FELUX

Longitudinal clinical evaluation of bone architecture and biomechanical changes in transplantation osteoporosis, funded by the Austrian National Bank Anniversary Fund

Team: Lukas Fischer, Rene Donner, Philipp Peloschek, Philippe Zysset, Georg Langs, Janina Patsch

Transplantation osteoporosis is a severe, rapidly progressive type of secondary bone disease. Although early antiosteoporotic treatment can prevent major bone loss, fractures occur. Dual-X ray-absorptiometry (DXA) is unable to monitor small density variations which could be indicative of potential treatment non-responders with elevated fracture risk. Improved risk assessment tools such as FRAX, which are well suitable for classical risk groups such as postmenopausal women, are inapplicable to transplant patients. Moreover, bone metabolism and microarchitectural changes after transplantation are little explored. Using novel imaging tools like high resolution peripheral quantitative computed tomography (HRpQCT), it is nowadays possible to study bone microarchitecture in vivo without biopsy. Thus it is possible to perform detailed, longitudinal monitoring of microarchitectural changes in the individual patient. Moreover, advanced biomechanical evaluations such as computerized compression tests (i.e. finite element modelling) can be derived from such data sets. Advanced computational image analysis is an essential step in the processing of HRpQCT since it offers approaches to efficiently deal with high-dimensional and complex patterns. Using HRpQCT of the distal radius, we will accompany over 100 patients during their first 2 years following lung transplantation (LUTX). Specifically, we aim to establish longitudinal FE modelling and advanced texture-based image analysis as novel, non-invasive monitoring tools for the in vivo-assessment of changes in bone microarchitecture.