{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:56:25Z","timestamp":1773032185200,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T00:00:00Z","timestamp":1511395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Dual\u2010energy X\u2010ray absorptiometry (DXA) is the gold standard technique to measure areal bone mineral density (aBMD) for the diagnosis of osteoporosis. Because DXA relies on the attenuation of photon to estimate aBMD, deposition of bone\u2010seeking metallic elements such as strontium, lead, and aluminum that differ in atomic numbers from calcium can cause inaccurate estimation of aBMD. Quantitative ultrasound (QUS) is another technique available to assess bone health by measuring broadband ultrasound attenuation (BUA), speed of sound (SOS), and an empirically derived quantity called stiffness index (SI). Because the acoustic properties are not prone to significant change due to changes in microscopic atomic composition of bone, it is hypothesized that QUS is unaffected by the presence of bone\u2010seeking elements in the bone. The objective of this study was to investigate the effect of strontium, lead, and aluminum on DXA\u2010derived aBMD and QUS parameters using bone\u2010mimicking phantoms compatible with both techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Bone\u2010mimicking phantoms were produced by homogeneously mixing finely powdered hydroxyapatite compounds that contain varying concentrations of strontium, lead, or aluminum with porcine gelatin solution. Seven strontium\u2010substituted phantoms were produced with varying molar ratio of Sr\/(Sr + Ca) ranging from 0% to 2%. Four lead\u2010doped phantoms and four aluminum\u2010doped phantoms were constructed with the respective analyte concentrations ranging from 50 to 200 ppm. An additional 0 ppm phantom was produced to be used as a baseline for the lead and aluminum phantom measurements. All phantoms had uniform volumetric bone mineral density (vBMD) of 200 mg\/cm\n                      <jats:sup>3<\/jats:sup>\n                      , and were assessed using a Hologic Horizon\n                      <jats:sup>\u00ae<\/jats:sup>\n                      DXA device and a Hologic Sahara\n                      <jats:sup>\u00ae<\/jats:sup>\n                      QUS device. Furthermore, theoretical aBMD bias for mol\/mol% substitution of calcium with the three bone\u2010seeking elements was calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Strong positive linear relationship was found between aBMD measured by DXA and strontium concentration (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001,\n                      <jats:italic>r<\/jats:italic>\n                      = 0.995). From the measurement of lead and aluminum phantoms using DXA, no statistically significant relationship was observed between aBMD and the analyte concentrations. For the QUS system, with an exception of BUA and lead concentration that exhibited statistically significant relationship (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.038,\n                      <jats:italic>r<\/jats:italic>\n                      = 0.899), no statistically significant change was observed in all QUS parameters with respect to the clinically relevant concentration of all three elements. The calculated theoretical aBMD bias induced by 1 mol\/mol% substitution of calcium with strontium, lead, and aluminum were 10.8%, 4.6%, and \u22120.7%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      aBMD measured by DXA was prone to overestimation in the presence of strontium, but acoustic parameters measured by QUS are independent of strontium concentration. The deviation in aBMD induced by the clinically relevant concentrations of lead and aluminum under 200 ppm could not be detected using the Hologic Horizon\n                      <jats:sup>\u00ae<\/jats:sup>\n                      DXA device. Furthermore, the SI measured by the QUS system was not affected by lead or aluminum concentrations used in this study.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.12641","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T20:42:41Z","timestamp":1509136961000},"page":"81-91","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of the effect of strontium, lead, and aluminum in bone on dual\u2010energy x\u2010ray absorptiometry and quantitative ultrasound measurements: A phantom study"],"prefix":"10.1002","volume":"45","author":[{"given":"Deok Hyun","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Da Silva","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jahan","family":"Tavakkoli","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"},{"name":"Institute for Biomedical Engineering, Science and Technology (iBEST) Keenan Research Centre for Biomedical Science St. Michael's Hospital Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubomira","family":"Slatkovska","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Skeletal Health Assessment Joint Department of Medical Imaging University of Toronto Toronto ON Canada"},{"name":"Osteoporosis Program University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela M.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Skeletal Health Assessment Joint Department of Medical Imaging University of Toronto Toronto ON Canada"},{"name":"Osteoporosis Program University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Pejovi\u0107\u2010Mili\u0107","sequence":"additional","affiliation":[{"name":"Department of Physics Ryerson University Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2007.11.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-2998(97)80025-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(96)00316-X"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(91)90032-A"},{"key":"e_1_2_8_6_1","volume-title":"Tables of X\u2010Ray Mass Attenuation Coefficients and Mass Energy\u2010Absorption Coefficients (version 1.4)","author":"Hubbell JH","year":"2004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.6028\/NIST.IR.5632"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022436"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2014.01.002"},{"issue":"4","key":"e_1_2_8_10_1","first-page":"19","article-title":"Rebalancing bone turnover in favour of formation with strontium ranelate: implications for bone strength","volume":"47","author":"Fonseca JE","year":"2008","journal-title":"Rheumatology"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1774"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2007.03.102"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1094-6950(06)60402-2"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2010.08.005"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20567"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000222556.89044.90"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/009841096161122"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.suppl_2.21"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-010-8861-4"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0048-9697(95)04218-P"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-10-44"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1992.202"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.suppl_2.9"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1981.149"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-160194"},{"issue":"1","key":"e_1_2_8_26_1","first-page":"S314","article-title":"Lead in the skeleton interferes with the accurate measurement of bone mineral density by DEXA [Abstract]","volume":"17","author":"Puzas JE","year":"2002","journal-title":"J Bone Miner Metab"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-583X(03)01677-X"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-11-200606060-00009"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-5122(99)00003-1"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00006863"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-013-0474-5"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2281.1998.00067.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697130802178471"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2008.11.024"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.040304"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2010.10.003"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1021\/ac401877d"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057-1976\/2\/1\/015006"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4963805"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(96)00347-X"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1088\/0957-0233\/16\/6\/017"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(01)00419-7"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2009.04.196"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:3:2:121"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1513569"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-002-1360-5"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2006.10.004"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-007-9044-y"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-002-2113-3"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2007.09.001"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:7:3:262"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2012.04.008"},{"key":"e_1_2_8_53_1","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1093\/clinchem\/45.9.1548","article-title":"Aluminum, iron, lead, cadmium, copper, zinc, chromium, magnesium, strontium, and calcium content in bone of end\u2010stage renal failure patients","volume":"45","author":"D'Haese PC","year":"1999","journal-title":"Clin Chem"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmp.12641","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.12641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T06:09:53Z","timestamp":1694326193000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.12641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,23]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1002\/mp.12641"],"URL":"https:\/\/doi.org\/10.1002\/mp.12641","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.32920\/25758024.v1","asserted-by":"object"},{"id-type":"doi","id":"10.32920\/25758024","asserted-by":"object"}]},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,23]]}}}