UCSF CCMBM Cores: Featured Services

CCMBM Cores:
Featured Services

The Core Center for Musculoskeletal Biology & Medicine (CCMBM) defines itself by emphasizing musculoskeletal-specific events, grants, and services that are critical to its members but not available elsewhere in the university system.

ACKNOWLEDGING THE CCMBM

If you have received a CCMBM grant, formed a collaboration at one of our events, or used one of our cores, please acknowledge the CCMBM in related publications and presentations. We suggest stating:

Research reported in this publication was supported by the UCSF Core Center for Musculoskeletal Biology and Medicine (CCMBM) of the National Institute of Health's National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under the award number P30AR066262 .

UPCOMING CCMBM EVENTS

February 6, 2:00-3:00pm; Parnassus, HSW-300
CCMBM Seminar Series: Osteocytic Osteolysis, Cathepsin K and Calcium Metabolism
Roland Baron, PhD, DDS, Professor and Chair of the Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine.
RSVP by February 1st: bit.ly/CCMBMseminar
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March 12, 10:30am; Mission Bay Campus, MH-2100
CCMBM Seminar Series: Weak Links Aren’t Always Weak: The Mechanics of Spine Fractures
Elise Morgan, PhD, Professor, Mechanical Engineering, Biomedical Engineering, Materials Science, Orthopaedic Surgery Associate Dean for Research and Technology, Boston University.
RSVP: bit.ly/CCMBMseminar
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Specific Aims Review
Have your specific aims page reviewed by established investigators as well as peers.

Reviews are available for CCMBM members at the following locations:
1. General sign up (Mission Bay)
2. Ortho-related sign up (Parnassus)
3. Radiology-related sign up (China Basin)

Become a CCMBM member to be eligible for these aims review.

March 12, 2:00pm; Mission Bay Campus, MH-2100
CCMBM Workshop: NIH Biosketch Workshop
This workshop was 'sold out' at ORS so don't miss your chance to attend this year. This program is ideal for postdocs and early career investigators as well as those who need to transition to the new NIH format.
Elise Morgan, PhD, Professor, Mechanical Engineering, Biomedical Engineering, Materials Science, Orthopaedic Surgery Associate Dean for Research and Technology, Boston University.
RSVP: bit.ly/CCMBMseminar
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April 9-10, 2019; Mission Bay Campus
Orthopaedic Surgery/CCMBM Scientific Retreat – SAVE-THE-DATE for this annual two-day retreat for musculoskeletal researchers, clinicians, and trainees. Featuring interactive exhibits, slam-style talks and posters by trainees, and special guests.

Trabecular Bone Score for Examination of Vertebral Bone Quality in Humans

Bone mineral density (BMD), such as that measured by dual-energy X-ray absorptiometry (DXA), is a strong predictor of fracture⁽¹⁾ and thus is the gold standard for screening, diagnosing, and managing osteoporosis. However, most individuals with a fragility fracture have BMD values in the “osteopenic” or even normal range,⁽²⁾ indicating that factors other than BMD contribute to bone strength. Indeed, it is now widely accepted that bone strength is determined by both bone density and “bone quality”, with bone quality encompassing bone architecture, bone turnover, matrix mineralization, and accumulation of damage within bone.⁽³⁾

Trabecular bone score (TBS) has been investigated as a potential measure of bone quality. TBS is a textural index that is derived from lumbar spine DXA images. It is evaluated by determining the variogram of the trabecular bone projected image, calculated as the sum of the squared gray-level differences between pixels at a specific distance and angle (Figure). The mean value of the individual measurements for L1–L4 represents the TBS (which is unitless). TBS predicts vertebral fracture risk independently of lumbar spine BMD^(4,5) and of 10-year fracture probability scores from the FRAX® model.⁽⁶⁾

Drs. Anne Schafer, John Shepherd, and Tiffany Kim received a CCMBM T/T Award to purchase and install TBS software for the Hologic Horizon DXA system at the UCSF CTSI Body Composition Laboratory, which is the sole DXA scanner available through the CTSI Clinical Research Services (CRS). Drs. Schafer and Kim are currently applying TBS analysis to their ongoing studies of bariatric surgery and skeletal health.

The TBS tool is now available as a CCMBM core resource, and also as a UCSF CTSI CRS core resource. TBS can be applied to all DXA spine scans collected in the future and also retrospectively applied to all previous spine scans from this CTSI Body Composition Laboratory Hologic Horizon, and even from the previous DXA scanner at the CTSI Clinical Research Center at Zuckerberg San Francisco General. CCMBM investigators access DXA and TBS through the CTSI CRS (https://accelerate.ucsf.edu/research/crs) but are encouraged to seek guidance from the CCMBM Epidemiology, Biostatistics, and Study Design (EBSD) Core.

For more information, please contact Dr. Schafer at anne.schafer@ucsf.edu.

Figure legend: Examples of TBS derivation in two postmenopausal women with similar lumbar spine BMD values by DXA, as published by Silva et al., J Bone Miner Res. 2014;29:518:30. The woman in the upper panel has a higher TBS than the lower. The images of the bone architecture and experimental variogram are illustrations to demonstrate the TBS principles and are not actual images from these particular patients. ⁽⁵⁾

References
1.   Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ, 3rd, O'Neill T, Pols H, Reeve J, Silman A, Tenenhouse A. Predictive value of BMD for hip and other fractures. J Bone Miner Res. 2005;20:1185-94.
2.   Sornay-Rendu E, Munoz F, Garnero P, Duboeuf F, Delmas PD. Identification of osteopenic women at high risk of fracture: the OFELY study. J Bone Miner Res. 2005;20:1813-9.
3.   Link TM, Heilmeier U. Bone Quality-Beyond Bone Mineral Density. Semin Musculoskelet Radiol. 2016;20:269-278.
4.   Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res. 2011;26:2762-9.
5.   Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP. Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res. 2014;29:518-30.
6.   McCloskey EV, Oden A, Harvey NC, Leslie WD, Hans D, Johansson H, Barkmann R, Boutroy S, Brown J, Chapurlat R, Elders PJ, Fujita Y, Gluer CC, Goltzman D, Iki M, Karlsson M, Kindmark A, Kotowicz M, Kurumatani N, Kwok T, Lamy O, Leung J, Lippuner K, Ljunggren O, Lorentzon M, Mellstrom D, Merlijn T, Oei L, Ohlsson C, Pasco JA, Rivadeneira F, Rosengren B, Sornay-Rendu E, Szulc P, Tamaki J, Kanis JA. A Meta-Analysis of Trabecular Bone Score in Fracture Risk Prediction and Its Relationship to FRAX. J Bone Miner Res. 2016;31:940-8.

ACKNOWLEDGING THE CCMBM