TBS, Strontium, and Prof. Didier Hans

Prof. Didier Hans, PhD, MBA co-founded Med-Imaps SA in 2006 and became CEO of Medimaps Group in 2012. He currently drives the company’s global strategy, orientation and business objectives, and oversees its Quality Management framework and policies.He holds a PhD in Medical Physics and an Executive MBA from HEC Geneva. https://www.medimapsgroup.com/team/didier-hans/

One of Medimaps Group's products, TBS iNsight™ (Osteo), is an advanced imaging software application for bone densitometers (DXA). It provides a way to better predict a patient’s risk for bone fracture, to fine-tune therapy decisions, and to improve patient management.

TBS iNsight™ is a Medical Device that is CE 2797 marked & has been cleared to be sold in the US.

https://www.medimapsgroup.com/tbs-osteo/

I recently had the opportunity to ask Prof. Hans a question by email. He graciously answered. 

My question:

Will a TBS score be affected by the bone strontium effect, as the BMD by DXA scan is?

His answer, paraphrased and confirmed: 

In our study of TBS and strontium ranelate, TBS was less affected by the larger atomic number of strontium than the BMD was affected. So, the study showed that strontium improved bone microarchitecture. 

DXA Scan of 18 August 2022 Showing Normal Density

Below is my recent axial DXA performed on a Horizon Prologic Wi DXA scanner and showing NORMAL BONE DENSITY! Even if my scores are lower by half due to strontium use, the changes are phenomenal. Fifteen years ago, I was diagnosed with osteoporosis. My scans have gotten progressively better since I began taking strontium citrate 14 years ago. For my next DXA scan, I will ask that a Trebecular Bone Score (TBS) be included.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. Strontium will not affect TBS as it does DXA. 

EXAM:  DXA AXIAL 8/18/2022

 INDICATION:  Postmenopausal.

 COMPARISON: 1/8/2018

 

FINDINGS:

 

Spine:  Total BMD of the spine L1-4 is 1.030 g/cm2, with a T-score of -0.2 and a Z-score of 2.2.

Left Femoral Neck: BMD is 0.741 g/cm2, with a T-score of -1.0  and a Z-score of 1.1.

 

Left Total Hip: BMD is 0.856 g/cm2, with a T-score of -0.7 and a Z-score of 1.0.

 

Right Femoral Neck: BMD is 0.752 g/cm2, with a T-score of -0.9 and a Z-score of 1.2.

Right Total Hip: BMD is 0.907 g/cm2, with a T-score of -0.3 and a Z-score of 1.5.

Spine density increased 5.2%. Left hip density decreased 1%. Right hip density increased 0.9%. These percent change findings may be inaccurate as exam was performed with different technique.

FRAX evaluation calculates 10-year probability of fracture:

 Major Osteoporotic: 7.9%%

 Hip: 1.3%%

IMPRESSION:

 Based on BMD, diagnosis is consistent with normal density.

 Follow up with DEXA and TBS: As needed.

WHO CRITERIA FOR T-SCORES:

 < or = -2.5 = osteoporosis

 < -1.0 and -2.5 = osteopenia

 > or = -1.0 = normal density