T-score adjustment for using lumbar spine trabecular bone score (TBS): the Manitoba BMD registry. Patients with type 2 diabetes have an increased risk of fracture despite having a higher areal bone mineral density. The trabecular bone score (TBS) a grayscale measurement of texture which is derived from the evaluation of the experimental variogram obtained from the Dual-energy X-ray Absorptiometry (DXA) images, is a relatively new tool to evaluate bone microarchitecture . Bone tissue was assumed to have an isotropic linear material property with a Young modulus of 15 GPa and a Poisson ratio of 0.3. Linear regression analyses, without and with adjustment for weight, were applied to estimate the variability in HRpQCT and biomechanical parameters when TBS, aBMD at the lumbar spine, or the combination of both was used as the explanatory variable. Subjects were eligible for inclusion if they had well-characterized PHPT (elevated serum calcium and elevated or inappropriately normal PTH levels). Parisien M , Cosman F , Mellish RW , et al. The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. Using cutoff points previously reported as having the best sensitivity and specificity in terms of fracture risk (19–23), we showed that 36% of patients with PHPT had degraded microarchitecture (TBS ≤1.20), an additional 36% had partially degraded microarchitecture (TBS >1.20 and <1.35), and only 27% had normal TBS values (TBS ≥1.35). When TBS is combined with bone density testing, we learn more about your bone health than with bone density testing alone. Site-matched spine TBS parameters were extracted from the DXA image using TBS iNsight software (version 1.9; medimaps, Geneva, Switzerland). Image analysis has been validated and detailed elsewhere (24–27). TBS correlated with all indices of trabecular microarchitecture, except trabecular thickness, after adjustment for body weight. The aim of this study was to estimate the reference values of TBS in both genders among the Iranian population to evaluate osteoporotic fractures in the future. This meta-analysis showed that compared with controls, diabetic patients had a lower trabecular bone score (TBS) than non-diabetic individuals, suggesting that TBS can be a useful measurement for the assessment of fracture risk in diabetic patients. Please enable it to take advantage of the complete set of features! The Relationship between Health Status and Social Activity of Perimenopausal and Postmenopausal Women (Health Status and Social Relationships in Menopause). It is a texture measurement that quantifies local variations in gray level distribution from dual-energy X-ray Absorptiometry (DXA) and is significantly correlated with three dimensional parameters of bone microarchitecture, independently of aBMD , , , . In contrast to 72% of patients with PHPT showing degraded or partially degraded microarchitecture by TBS, only 46% were classified as osteopenic or osteoporotic by lumbar spine T-score. Rubin MR , Bilezikian JP , McMahon DJ , et al. The normal range for serum calcium is 8.6 to 10.2 mg/dL and for serum PTH is 14 to 66 pg/mL. Although we have not assessed differences in TBS in patients with PHPT with or without fracture, we did show positive correlations between TBS and whole bone stiffness at the radius (r = 0.442; P = .04) and at the tibia (r = 0.516; P = .02) as measured by FEA of HRpQCT images. TBS iNsight est dérivé de l’évaluation du variogramme, expérimentale, obtenue à partir des niveaux de gris de l’ image DXA .  |  Women were considered postmenopausal if they had not had a menstrual period for more than 1 year. Standard bone density measurement is used to calculate and classify a patient’s risk for experiencing fracture(s), as high, moderate or low risk. Trabecular Bone Score: A New DXA-Derived Measurement for Fracture Risk Assessment. Bone mineral density was expressed in grams per square centimeter and in T-score unitage. It was developed to reflect bone microarchitecture. Attention: TBS values are accurate only for patients (women and men) with a BMI in the range [15 – 37 kg/m²] Individuals with fracture risk assessed since April 15, 2015 . A 3-year study, Trabecular bone score (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism, Effects of anti-resorptive agents on trabecular bone score (TBS) in older women, Copyright © 2013 by The Endocrine Society, Slit2 regulation of hyaluronan & cytokine synthesis in fibrocytes in thyroid associated ophthalmopathy, Testosterone Replacement Therapy added to Intensive Lifestyle Intervention in Older Men with Obesity and Hypogonadism, Anti-Müllerian hormone levels in adolescence in relation to long-term follow-up for presence of polycystic ovary syndrome, Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy, Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning, The Journal of Clinical Endocrinology & Metabolism, About The Journal of Clinical Endocrinology & Metabolism, Receive exclusive offers and updates from Oxford Academic, Abnormalities in Cortical Bone, Trabecular Plates, and Stiffness in Postmenopausal Women Treated With Glucocorticoids, Bariatric Surgery Results in Cortical Bone Loss, TBS (Trabecular Bone Score) and Diabetes-Related Fracture Risk. The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. Use of Trabecular Bone Score (TBS) as a Complementary Approach to Dual-energy X-ray Absorptiometry (DXA) for Fracture Risk Assessment in Clinical Practice. With significant correlations between TBS and volumetric and microstructural indices, as well as biomechanical measurements by HRpQCT, a method that has greater resolving power but is not widely accessible, TBS could become a helpful clinical tool in the assessment of skeletal involvement in PHPT. Keywords: osteoporosis, trabecular bone score (TBS), bone mineral density (BMD), autoimmune diseases (AD), bone loss. Trabecular bone score (TBS), a novel tool in the evaluation of osteoporosis is an indirect indicator of bone microarchitecture. The Trabecular Bone Score (TBS), a novel gray-scale textural analysis of spine DXA images, provides a quantitative estimate of trabecular microarchitecture using variograms of 2D projection images . It is an index of bone microarchitecture that provides skeletal information complementary to that obtained from standard bone mineral density (BMD) measurement. Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. Whereas overt skeletal disease, formerly a common finding, is rarely seen now, dual-energy X-ray absorptiometry (DXA) routinely detects evidence for skeletal involvement. There are no studies assessing whether trabecular bone score characterizes bone quality in kidney transplant recipients. The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to bone microarchitecture and fracture risk. TBS® performs a gray level analysis (textures) on the DEXA images to determine bone integrity. Baseline characteristics of 22 postmenopausal women with PHPT are described in Table 1. Cheng X, Yuan H, Cheng J, Weng X, Xu H, Gao J, Huang M, Wáng YXJ, Wu Y, Xu W, Liu L, Liu H, Huang C, Jin Z, Tian W; Bone and Joint Group of Chinese Society of Radiology, Chinese Medical Association (CMA), Musculoskeletal Radiology Society of Chinese Medical Doctors Association, Osteoporosis Group of Chinese Orthopedic Association, Bone Density Group of Chinese Society of Imaging Technology, CMA*. By HRpQCT, both trabecular and cortical compartments are abnormal at the radius and tibia in postmenopausal women with PHPT. Trabecular Bone Score (TBS®) by Medimaps is a fracture risk predictor using DEXA as a source. Front. In this article, we review the development, validation, clinical application, and limitations of TBS. In this study, the researchers aimed to evaluate the association between TBS and new bone formation independently of fatty lesions on spinal MRI, both … Shayganfar A, Ebrahimian S, Masjedi M, Daryaei S. J Res Med Sci. This work was supported by the National Institutes of Health (Grants R01 DK32333 and R01 AR051376) and by the Brazilian National Council of Technological and Scientific Development (to B.C.S.). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Krueger D., Fidler E., Libber J., Aubry-Rozier B, Hans D, Binkley N. Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. Breban S , Briot K , Kolta S , et al. Correlations between TBS and aBMD at the lumbar spine (r = 0.367), total hip (r = 0.269), and femoral neck (r = 0.350) were not significant, but significant correlations were found between TBS and aBMD at the one-third radius (r = 0.427; P = .047) and UD radius (r = 0.450; P = .036). Differences in the quality of trabecular bone can also be recognized when HRpQCT findings are compared with histomorphometric and μCT analyses of iliac crest bone biopsy samples in PHPT. Trabecular bone score (TBS) is a novel gray-level textural analysis that can be applied to DXA images to estimate trabecular microarchitecture and has been shown to be related to direct measures of bone microarchitecture and fracture risk (12). BMC Nephrol. The average creatinine clearance was normal at 77.7 mL/min per 1.73 m2. Reduced bone stiffness assessed by FEA of HRpQCT images (36, 37), as well as low TBS (15–17, 19–21), has been associated with fragility fractures in postmenopausal women. Our study has important strengths. TBS is important because about one-half of people who break bones do not have a bone density that is classified as osteoporosis. Prevalence of subjects with osteoporosis, osteopenia, or normal aBMD at the lumbar spine by DXA (A) and degraded microarchitecture (TBS ≤1.2), partially degraded microarchitecture (TBS >1.2 and <1.35), and normal TBS at the lumbar spine (TBS ≥1.35) (B).  |  Copyright © 2017 Elsevier Inc. All rights reserved. The Trabecular Bone Score (TBS), a novel gray-scale textural analysis of spine DXA images, provides a quantitative estimate of trabecular microarchitecture using variograms of 2D projection images . It was developed to reflect bone microarchitecture. Quant Imaging Med Surg. HHS In addition to predicting fracture risk in primary osteoporosis and healthy subjects, TBS has also been shown to predict fracture in individuals with secondary osteoporosis related to several diseases, such as diabetes, rheumatoid arthritis, and subclinical hypercortisolism (38–40). Serum total calcium (normal, 8.4–10.2 mg/dL) and albumin were measured using standard methods (Quest Diagnostics, Madison, New Jersey), and calcium values were corrected for albumin concentration <4 g/dL. Citation: Ruaro B, Casabella A, Paolino S, Alessandri E, Patané M, Gotelli E, Sulli A and Cutolo M (2020) Trabecular Bone Score and Bone Quality in Systemic Lupus Erythematosus Patients. Keywords: Twenty-two postmenopausal women with PHPT were recruited from Columbia University Medical Center (CUMC). Likewise, trabecular bone stiffness characterizes the mechanical competence of the trabecular bone compartment. Outcomes measured were areal bone mineral density by DXA, TBS indices derived from DXA images, HRpQCT standard measures, and bone stiffness assessed by finite element analysis at distal radius and tibia. Red bone marrow, where all the blood cells are made, fills the space between the trabecular pores. Cohen et al (34) have also found modest or no correlations between microarchitecture parameters as assessed by HRpQCT of the radius and tibia and histomorphometry and μCT of iliac crest biopsy samples. Cohen A , Dempster DW , Muller R , et al. With the advent of the multichannel autoanalyzer in the early 1970s, the clinical presentation of PHPT changed from symptomatic (1) to asymptomatic (2–4). Significant correlations between TBS and 3D direct measurements of trabecular microstructure were previously observed in human cadaver bone specimens (vertebrae, femur, and radius) (12, 13). Results on Trabecular Bone Score (TBS) in these patients are lacking. TBS quantification is readily … Chinese expert consensus on the diagnosis of osteoporosis by imaging and bone mineral density. A TBS threshold of 1.200 has been used in numerous studies to identify patients at high risk of fracture. Because BMI is taken into account in the calculation of the TBS, part of the variability in HRpQCT measurements explained by TBS alone might depend on some interaction of TBS with weight. 1. Descriptive statistics are expressed as means ± SEM. Trabecular bone, also called cancellous bone, is porous bone composed of trabeculated bone tissue. The Trabecular Bone Score is a rather new index obtained at the lumbar spine at the same time as a real bone mineral density. Methods . The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. However, HRpQCT indices of trabecular microarchitecture and stiffness were better predicted by L1–L4 aBMD, and the combination of TBS and L1–L4 aBMD was only slightly better in predicting their variance. The other authors have nothing to disclose. Low trabecular bone score (TBS) is associated with new bone formation independent of fat metaplasia on spinal MRI in patients with ankylosing spondylitis (AS), according to study results published in Scandinavian Journal of Rheumatology.. Boutroy S , Hans D , Sornay-Rendu E , Vilayphiou N , Winzenrieth R , Chapurlat R. Lamy O , Krieg MA , Stoll D , Aubry-Rozier B , Metzger M , Hans D. Vasic J , Gojkovic F , Petranova T , et al. Yu N , Donnan PT , Flynn RW , Murphy MJ , Smith D , Rudman A , Leese GP. Boutroy S , Vilayphiou N , Roux JP , et al. Similarly, in the study of Boutroy et al (21), nonosteoporotic women whose TBS values were less than 1.209 (the first TBS quartile threshold) had a significant higher incidence of fragility fracture. These findings, however, are not consistent with recent observations using technologies that have greater resolving power than DXA, such as high-resolution peripheral quantitative computed tomography (HRpQCT) in which trabecular microarchitectural deficits are seen (6, 7). Boutroy S , Bouxsein ML , Munoz F , Delmas PD. The utility and limitations of using trabecular bone score with FRAX. Epub 2020 May 22. Trabecular Bone Score (TBS) Trabecular Bone Score (TBS) is measured from a lumbar spine DXA image and thus no extra scan is required. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Several salient observations have emerged. Using AP spine data obtained during routine DXA exams, TBS iNsight™ produces a clinically significant 1,2 fracture risk parameter. 3D-analysis of cortical and trabecular bone from hip DXA is a new method for non-invasive bone structure assessment, providing separate assessment of the cortical layer and trabecular macrostructure.