PUBLICATIONS BOOKLET v1.2
3D-SHAPER TECHNOLOGY

3D-SHAPER MEDICAL
PUBLICATIONS BOOKLETAPR 2023
3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

3D-SHAPER Technology
DXA is a quick, painless and low-radiation dose imaging modality that provides 2D
measurements of bone density. DXA does not however provide clinicians with a way toanalyse and visualise bone in 3D to assess local fragilities in the cortical and trabecularcompartments, nor can it effectively assess the efficacy of selected therapies
longitudinally.
This is possible using Quantitative Computed Tomography (QCT), however QCT issignificantly more expensive and time consuming, and exposes patients to much larger
radiation doses. It is therefore not commonly used for this purpose.

But what if you could obtain 3D QCT-like results, from a standard 2D DXA image?
That means no extra radiation, no long scan time, and no hefty price tag!
Well, that’s where 3D-Shaper comes in. 3D-Shaper uses advanced technology totransform a standard 2D DXA image into a patient-specific 3D QCT-like model, providing
you with a fast, safe and cost-effective solution for visualising and assessing local changes
in a patients Cortical and Trabecular bone.
Why is this important? Visualising compartments separately allows clinicians to assess thebone density in specific regions of the bone, and therefore identify where there arepotential local fragilities. As therapies affect bone regions differently depending on theirmode of action, 3D-Shaper enables clinicians to be highly selective when choosing toprescribe a therapy, whilst simultaneously providing evidence-based rationale to support
decision making. Subsequent follow-ups will then allow for rapid monitoring and analysis
of a therapy’s effectiveness over time.
The following compilation of papers and posters represents the latest research into 3DShaper’s software solution.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

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PUBLICATIONS BOOKLET v1.1

3D-SHAPER studies per country

3D-SHAPER TECHNOLOGY

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

A total of 237 studies*, 17 countries and 4 continents have used 3D-SHAPER technology

3*Includes: Journal Publications, Conference Abstracts, Posters and Oral presentations

PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Table of Contents
Featured Studies ................................................................................................................... 5
Technical & Validation ....................................................................................................................... 5
Association with Fracture ................................................................................................................... 8Treatment Monitoring ...................................................................................................................... 11
Secondary Osteoporosis .................................................................................................................. 17
Hyperparathyroidism ....................................................................................................................................................................... 18
Obesity ............................................................................................................................................................................................... 19
Diabetes ............................................................................................................................................................................................. 19
Cancer................................................................................................................................................................................................ 20
Glucocorticoids ................................................................................................................................................................................ 20
Down Syndrome............................................................................................................................................................................... 21
Spinal Cord Injury ............................................................................................................................................................................. 21
Rheumatoid Arthritis ....................................................................................................................................................................... 22
Hypophosphatasia .......................................................................................................................................................................... 22
Acromegaly ...................................................................................................................................................................................... 23

Sport, exercise, muscle & bone ....................................................................................................... 24

Full Study Bibliography ....................................................................................................... 27
Contact us .......................................................................................................................... 40

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
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4PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Featured Studies
Technical & Validation
3D-Shaper’s technology is being used worldwide to assess changes in the cortical, trabecular andintegral bone compartments from a standard 2D DXA image. But how do we know this technique
works? How accurate is it? And how valid are the results that are output from the software?
Well, it turns out that 3D-Shaper’s statical modelling method is a highly accurate alternative to
QCT and has achieved statistically significant correlations when compared against QCT imaging.
This section outlines some of the key studies highlighting the accuracy and validity of the 3DShaper technology.

To date, there have been a total of 55 studies across 7 countries related to ´Technical &Validation’:

KEY PUBLICATIONSTUDYCOHORTOUTCOMES

3D-DXA:
Assessing thefemoral shape
the trabecularmacrostructure
and the cortex
in 3D fromDXA images.

