Bone Densitometry Research

The bone densitometry section is involved in basic and clinical research, and continues to develop and present new research in collaboration with researchers both on the Royal Adelaide Hospital campus, South Australia, and beyond (including work with equipment manufacturers).

Current Projects

• The Effect of Kinase Inhibition on Skeletal Remodelling in CML Patients Undergoing Imatinib (Glivec) or Nilotinib Therapy
  Investigators: Prof Tim Hughes, Dr Andrew Zannettino, Dr Andrea Dewar
  To purpose of this study is to determine whether administration of imatinib mesylate or nilotinib to chronic myeloid leukaemia patients is associated with osteopetrosis (increased bone density).
  The specific aims of this project are:
  • To determine whether imatinib/nilotinib therapy increases bone mineral density and alters body composition
  • To determine whether imatinib/nilotinib therapy is associated with altered levels of serum biochemistry markers which are indicative of bone remodelling (phosphate, calcium, hydroxyvitamin D, osteocalcin, pro-collagen type I N-terminal propeptide, collagen telopeptides);
  • To determine whether imatinib/nilotinib therapy alters indicies of bone formation and bone resorption as determined from histological examination of bone trephine specimens.
    
    
• Metformin in Gestational Diabetes: The Offspring Follow Up
  Investigators: Dr Janet Rowan, Dr William Hague, Dr Suzette Coat
  • Offspring of women with gestational diabetes mellitus who were treated with metformin during pregnancy compared to those who were treated with insulin will:
  • Have less body fat and less central adiposity.
  • Be more insulin sensitive.
  • Have similar neurodevelopment scores

  We are providing DXA services to determine body composition in a cohort of over 2-3 year old 150 children

• Rheumatoid Arthritis
  Investigators : Dr Susanna Proudman, Dr Les Cleland
  An investigation of the changes in bone mineral density of the hand in early rheumatoid arthritis.
  The project involves the Rheumatology Unit of the Royal Adelaide Hospital and aims to :
  • establish normal ranges of hand bone mineral density (hBMD) in a normal population
  • compare whole hand and distal metacarpal bone density as suitable methods for detection and quantification of rheumatoid osteopaenia
  • examine longitudinally hBMD, indices disease activity and radiological disease progression changes in a rheumatoid population
    
    
• DXA operator radiation dosimetry
  Investigators: Ms Tara Zammit, Assoc Prof Nick Pocock, Mr Chris Schultz, Mr Bob Gaffney
• Some published reports have indicated relatively high radiation doses to DXA operators, which has been used by some DXA equipment distributors to indicate superiority of their equipment. A first principles analysis of this data indicates that the doses are not as great as reported. This study examines the radiation doses to operators at several sites across Australia and collected actual dosimetry information at the operator workstation to determine the accuracy of these reports.

• Effect of rotation on DXA BMD measurements
  Investigators: Ms Chris Barber, Mr Arash Badiei, Mr Chris Schultz
  • DXA measurement determines BMD by projecting three-dimensional information into two-dimensions. BMD is compared to a reference range to determine further action, relying on standardised bone orientation. Potential misdiagnosis may result from bones exhibiting axial rotation deviating from the ideal. The aim of the study is to assess the degree to which axial rotation of scanned objects could affect BMD measurements.
    
    
• Spinal Injury
  Investigators: Dr Ruth Marshall, Mr Chris Schultz, Dr Barry Chatterton, Dr Rob Fraser, Mr Grahame Jones
  The project is investigating changes in bone mineral density after spinal cord injury and involves the Spinal Injury Unit at Hampstead Centre.
  The aims of the project are to :
• describe the rate of bone loss over 2 years in individuals following a spinal cord injury
• identify patterns of bone loss associated with various types of spinal cord injury
• identify biochemical predictors of rapid bone loss

Recent projects

• Kyphoplasty - bone/implant interactions
  Investigators: Dr Rob Moore, Dr Reza Zarrinkalam, Mr Chris Schultz
  • Kyphoplasty is a novel technique for reducing the effect of vertebral fracture, by introducing methacrylate into the damaged vertebrae. However, the effect of this on biochemical and mechanical processes has not been extensively studied.
    We have developed an animal model of osteoporosis to test this relationship, and are now evaluating the interaction with BMP.
    
