The
use of Energy Dispersive X-ray Diffraction (EDXRD)
for the Determination of Bone Mineral Density
A W Allday and
M J Farquharson
Department
of Radiography, City University
Rutland Place, Charterhouse Square London U.K.
Introduction
The increased porosity of bone, as a consequence
of the reduction of bone mineral density (BMD), is known generally as osteoporosis.
BMD loss may be localised to certain bones (or areas of bone), perhaps
resulting from the disuse of a limb, or it may involve the entire skeleton
due to the manifestation of a metabolic bone disease. Although the whole
skeleton may be affected, osteoporosis manifests itself in certain regions
to a greater extent than others, especially in regions with a greater surface
area of bone.
Bone may be classified as either cortical bone
or trabecular bone. The surrounding structure of bone is a hard, dense
shell, known as cortical bone. Regions of bone that are filled with marrow
are hollow except for a series of bony struts known as trabecular bone.
These trabeculae enclose the bone marrow area and form a strengthening
structure.
Bone is continuously being broken down and remodelled
by dedicated cells called osteoclasts and osteoblasts. Trabecular regions
of bone have a far greater surface area for a given BMD when compared to
that of cortical bone, leading to a more active remodelling metabolism.
As such, the internal trabecular regions of bones like the vertebral bodies
or the femur are far more likely to show a significant manifestation of
osteoporosis, becoming less dense and more porous. The measurement of bone
mineral density with a view to detecting the onset of osteoporosis might
therefore be improved if the density of trabecular bone were measured in
isolation.
Measuring Bone Mineral Density
There are numerous techniques that have been used
to measure the density of bone. The many various techniques are based on
a diversity of different aspects of radiation physics. The key methods
are noted briefly. A detailed introduction to BMD measurement may be found
in a review article by Speller et al (1989).
A series of radiographs, usually of the hands,
are taken over a period of time for the BMD measurement techniques of radiogrammetry
and photodensitometry. For radiogrammetry, the thickness of the cortical
bone is measured from each radiograph. Subsequent radiographs may show
a decreasing thickness of cortical bone, indicating a loss in bone mass.
With the photodensitometry method, optical densities are measured from
the radiographs to determine mineral density, via a calibration phantom.
A measure of BMD may be obtained by employing
photon absorptiometry methods, in which a collimated photon beam from an
isotope source of radiation is directed through the site of interest. The
subsequently measured photon attenuation is related to BMD. The site to
be measured must be immersed in water to eliminate the effects of the soft
tissue surrounding the bone. A variation of this method has led to the
development of dual energy x-ray absorptiometry (DEXA). The isotope is
replaced with an x-ray source, which is used to generate beams of two different
energies. The use of two energies removes the necessity for water immersion.
Other BMD measurement techniques include neutron
activation and ultrasonic attenuation. Neutron activation can be used to
determine the quantity of a particular element within the site of interest
by measuring the quantity of g-rays generated
from n,g reactions. Alternatively, since
ultrasound waves are attenuated when directed through tissue, the tissue
composition may be determined by the degree of attenuation. Bone with a
lower mineral density will attenuate the ultrasonic waves to a lesser degree
than healthy bone, providing the necessary BMD information.
Data from quantitative computerised tomography
(QCT) images (reconstructed from x-ray profiles of the site of interest)
can be related directly to bone mineral. It is thought that this ability
to isolate the QCT response of trabecular bone offers an improvement in
accuracy over the previous techniques that measure total bone mass (trabecular
and cortical bone). As previously noted, osteoporosis manifests itself
more readily in trabecular bone, so removing the effect of cortical bone
will increase the sensitivity of the detection.
A New Method for Bone Mineral Density Measurement
Research is being conducted into a method
that isolates BMD measurement to trabecular regions of bone only. It utilises
the coherent scattering of x-ray photons and is known as energy dispersive
x-ray diffraction (EDXRD).
The EDXRD technique allows a scatter angle to
be defined. A solid scatter angle produces a scatter which may be accurately
positioned to fall within a volume of interest. For the purposes of EDXRD
BMD measurement for osteoporosis detection, the scatter volume is chosen
to fall within a site of trabecular bone.
An EDXRD experimental system is shown schematically
in Figure 1. A polyenergetic source of x-ray photons is generated
using an x-ray tube. These photons are collimated into a fan beam with
primary lead slit collimators, which is set to be incident on a sample
under investigation. Within the sample, some coherent scattering will occur,
an optimum of which will take place at a fairly shallow experimental scatter
angle f. Collimators are arranged at this angle
(from the incident beam) so that only photons scattered at the chosen angle
f will reach the detector. It is this
arrangement that defines the scattering volume. The final beam generated
with this geometry is detected with a high purity germanium detector and
then processed, using a multichannel analyser.