157 subjects;•
57 males•
100 females•
Normal/Osteopenic/
Osteoporotic

3D-DXAtechnology is an
accurate method
to measure bonedensity
distribution(cortical andtrabecularcompartments)from routine hip
DXA scan, without
adding scan/radiation dose to
the patient.

[2017]
Available here

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

Spain

Correlation coefficients*: integral vBMD: 0.95,
trabecular vBMD: 0.86; cortical vBMD: 0.93; Mean
cortical thickness: 0.91
*Calculated with first version without calibration
between DXA models. Values recalculated withversion 2.7.4: from 0.91 to 0.93

Humbert L,
Martelli Y,
Fonollà R,
Steghöfer M,
Di Gregorio S,
Malouf J,
Romera J,
Del Río Barquero LM.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

3D Analysis ofCortical andTrabecular Bonefrom Hip DXA:
Precision and Trend
Assessment Intervalin Postmenopausal
Women.

60 Subjects
Precision
Study:• 48 Male• 12 Female• Over 50

Trend
Assessment
Intervals inpostmenopausal
women weresimilar to thosemeasured for
aBMD
measurements.
DXA-derived 3D
measurements
could potentiallyprovideadditional
indicators to
improve patientmonitoring inclinical practices.

[2019]

53 Subjects
Longitudinal
Study:• 53
FemaleAvailable here

3D patient-specificfinite element
models of theproximal femur
based on DXA
towards theclassification of
fracture and nonfracture cases.

[2019]
Available here

111 Subject
2 groups:• 62
fracturecases•
49 nonfracture
control

RESULTS & VISUALIZATIONSLeast significant changes were 10.39 and 8.72
mg/cm3 for integral volumetric BMD, 9.64 and9.59 mg/cm3 for trabecular volumetric BMD and6.25 and 5.99 mg/cm2 for cortical surface BMD.
Trend assessment intervals in postmenopausal
women were 2.9 years (integral volumetric BMD),
2.6 years (trabecular volumetric BMD) and 3.5
years (cortical surface BMD) As a comparison,trend assessment intervals for aBMD were 2.8
years at neck, and 2.7 years at total femur.

3D FE models
derived from
DXA scans mightsignificantly
improve theprediction of hip
fracture risk;
providing a new
insight forclinicians to use
FE simulations inclinical practicefor osteoporosis
management.

COUNTRY &AUTHORS

Spain
Humbert L,
Winzenrieth R,
Di Gregorio S,
Thomas T,
Vico L,
Malouf J,
del Río L.

Spain

•

•

•

The major principal stress was better
discriminator (AUC > 0.80) than thevolumetric BMD (AUC ≤ 0.70).
High discrimination capacity was achieved
when the analysis was performed by bone
type, zone of fracture and gender/sex.
Outcomes suggested that the trabecularbone is critical for fracture discrimination.

Ruiz Wills C,
Olivares AL,
Tassani S,
Ceresa M,
Zimmer V,
González BallesterMA,
Del Río LM,
Humbert L,
Noailly J.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Discriminationofosteoporosisrelated
vertebralfractures by
DXA-derived
3D
measurements:
a retrospective
case-control
study.

74
postmenopausal
women:• 37 withincident
vertebralfractures and• 37 agematched
controls
without any
type offracture

Trabecular
vBMD was themeasurementthat best
discriminates
between fracture
and control
groups: AUC of
0.733 against
0.682 for aBMD.

[2019]
Available here

Structural
Parameters of
the Proximal
Femur by 3Dimensional
Dual-Energy Xray
Absorptiometry
Software:Comparison
With
Quantitative
Computed
Tomography.

[2018]
Available here

60 subjects with
DXA and QCTThis study
showed theability of corticaland trabecularmeasurementsfrom DXAderived 3Dmodels todiscriminate
between fracture
and control
groups.

Our study
demonstrated that
accurate estimatesof structuralparameters for the
femur can beobtained from 3DDXA models. This
provides clinicianswith 3D indexes
related to thefemoral strengthfrom routine
anteroposterior
DXA scans, which
could potentially
improveosteoporosis
management andfracture
prevention.