    
  Normal range of bone density in sheep
  Investigators: Mr Chris Schultz, Dr Tim Kuchel, Ms Jodie Dier
• Sheep are used as a model by many researchers in orthopaedics and nutrition. However, there is no normal range for bone density or body composition over time.
  This study measures bone and tissue composition values in a small flock of female lambs from 4 months to 2 years serially. There will also be measurement of these parameters in 3, and 4 year old ewes.
  
  
• Comparison of GE-LUNAR DPX Pro and DPX-IQ bone densitometers
  Investigators: Mr Chris Schultz
  • The replacement of the original LUNAR DPX-L bone densitometer with a GE-LUNAR DPX Pro required a comparison of results between the older pencil beam technology and the newer instrument, which also uses different software algorithms for analysis. The aim of the project was to determine if there were significant differences between the two scanners by scanning a series of 30 volunteer patients on both instruments, with informed consent.
    
    
• Effects of soft tissue on bone mineral density
  Investigators: Ms Kari Hughes, Mr Chris Schultz
  • Current X-ray based bone densitometers rely on soft tissue adjacent to the bone to determine the mineral content at a point. However, it is unclear if asymmetry in air or fat (due to bowel gas or fat deposits) adjacent to the bone influences the results.
    We are investigating the effect of tissue asymmetry in a model system using our pencil and fan beam densitometers.
    
    
• Oyster shell mineral mass
  Investigators: Michael Laws, Darren Fisher, Dr John Carragher
• The measurement of mineral content of oyster shells is normally a destructive process, limiting the ability to assess oyster shell strength variance. Researchers from SARDI have worked with us to assess the mineral content in the shell to determine shell mass and strength in different genetic strains of Pacific oysters, and therefore improve oyster quality.
  
  
• Influence of heavy metals on dolphin bone mineral
  Investigators: Ms Trish Lavery
  • Examination of the pathology of heavy metals in dolphin populations around South Australia. One apparent effect on dolphin populations appears to be changes in mineralisation. DXA and histomorphometric examination of dolphin vertebrae are part of this larger study of the effects of heavy metals in these marine vertebrates.
    
    
• Prosthetic implants
  • A longtudinal study of bone changes around prosthetic femurs working the Dept of Orthopaedics and Trauma of the Royal Adelaide Hospital
    

• Clinical Drug trials
  The department is a provider of bone densitometry services for international drug trials, and has been involved with a number of pharmaceutical companies.
  We have worked (or are working) with :
  
  • Eli Lilly investigating Evista (Raloxifene). This new pharmaceutical was tested at a number of centres around the world, and monitored biochemical, bone density changes and lifestyle factors in both treatment and prevention of osteoporosis.
    Locally, the projects were managed by Assoc. Prof. Allan Need of the Division of Clinical Chemistry in the Institute of Medical & Veterinary Science and a team of research & support staff.
  • Merck,Sharpe and Doehme to evaluate the effect of alendronate in transplant patients, and in patients with rheumatoid arthritis.
  • Dr Gary Wittert and Janssen-Cilag investigating a new pharmaceutical which may help in weight reduction, using the body composition capability of DXA.
  • Evaluation of a new treatment regimen for bisphosphonates with Roche

Body composition

• Smith D, Forster K, Withers R, Schultz C, Gaffney R, Chatterton B, Body fat measurement by 4 different modalities, Aust NZ J Med, 21(4):624, 1991
  
• Withers RT, Smith DA, Chatterton BE, Schultz CG, Gaffney RD, A comparison of 4 methods of estimating the body composition of male endurance athletes, Eur J Clin Nut, 46:773-784, 1992
  
• Withers, RT, Smith DA, Brinkam M, Schultz CG, Clark DG, Chatterton BE, Multicompartment models of body composition in elderly males, National Annual Scientific Conference in Sports Medicine, Melbourne 1993
  
• Laforgia J, Withers RT, Pillans RK, Shipp NJ, Chatterton BE, Schultz CG and Leaney F, Comparison of three body composition models in trained and sedentary males. Proceedings of the 1996 Nutrition Society of Australia Annual Scientific Meeting New South Wales , 1996
  
