Bone Reports (2018), https://doi.org/10.1016/j.bonr.2021.101103, 2021; PMID: 34377749

A systematic review and meta-analysis of pediatric normative peripheral quantitative computed tomography data

Year: 2021

M. Medeleanu, R. Vali, S. Sadeghpour,
Department of Physiology, Faculty of Medicine, University of Toronto Toronto, Ontario, Canada. Email: maria.medeleanu@mail

Abstract

Background: Peripheral-quantitative computed tomography (pQCT) provides an intriguing
diagnostic alternative to dual-energy X-ray absorptiometry (DXA) since it can measure 3D bone geometry and differentiates between the cortical and trabecular bone compartments.
Objective: To investigate and summarize the methods of image acquisition of pQCT data in
children, adolescents and/or young adults (up to 20 years) and to aggregate normative pQCT data in the literature.
Evidence Acquisition: A literature search was conducted in MEDLINE and EMBASE from
1947 to December 2020. Quality of the included articles were assessed using Standards for
Reporting of Diagnostic Accuracy (STARD) scoring system and USPSTF Study Design
Categorization. Seven articles, encompassing a total of 2,134 participants, were aggregated in the meta-analysis. Due to dissimilar age groups and scan sites, only seven pQCT parameters of the 4% radius, 4% tibia and 38% tibia were analyzed in this meta-analysis.
Evidence Synthesis: The overall fixed-effect overall estimates of trabecular vBMD of the 4%
radius were: 257.73 (251.69, 263.77), mg/cm3 in 8 to 9 year-old girls, 212.05 (203.86, 229.24) in
10 to 12 year-old girls, 22.4.98 (220.00, 229.96) in 12 to 13 year-old girls, 259.97 (254.85,
265.10) in 12 to 13 year-old boys and 171.55 (163.41,179.69) in 16 to 18 year-old girls. 21 of 54
(38.9%) primary papers received a "good" STARD quality of reporting score (<90 and 70.%)
(mean STARD score of all articles= 69.4%). The primary articles of this review had a "good"
level USPSTF study design categorization. However, most of the normative data in these articles were non-comparable and non-aggregable due to a lack of standardization of reference lines, acquisition parameters and/or age at acquisition.
Conclusion: There is not sufficient information to prove that pQCT would be appropriately
suited for use in the pediatric clinical setting. Normative pediatric data must be systematically derived for pQCT should it ever be a modality that is used outside of research.

GID: 5517; Last update: 27.07.2021