PMID- 22991066
OWN - NLM
STAT- MEDLINE
DCOM- 20130626
LR  - 20211021
IS  - 1523-4681 (Electronic)
IS  - 0884-0431 (Print)
IS  - 0884-0431 (Linking)
VI  - 28
IP  - 2
DP  - 2013 Feb
TI  - Vertebral fractures and trabecular microstructure in men with prostate cancer on 
      androgen deprivation therapy.
PG  - 325-32
LID - 10.1002/jbmr.1771 [doi]
AB  - Androgen deprivation therapy (ADT), a treatment for prostate cancer, is 
      associated with bone loss and fractures. Dual-energy X-ray absorptiometry 
      (DXA)-measured bone mineral density does not assess vertebral fractures (VF). 
      High-resolution micro-magnetic resonance imaging (HR-MRI) assesses bone 
      microarchitecture and provides structural information. To determine if VF 
      identification increased the diagnosis of osteoporosis beyond DXA and if HR-MRI 
      demonstrated skeletal deterioration in men with VF, we cross-sectionally studied 
      137 men aged >/= 60 years with nonmetastatic prostate cancer on ADT for >/= 6 months. 
      Vertebral fracture assessment (VFA) by DXA was confirmed with X-rays. HR-MRI of 
      the wrist included bone volume to total volume (BV/TV), surface density 
      (trabecular plates), surface/curve ratio (plates/rods), and erosion index (higher 
      depicts deterioration). VF were found in 37% of men; the majority were unknown. 
      Seven percent of participants were classified as osteoporotic by hip or spine 
      DXA. Thirty-seven percent of men without osteoporosis by DXA had VF identified, 
      suggesting that 90% of patients with clinical osteoporosis would have been 
      misclassified by DXA alone. By ANOVA comparison across VF grades, the BV/TV, 
      surface density, and spine, hip, and wrist DXA were lower, and erosion index was 
      higher in men with moderate-severe VF compared with lesser grades (all p < 0.05). 
      By unadjusted ROC analysis, the addition of HR-MRI to DXA at the spine, hip, and 
      femoral neck added substantially (AUC increased 0.831 to 0.902, p < 0.05) to 
      prediction of moderate-severe vertebral fracture. HR-MRI indices were associated 
      with spine, hip, and wrist DXA measures (p < 0.01). Longer duration of ADT was 
      associated with lower BV/TV, surface density, and surface/curve ratio (p < 0.05). 
      ADT for men with prostate cancer is associated with silent VF. DXA alone leads to 
      misclassifications of osteoporosis, which can be avoided by VF assessment. HR-MRI 
      provides a novel technique to assess deterioration of structural integrity in men 
      with VF and adds micro-structural information.
CI  - Copyright (c) 2013 American Society for Bone and Mineral Research.
FAU - Greenspan, Susan L
AU  - Greenspan SL
AD  - Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA 15213, USA. 
      greenspn@pitt.edu
FAU - Wagner, Julie
AU  - Wagner J
FAU - Nelson, Joel B
AU  - Nelson JB
FAU - Perera, Subashan
AU  - Perera S
FAU - Britton, Cynthia
AU  - Britton C
FAU - Resnick, Neil M
AU  - Resnick NM
LA  - eng
GR  - P30 AG024827/AG/NIA NIH HHS/United States
GR  - UL1 TR000005/TR/NCATS NIH HHS/United States
GR  - K24 DK062895/DK/NIDDK NIH HHS/United States
GR  - 2 P30 AG024827-06/AG/NIA NIH HHS/United States
GR  - 2K24DK062895-06/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - England
TA  - J Bone Miner Res
JT  - Journal of bone and mineral research : the official journal of the American 
      Society for Bone and Mineral Research
JID - 8610640
RN  - 0 (Androgen Antagonists)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Absorptiometry, Photon
MH  - Androgen Antagonists/pharmacology/*therapeutic use
MH  - Biomarkers/metabolism
MH  - Bone Density/drug effects
MH  - Bone Remodeling/drug effects
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Prostatic Neoplasms/*complications/diagnostic imaging/*drug 
      therapy/physiopathology
MH  - Spinal Fractures/complications/diagnostic imaging/*pathology/physiopathology
PMC - PMC3889112
MID - NIHMS536409
EDAT- 2012/09/20 06:00
MHDA- 2013/06/28 06:00
PMCR- 2014/01/13
CRDT- 2012/09/20 06:00
PHST- 2011/12/19 00:00 [received]
PHST- 2012/08/22 00:00 [revised]
PHST- 2012/09/14 00:00 [accepted]
PHST- 2012/09/20 06:00 [entrez]
PHST- 2012/09/20 06:00 [pubmed]
PHST- 2013/06/28 06:00 [medline]
PHST- 2014/01/13 00:00 [pmc-release]
AID - 10.1002/jbmr.1771 [doi]
PST - ppublish
SO  - J Bone Miner Res. 2013 Feb;28(2):325-32. doi: 10.1002/jbmr.1771.