• Withers RT, Noell CJ, Whittingham NO, Chatterton BE, Schultz CG, Keeves JP, Body composition changes in elite male bodybuilders during preparation for competition, Aust J Science Med in Sport, 29(1):11-16, 1996
  
• Withers RT, Laforgia J, Pillans RK, Chatterton BE, Schultz CG and Leaney F, Comparison of 2,3, and 4 compartment body composition models in female athletes, Proc Aust Physiol Pharmacol Soc, 27(2):121P, 1996
  
• Laforgia J, Withers RT, Williams AD, Murch BJ, Chatterton BE, Schultz CG, Leaney F & Giles LC, Effects of suspending exercise training on the resting metabolic rate, Proc Aust Physiol Pharmacol Soc, 28(2):36P, 1997
  
• Withers RT, Laforgia J, Pillans RK, Tucker K, Leaney F, Chatterton BE and Schultz CG. Comparison of 2,3 and 4 compartment body composition models in sedentary females. Medicine and Science in Sports and Exercise 1997 29:S38.
  
• Yeap Bu B, Burnet RB, Scroop G, Chatterton BE, Gaffney RD, Wittert GA. Chronic fatigue syndrome: is total body potassium important? Med J Aust 164(March):384 1996.
  
• Withers RT, Noell CJ, Whittingham NO, Chatterton BE, Schultz CG, Keeves JP, Body composition changes in elite male bodybuilders during preparation for competition, Aust J Science Med Sport, 29(1):11-16, 1996
  
• Withers RT, Laforgia J, Pillans RK, Shipp NJ, Chatterton BE, Schultz CG and Leaney F. Comparisons of two-, three-, and four-compartment models of body composition analysis in men and women. Am. Physiol. Soc, 1998; 85: 238-245.
  
• Laforgia J, Withers RT, Williams AD, Murch BJ, Chatterton BE, SCHULTZ CG and LEANEY F. Effect of 3 weeks of detraining on the resting metabolic rate and body composition of trained males. Eur. J. Clin. Nutrit, 1999; 53: 126-133.
  
• Smith DA, Withers RT, Brinkman M, Tucker RC, Chatterton BE, Schultz CG and Clark DG. Resting metabolic rate, body composition and aerobic fitness comparisons between active and sedentary 54-71 year old males. Eur. J. Clin. Nutrit, 1999; 53: 434-440.
• Withers RT, LA Forgia J, Pillans RK, Williams AD, Leaney F Chatterton BE and Schultz CG. Multicompartment body composition models and male athletes. Medicine and Science in Sports and Exercise, 1998; 30(Suppl.5).
  
• Laforgia J, Withers RT, Williams AD, Chatterton BE and Schultz CG. Detection of longitudinal body composition changes using 2, 3 and 4 compartment body composition models. Nutrition Soc. of Aust, 1998; 22: 174.
  
• VAN DER PLOEG GE, BROOKS AG, WITHERS RT, DOLLMAN J, LEANEY F and CHATTERTON BE. Body composition changes in female bodybuilders during preparation for competition. Eur J Clin Nutrit 2001; 55: 268-277.
  
• LAFORGIA J, VAN DER PLOEG GE, WITHERS RT, GUNN SM, BROOKS AG and CHATTERTON BE. Impact of indexing resting metabolic rate against fat-free mass determined by different body composition models. Eur J Clin Nutrition, 2004; 58(8): 1132-1141.

General bone mineral density

• Nordin BEC, Chatterton BE, Schultz CG, Need AG, Horowitz M, Regional bone mineral density interrelationships in normal women and osteoporotic postmenopausal women, J Bone Mineral Res, 11(6) : 849-856, 1996
  
• Schultz, CG A high resolution densitometry utility based on the Molsgaard ND1100A single photon densitometer, Australia & New Zealand Society of Nuclear Medicine 21^st Annual Scientific Meeting, Melbourne, 1990.
  
