Miyuki Takasu MD, Presenter: Nothing to Disclose

Yukiko Honda MD, Abstract Co-Author: Nothing to Disclose

Shuji Date, Abstract Co-Author: Nothing to Disclose

Masao Kiguchi RT, Abstract Co-Author: Nothing to Disclose

Kenichiro Matsuzaki, Abstract Co-Author: Nothing to Disclose

Kazuo Awai MD, Abstract Co-Author: Research Grant, Toshiba Medical Sysmtes Research Grant, Hitachi Medical Corporation Research Grant, Bayer AG Research Consultant, DAIICHI SANKYO Group Research Grant, Eizai Ltd

Takahisa Suzuki, Abstract Co-Author: Nothing to Disclose

Kazuaki Tanabe, Abstract Co-Author: Nothing to Disclose

Bone loss is a common disorder associated with gastric surgery, and a large number of postgastrectomy patients remain at risk for developing osteoporosis. The purpose of this study was to determine the prevalence of secondary osteoporosis (SO) and trabecular microstructural changes following gastrectomy using multidetector computed tomography (CT).

Spinal microarchitecture was examined in patients post distal gastrectomy (n=92), patients post total gastrectomy (n=111), and in 85 sex- and age-matched controls using a 64-detector CT. Using a bone mineral phantom and a 3D image analysis system, bone mineral content per tissue volume (BMC/TV), trabecular parameters, and mechanical properties of the third lumbar vertebrae were caluculated. Using BMC/TV with a reported cutoff value 58 mg/cm3, the prevalence of SO according to surgical procedures was analyzed using the Cochran-Armitage trend test. A multivariate regression model of patients’ characteristics including age, sex, postoperative period, and surgical procedure was constructed to identify predictors of SO. The trabecular parameters were compared among three groups, including control subjects, patients with SO, and patients without SO by the Scheffe’s post hoc test.

The prevalences of SO were 29.1% for post distal gastrectomy and 33.8% for post total gastrectomy in males, and 51.6% for post distal gastrectomy and 62.2% for post total gastrectomy in females. There were significant increase in the prevalence of SO from control cohort, distal gastrectomy cohort, to total gastrectomy cohort (P=0.04 for males, P=0.02 for females). Multivariate regression analysis demonstrated that patients’ age (P<0.001) and sex (P<0.001) were significantly related to SO. The microstructural and mechanical indices, including trabecular thickness and failure load, were significantly lower in patients with SO than in patients without SO.

The prevalence of SO significantly increased from control group to total gastrectomy group. Patients’ age and sex were significantly related to the risk of SO after gastrectomy. Bone quality and failure load were significantly reduced in patients with SO.

Vertebral microarchitecture parameters obtained by clinical multidetector CT, together with bone mineral content measurement, provided useful information for assessing SO in post gastrectomy patients.

Takasu, M, Honda, Y, Date, S, Kiguchi, M, Matsuzaki, K, Awai, K, Suzuki, T, Tanabe, K, Trabecular Bone Changes and Subclinical Secondary Osteoporosis Following Gastrectomy Detected by Multidetector CT.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044246.html