Obtaining high-resolution scans of bones and joints for clinical applications is challenging. HR-pQCT is considered the best technology to acquire high-resolution images of the peripheral skeleton in vivo, but a breakthrough for widespread clinical applications is still lacking. Recently, we showed on trapezia that CBCT is a promising alternative providing a larger FOV at a shorter scanning time. The goals of this study were to evaluate the accuracy of CBCT in quantifying trabecular bone microstructural and predicted mechanical parameters of the distal radius, the most often investigated skeletal site with HR-pQCT, and to compare it with HR-pQCT. Nineteen radii were scanned with four scanners: (1) HR-pQCT (XtremeCT, Scanco Medical AG, @ (voxel size) 82 μm), (2) HR-pQCT (XtremeCT-II, Scanco, @60.7 μm), (3) CBCT (NewTom 5G, Cefla, @75 μm) reconstructed and segmented using in-house developed software and (4) microCT (VivaCT40, Scanco, @19 μm—gold standard). The following parameters were evaluated: predicted stiffness, strength, bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), separation (Tb.Sp) and number (Tb.N). The overall accuracy of CBCT with in-house optimized algorithms in quantifying bone microstructural parameters was comparable (R² = 0.79) to XtremeCT (R² = 0.76) and slightly worse than XtremeCT-II (R² = 0.86) which were both processed with the standard manufacturer’s technique. CBCT had higher accuracy for BV/TV and Tb.Th but lower for Tb.Sp and Tb.N compared to XtremeCT. Regarding the mechanical parameters, all scanners had high accuracy (R² \(\ge\) 0.96). While HR-pQCT is optimized for research, the fast scanning time and good accuracy renders CBCT a promising technique for high-resolution clinical scanning.

获得用于临床应用的骨骼和关节的高分辨率扫描具有挑战性。HR-pQCT被认为是获得体内外周骨骼高分辨率图像的最佳技术，但仍缺乏广泛临床应用的突破。最近，我们在梯形图上展示了 CBCT 是一种很有前途的替代方法，可在更短的扫描时间内提供更大的 FOV。本研究的目的是评估 CBCT 在量化小梁骨微观结构和预测的桡骨远端机械参数方面的准确性，桡骨远端是 HR-pQCT 最常研究的骨骼部位，并将其与 HR-pQCT 进行比较。用四台扫描仪扫描了十九个半径：（1）HR-pQCT（XtremeCT，Scanco Medical AG，@（体素尺寸）82 μm），（2）HR-pQCT（XtremeCT-II，Scanco，@60.7 μm），（3 ) CBCT (NewTom 5G, Cefla, @75 μm) 使用内部开发的软件和 (4) microCT（VivaCT40，Scanco，@19 μm-黄金标准）重建和分割。评估了以下参数：预测的刚度、强度、骨体积分数 (BV/TV) 和小梁厚度 (Tb.Th)、分离 (Tb.Sp) 和数量 (Tb.N)。使用内部优化算法的 CBCT 在量化骨显微结构参数方面的整体准确性相当（R ²  = 0.79) 到 XtremeCT ( R ²  = 0.76) 并略差于 XtremeCT-II ( R ²  = 0.86)，两者均采用标准制造商的技术处理。与 XtremeCT 相比，CBCT 对 BV/TV 和 Tb.Th 的准确度更高，但对 Tb.Sp 和 Tb.N 的准确度较低。关于机械参数，所有扫描仪都具有较高的精度（R ² \(\ge\) 0.96）。虽然 HR-pQCT 针对研究进行了优化，但快速的扫描时间和良好的准确性使 CBCT 成为高分辨率临床扫描的有前途的技术。