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dc.contributor.authorCervenka, Tomas
dc.contributor.authorGiangregorio, Lora M.
dc.contributor.authorSievänen, Harri T.
dc.contributor.authorCheung, Angela M.
dc.contributor.authorCraven, Beverly C.
dc.date.accessioned2019-01-04 16:33:19 (GMT)
dc.date.available2019-01-04 16:33:19 (GMT)
dc.date.issued2018-10
dc.identifier.urihttps://doi.org/10.1016/j.jocd.2018.07.003
dc.identifier.urihttp://hdl.handle.net/10012/14303
dc.descriptionThe final publication is available at Elsevier via https://doi.org/10.1016/j.jocd.2018.07.003. © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.description.abstractIn 2015, the International Society for Clinical Densitometry (ISCD) position statement regarding peripheral quantitative computed tomography (pQCT) did not recommend routine use of pQCT, in clinical settings until consistency in image acquisition and analysis protocols are reached, normative studies conducted, and treatment thresholds identified. To date, the lack of consensus-derived recommendations regarding pQCT implementation remains a barrier to implementation of pQCT technology. Thus, based on description of available evidence and literature synthesis, this review recommends the most appropriate pQCT acquisition and analysis protocols for clinical care and research purposes, and recommends specific measures for diagnosis of osteoporosis, assigning fracture risk, and monitoring osteoporosis treatment effectiveness, among patients with neurological impairment. A systematic literature search of MEDLINE, EMBASE©, CINAHL, and PubMed for available pQCT studies assessing bone health was carried out from inception to August 8th, 2017. The search was limited to individuals with neurological impairment (spinal cord injury, stroke, and multiple sclerosis) as these groups have rapid and severe regional declines in bone mass. Of 923 references, we identified 69 that met review inclusion criteria. The majority of studies (n = 60) used the Stratec XCT 2000/3000 pQCT scanners as reflected in our evaluation of acquisition and analysis protocols. Overall congruence with the ISCD Official Positions was poor. Only 11% (n = 6) studies met quality reporting criteria for image acquisition and 32% (n = 19) reported their data analysis in a format suitable for reproduction. Therefore, based on current literature synthesis, ISCD position statement standards and the authors’ expertise, we propose acquisition and analysis protocols at the radius, tibia, and femur sites using Stratec XCT 2000/3000 pQCT scanners among patients with neurological impairment for clinical and research purposes in order to drive practice change, develop normative datasets and complete future meta-analysis to inform fracture risk and treatment efficacy evaluation.en
dc.description.sponsorshipSpinal Cord Injury - Ontarioen
dc.description.sponsorshipCanada Research Chair in Musculoskeletal and Postmenopausal Health
dc.description.sponsorshipOntario Ministry of Research and Innovation
dc.description.sponsorshipCanadian Foundation for Innovation
dc.description.sponsorshipCanadian Institutes of Health Research [grant 86251]
dc.description.sponsorshipONF-REPAR [2011-ONF-REPAR2-885]
dc.description.sponsorshipRick Hansen Foundation [2011-15S-RES3-tri-100812]
dc.description.sponsorshipCraig H. Neilsen Foundation [350642]
dc.language.isoenen
dc.publisherElsevieren
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectpQCTen
dc.subjectimage acquisitionen
dc.subjectneurological impairmenten
dc.subjectspinal cord injuriesen
dc.subjectsystematic reviewen
dc.titlePeripheral Quantitative Computed Tomography: Review of Evidence and Recommendations for Image Acquisition, Analysis, and Reporting, Among Individuals With Neurological Impairmenten
dc.typeArticleen
dcterms.bibliographicCitationCervinka T, Giangregorio L, Sievanen H, Cheung AM, Craven BC, Peripheral Quantitative Computed Tomography: Review of Evidence and Recommendations for Im-age Acquisition, Analysis and Reporting, Among Individuals with Neurological Impairment, Journal of Clinical Densitometry (2018), doi: 10.1016/j.jocd.2018.07.003en
uws.contributor.affiliation1Faculty of Applied Health Sciencesen
uws.contributor.affiliation2Kinesiologyen
uws.typeOfResourceTexten
uws.peerReviewStatusRevieweden
uws.scholarLevelFacultyen


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