• Chatterton BE, Kitchener WL, Schultz CG, Nordin BEC, A low-cost forearm bone densitometer. Comparison with a high precision instrument, Aust NZ J Med, 20:469, 1990
  
• Chatterton BE, Kitchener WL, Schultz CG, Nordin BEC, A low-cost forearm bone densitometer. Comparison with a high precision instrument, ANZ Society of Nuclear Medicine, 21^st Annual Scientific Meeting, Melbourne 1990
  
• Schultz CG, Magarey A, Boulton TJC, Cockington R, Chatterton BE, A prospective study of bone mineral changes during puberty in a child cohort, Aust NZ J Med, 22(4):414, 1992
  
• Need AG, Chatterton BE, Horowitz M, Schultz CG, Nordin BEC, Interrelationships between local and total body bone mineral density in normal and osteoporotic women, Aust NZ Bone & Mineral Society, Annual Meeting, New Zealand, 1993
  
• Magarey AM, Schultz CG, Boulton TJC, Chatterton BE, Longitudinal monitoring of forearm mineral changes during adolescence and parent-child associations, Aust NZ Bone & Mineral Society, Brisbane 1994
  
• Nordin BEC, Chatterton BE, Schultz CG, Need AG, Horowitz M, Regional bone mineral density interrelationships in normal and osteoporotic postmenopausal women, International Bone Meeting, Denmark, 1995
  
• Chatterton BE, Thomas CM, Schultz CG, Nordin BEC, BUA of the Os-Calcis is the Best Predictor of Fracture, Fifth Bath Conference on Osteoporosis and Bone Mineral Measurement, United Kingdom, 1996
  
• Schultz CG, Chatterton BE, Gaffney RD, Automatic Reporting of BoneDensitometry Scans, Fifth Bath Conference on Osteoporosis and Bone Mineral Measurement, United Kingdom, 1996
  
• Schultz CG, Chatterton BE, A Mobile Bone Densitometry Service in Rural Australia, Fifth Bath Conference on Osteoporosis and Bone Mineral Measurement, United Kingdom, 1996
  
• Tucker KN, Schultz CG and Chatterton BE. Mobile bone densitometry service in rural South Australia. Presented at the 27th Annual Scientific Meeting Auckland New Zealand, published in the Australian and New Zealand Society of Nuclear Medicine, 28(3) 1997.
  
• Chatterton, BE. Australian National Consensus Conference on Osteoporosis. Presented in Canberra, 23-24th October, 1996. Published in December 1996 Edition of ANZ Nuclear Medicine, pp 22-23.
  
• Need AG, Horowitz M, Stiliano A, Scopacasa F, Morris HA and Chatterton BE. Vitamin D receptor genotypes are related to bone size and bone density in men European Journal of Clinical Investigation 26:793-796, 1996
  
• Magarey AM, Boulton TJC, Chatterton BE, Schultz C, Nordin BEC and Cockington RA. Bone growth from 11 to 17 years: relationship to growth, gender and changes with pubertal status including timing of menarche. Acta Paediatr 1999; 88: 139-146.
  
• NORDIN BEC, NEED AG, STEURER T, MORRIS HA, CHATTERTON BE and HOROWITZ M. Nutrition, Osteoporosis and Aging. Annals NY Acad. Sci, 1998; 854: 336-351.
  
• Magarey AM, Boulton TJC, Chatterton BE, Schultz C and Nordin BEC. Familial and environmental influences on bone growth from 11-17 years. Acta Paediatr 1999; 88: 1204-10.
  
• SCOPACASA F, HOROWITZ M, WISHART JM, MORRIS HA, CHATTERTON BE and NEED AG. The relation between bone density, free androgen index and estradiol in men 60 to 70 years old. Bone 2000; 27 (1): 145-149.
  
• Chatterton BE, Thomas CM and Schultz CG. Liver density measured by DXA correlates with serum ferritin in patients with ß thalassaemia major. Journal of Clinical Densitometry, 2003.
  
• BEARD H, SCHULTZ CG and MOORE RJ. Steroid-induced vertebral osteoporosis in sheep. Proceedings of the Third Clare Valley Bone Meeting An International Society for Fracture and Repair, March 2004.
  
• BEARD H, SCHULTZ CG and MOORE RJ. The sheep as a model for vertebral osteoporosis: a pilot study. Proceedings of the Spine Society of Australia Meeting, April 2004.
  
• HUGHES K, CHATTERTON B and SCHULTZ C. Does fat in the bowel affect a BMD measurement of the lumbar spine? Proceedings of the 35th ANZSNM Annual Scientific Meeting, Melbourne 30th April – 2nd May 2005.
  