Fig. 1. An Experimental
System for EDXRD Measurement
The optimum experimental scatter angle f
will depend on the molecular structure of the sample material under investigation
and the wavelength/energy of the incident photons. Since the bone mineral
in the trabecular sample has a crystal-like structure, Bragg’s Law will
describe the conditions under which the constructive interference of x-ray
photons occurs (equation 1).
nl
= 2d sinn (Equation 1)
l is the wavelength
of the photons, d is the spacing between the scattering planes,
q is the Bragg scatter angle (half the experimental
scatter angle f) and n is the
order of diffraction.
Constructive interference of the photons will
occur when the wavelength is a whole multiple of
2d sin q.
Figure 2 shows when this condition is satisfied
for a given Bragg scatter angle q and scatter
plane spacing d. The paths of three photons are shown before scattering
(x, y, z) and after scattering
(x’, y’, z’).

Fig. 2. Bragg Diffraction
There may be many scattering planes within a given
material, presenting a range of plane spacings d. Some wavelengths
from the energy range of the incident spectrum will satisfy Bragg’s Law
for constructive interference (for a particular value of d). This
leads to the detection of a spectrum of photon energies that will have
a unique ‘signature’ related to the material under investigation, in this
case trabecular bone (predominantly formed from hydroxylapitite). This
signature spectrum will change for a different material because the spacings d will change. Peaks within the signature spectrum will be at energies
that correspond with materials present within the scattering volume. The
intensity of each peak can be related to the quantity of each material.
An EDXRD spectrum for a bone phantom is shown
in Figure 3. The phantom consists of a mixture of cleaned, ground
bone and fat, which together simulate in vivo bone and marrow. The spectrum
was produced using the experiment illustrated by Figure 1. In this example,
the peak at 27.5 keV predominantly represents the scatter contribution
from the fat content of the phantom. The small peak at 33 kVp and the large
peak at 40 kVp predominantly represent the scatter contribution from the
hydroxylapitite content of the bone.

Fig. 3. An EDXRD Spectrum
of Bone and Fat Mix Phantom
(60 kVp at a 6 Degree Experimental Scatter Angle f)
It is the intensities of the peaks for bone material
within the spectra that is thought may be analysed to provide an accurate
measure of bone mineral density within the scatter volume. If the scatter
volume is positioned within a region of trabecular bone, a value for trabecular
BMD may be used to provide an accurate indication to the presence or severity
of osteoporosis.
EDXRD research currently being implemented at
the City University Radiation Laboratory is concentrating on finding the
minimum detectable limits of the technique. This involves work with bone
samples, taken from total hip replacement operations, to simulate very
small amounts of uniform BMD loss and the design of an optimised EDXRD
system which will be compared to currently used methods such as DEXA. An
attempt will also be made to relate small BMD losses as well as trabecular
architecture, to changes in trabecular bone strength.
It is hoped that the EDXRD method can be shown
to be sufficiently accurate, and of sufficiently low radiation dose, to
be ultimately accepted in the clinical environment for BMD detection. If
it can be shown that EDXRD can be used to detect smaller BMD changes than
methods currently in use, the onset of osteoporosis in a patient might
be detected earlier. Thus a treatment programme could be started sooner,
perhaps preventing debilitating fractures that are also expensive to treat..
Further information about these EDXRD
methods may be obtained by e-mailing the authors at
A.W.Allday@city.ac.uk
M.J.Farquharson@city.ac.uk
or by referring to the papers by Farquharson
et al (1997) and Farquharson and Speller (1998).
References
Farquharson, M. J., Luggar, R. D. and Speller,
R. D. 1997. Multivariate calibration for quantitative
analysis of EDXRD spectra
from a bone phantom, Appl. Radiat. Isot. 48, 1075-1082.
Farquharson, M. J. and Speller, R. D. 1998. Trabecular
bone mineral density measurements using
energy dispersive x-ray
diffraction (EDXRD), Radiat. Phys. Chem. 51, 607-608.
Speller, R. D., Royle, G. J. and Horrocks, J.
A. 1989. Instrumentation and techniques in bone
density measurement, J. Phys.E: Sci. Instrum. 22, 202-214.
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