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Table 2  Summary of studies characteristics, patient or specimen demographic details and main findings or summaries

From: Methods for bone quality assessment in human bone tissue: a systematic review

 

Category

Methods

Main indicators

Advantages

Limitations

Imaging modalities

X-ray-based modalities

Radiography

CTI, CMI, THI

Simplicity, low-cost, low radiation dose

Insufficient precision, 2D imaging

DEXA

BMC, BMD

Low radiation dose, accuracy, simplicity

2D imaging, cannot capture the 3D micro-architecture

CT-based modalities

QCT, pQCT, HR-pQCT

3D-morphology, BMC, BMD

High spatial resolution,, reproducible, 3D imaging, non-invasiveness

Larger radiation does, expensive equipment

Micro-CT

3D-microstructure, BV/TV, Tb.Th, Tb.Sp; Tb.N, BS/TV, BS/BV, SMI, Conn.D

Comprehensive, high spatial resolution,

3D bone structure, non-invasiveness

Larger radiation does, expensive equipment

MR-based modalities

NMR, HR-MRI, μMRI

3D bone geometry, trabecular morphology

High accuracy, no radiation, high-resolution

3D imaging, non-invasiveness

Expensive equipment, professional operation, more susceptible to image post-processing

Mechanical testing

Traditional testing

Compression, tension, bending, and torsion tests

Elastic modulus, Ultimate strength,

Yield strength

Directness, accuracy, simplicity

Destructive testing, cannot be repeated

Indentation testing

Macro-indentation, RPI, nano-indentation

Hardness, Brittleness

Directness, simplicity, minimally invasiveness

Its outcomes are relatively sole, limited to superficial sites, reliability and significance of parameters need to be validated further

Bone composition

Computerized quantitative contact microradiography method, HPLC, et al

DBM, Organic phases

An intrinsic effect on bone stiffness and strength

Not comprehensive enough