• WORMALD JL, HUGHES KG, SCHULTZ CG and CHATTERTON BE. Audit of rural BMD service in South Australia. Proceedings of the ANZBMS 15th Annual Scientific Meeting, Perth, September 2005.
  
• ZARRINKALAM MR, BEARD H, ATKINS GJ, FINDLAY DM, WELLDON KJ, SCHULTZ CG and MOORE RJ. Characterisation of bone quality in the femur and vertebra in a sheep model of steroid-induced osteoporosis. Proceedings of the ANZBMS 15th Annual Scientific Meeting, Perth, September 2005.
  
• MUHLHAUSLER BS, SCHULTZ CG, CHATTERTON BE and MCMILLEN IC. Effects of birthweight, gender and postnatal growth rate of adiposity in the young adult sheep. Presented at the Australian Health and Medical Research Congress, November 2005.
  
• BRATKOVIC D, KETTERIDGE D, CHATTERTON BE and FLETCHER JM. Bone density in patients with chronic lactic acidosis. IXth International congress of inborn errors of metabolism, Brisbane, Sept 2003.
• SCHULTZ CG, DIER J, CHATTERTON BE, KUCHEL TR and MOORE RJ. “Establishing a normal range of bone and tissue in sheep”. Proceedings of the IOF + ANZBMS Combined Meeting, October 2006.
• ZAMMIT T, SCHULTZ C, GAFFNEY R and POCOCK N. “Operator radiation exposure from the GE-lunar prodigy”. Proceedings of the IOF + ANZBMS Combined Meeting, October 2006.
• BARBER C, SCHULTZ CG, BADIEI A and FAZZALARI NL. “Effects of rotation on DXA lumbar spine BMD measurements”. Proceedings of the IOF + ANZBMS Combined Meeting, October 2006.
• SCHULTZ CG, LLEWELLYN-SMITH IJ, FINDLAY DM and CLARK JM. “Bone mineral density accrues in growing spinal cord transacted rats”. Proceedings of the IOF + ANZBMS Combined Meeting, October 2006.
• LARK JM, JELBART M, RISCHBIETH H, STRAYER J, CHATTERTON B, SCHULTZ C and MARSHALL R. Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss.  Spinal Cord 2007; 45: 78-85. 
• SCHULTZ CG and CHATTERTON BE.  Longitudinal measures of body composition after spinal cord injury and the influence of motor and sensory function scores.  ANZ Nuclear Medicine 2007; 38(2): 2-7.

Prosthetic implants

• Matthews S, Pearcy MJ, Fazzalari NL, Parkinson IH, Manthey BA, Schultz CG, Howie DW, Correlations between the mechanical properties, radiology and histomorphometry of human femoral bone, Clin Biomech, 7:153-160, 1992
  
• Schultz CG, Wang AW, Chatterton BE, Howie D, Functional image analysis of bone density images, 6^th World Congress of Nuclear Medicine and Biology, Sydney 1994
  
• Schultz CG, Wang AW, Chatterton BE, Howie DW, Functional image vs conventional Gruen analysis of total hip arthroplasties (THA), Perth International Bone Meeting, Fremantle, Western Australia, 1995
  
• Nordin BEC, Chatterton BE, Schultz CG, Need AG, Horowitz M, Which bone to measure, Perth International Bone Meeting, Fremantle, Western Australia, 1995
  
• Schultz CG, Chatterton BE, Early experience with the Lunar Expert imaging densitometer, Perth International Bone Meeting, Fremantle, Western Australia, 1995
  
• Wang A, Schultz C, Howie D, Chatterton B, Pearcy M, Evaluation of femoral bone mineral density in cemented THA using dual energy X-ray absorptiometry (DXA), American Academy of Orthopaedic Surgeons Conference, 1995
  
• Tucker KN, Schultz CG and Chatterton BE. Mobile bone densitometry service in rural South Australia. Presented at the 27th Annual Scientific Meeting Auckland New Zealand, published in the Australian and New Zealand Society of Nuclear Medicine, 28(3) 1997.
  
• Withers RT, LaForgia J, Pillans RK, Williams AD, Leaney F, Chatterton BE & Schultz CG. Multicompartment body composition models and male athletes, Medicine and Science in Sports and Excercise, 30(5)-Suppl:S276, 1998
  
• Tucker KN, Schultz CG and Chatterton BE. Mobile bone densitometry service in rural South Australia. ANZ J. Med, 1998; 28(5): 693.
  
• Marshall R, Crotty M, Chatterton B, Schultz C, Clark J, Jelbart M, Rischbeith H and StrayeR J. Changes in body composition and bone mineral density throughout the body after acute spinal cord injury. Presented at the Annual Scientific Meeting of International Medical Society of Paraplegia in association with Nordic Medical Society of Paraplegia, June 18-20, 1999 – Copenhagen, Denmark, (First prize, scientific poster).
  
• Schultz CG and Chatterton BE. A comparison of normal range distribution with manufacturer supplied normal range of three bone densitometers. Presented at ANZBMS, Cairns, July 2000.
  
• Chatterton BE, Thomas CM and Schultz CG. Dual energy x-ray absorptiometry (DXA) in the assessment of liver iron in patients with beta thalassaemia major. Nucl Med Comm 2000; 21(5): 488.
  
• Marshall R, Strayer J, Chatterton B, Schultz C, Jelbart M, Clark J, Rischbeith H and Donohue S. NMES influences bone and whole-body metabolism when applied in acute SCI. IMSOP 2000.
  
• CG SCHULTZ, J CLARK, H RISCHBIETH, P WESLEY, J STRAYER, M JELBART, R MARSHALL, BE CHATTERTON. Longitudinal measures of BMD and body composition after Spinal Cord Injury (SCI). Eighth Bath Conference on Osteoporosis, Bath, 5-7 December 2001
  
• Marshall R, Rischbieth HM, Jelbart JM, Strayer J, Clark J, Donohoe S, Chatterton B and Schultz C. Conditioning of lower extremity muscle by low level neuromuscular electrical stimulation [(LE)NMES], has no influence upon either body composition or bone mineral density (BMD) after spinal cord injury (SCI). 1st JOINT SCIENTIFIC MEETING: IMSOP/ASIA, Vancouver May 3-6 2002.
  
• Hughes K, Schultz CG and Chatterton BEC. The effect of varying tissue composition on BMD measurements. Proceedings of ANZBMS Annual Scientific Meeting, Adelaide 2002; Page 58.
  
• Muhlhausler B, Schultz C, Chatterton BE and McMillen IC. Adiposity is positively correlated with weight gain over the first 6 months of life in the female lamb. Proceedings of the Australian Society for Medical Research 2003.
  
• Hughes K, Chatterton BE, Schultz CG and Scutter SD. Evaluation of the precision of BMD measurements of the lumbar spine in studies performed 3 hours apart. Proceedings of the National Osteoporosis Society Conference in Bath 2003, Osteoporosis International 14(4), Page S19-20.
• FOSTER B and SCHULTZ CG. “Case study: Changes in bone mineral content and density measured by DXA after distraction lengthening of a lower limb”. Proceedings of the ANZSNM 37th Annual Scientific Meeting Adelaide, 2007; Pages 43-44.
• BARBER C, SCHULTZ CG and BADIEI A. “Axial rotation significantly effects DXA lumbar spine BMD measurements”. Proceedings of the ANZSNM 37th Annual Scientific Meeting Adelaide, 2007; Page 43.
  
• BARKER DS, SCHULTZ C, KRISHNAN J and HEARN TC. “Bilateral symmetry of the human metacarpal: the validity of matched pairing for biomechanical assessment”. Proceedings of ANZBMS Annual Scientific Meeting, Adelaide 2002; Page 84.
  
• Barker, DS. Schultz, C. Krishnan, J Hearn, TC. Bilateral symmetry of the human metacarpal - The validity of matched pairing for biomechanical assessment, J Biomech, submitted for publication

Rheumatology

• Hill CL, Cleland LG, Schultz C, Chatterton BE and Pile KD. Measurement of hand bone mineral density in early rheumatoid arthritis using dual energy x-ray absorptionmetry (DXA). Presented at 61st National Meeting of Amercian College of Rheumatology and to be published in Arthritis & Rheumatism.