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

Spain
López Picazo M,
Humbert L,
Di Gregorio S,
González BallesterMA,
Del Río Barquero LM.

Images showing: Average trabecular vBMD changes
and AUC map, and average differences in corticalsBMD and AUC map.

Spain

Correlation coefficients were:• 0.86 for the femoral neck axis length• 0.71 for the femoral neck shaft angle.
• From 0.86 to 0.96 for the cross-sectionalparameters• From 0.84 to 0.97 for the volumetric structuralparameters

Clotet J,
Martelli Y,
Di Gregorio S,
Del Río Barquero LM,
Humbert L.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Association with Fracture
DXA, known for its ability to assess areal Bone Mineral Density and provide clinicians with a TScore to support the subsequent diagnosis of Osteoporosis, low BMD or normal BMD. This
information is widely used, amongst other factors, to help indicate a person’s risk of sustaining afracture.
3D-Shaper takes this one step further by exploring the bone in full 3D and proving clinicians withquantitative, patient-specific measurements for Cortical, Trabecular and Integral bone.
But how are these values associated with fracture? What clinical significance can they provide?
This section outlines a few key studies that have researched exactly this, identifying how 3DShaper can support clinical decision making and identify patients at risk.

To date, there have been a total of 38 studies across 5 countries related to ‘Association
with Fracture’:

KEY PUBLICATION
STUDY
Predictive ability ofnovel volumetric andgeometric indicesderived from dualenergy X-ray
absorptiometricimages of theproximal femur for hip
fracture comparedwith conventional
areal bone mineraldensity: the Japanese
Population-based
Osteoporosis (JPOS)
Cohort Study.

[2021]
Available here

COHORT
1331
Women
Age 40–79
years atbaseline
Baselinesurvey & atleast one
follow-up
survey over
20 years

OUTCOMESRESULTS & VISUALIZATIONSvBMD obtained
from 3D modelingusing routinely
obtained hip DXA
images significantly
improved hip
fracture risk
prediction overconventional
Femoral NeckaBMD, but not
Total Hip aBMD.

COUNTRY &AUTHORSJapan•

A significantly larger AUC of trabecularvolumetric BMD (vBMD) at the total hip (AUC =0.741), femoral neck (AUC = 0.748), andintertrochanter (AUC = 0.738) and significant
NRI (0.177, 0.149, and 0.195, respectively) wereobserved compared with FN-aBMD (AUC =0.701), but not TH-aBMD.

Iki M,
Winzenrieth R,
Tamaki J,
Sato Y,
Dongmei N,
Kajita E,
Kouda K,
Yura A,
Tachiki T,
Kamiya K,
Kagamimori S.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

8PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

STUDY

Association
betweenosteoporotic
femoral neckfractures andDXA-derived 3D
measurements atlumbar spine: acase-control
study.

COHORTOUTCOMES

61 women withtranscervical hip
fracturesThis study
showed theassociation of
DXA-derived
measurements atlumbar spinewith transcervicalhip fractures. A
strongassociation
between vBMD
at the posteriorvertebralelements andtranscervical hip
fractures wasobserved,
probably
because of
globaldeterioration of
the cortical bone

61 age-matched
women without
any type offracture[2020]
Available here

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

Spain•

Integral vBMD, cortical vBMD, cortical sBMD,
and cortical thickness were the DXA-derived
3D measurements at lumbar spine thatshowed the stronger association withtranscervical hip fractures•

The highest AUC (0.726) and OR (2.610) at the
lumbar spine were found for integral vBMD at
the posterior vertebral elements. Significantly,
lower AUC (0.617) and OR (1.607) were found
for trabecular vBMD at the vertebral body.

López Picazo M,
Humbert L,
Winzenrieth R,
Di Gregorio S,
González BallesterMA,
Del Río Barquero LM.

.

DXA-based 3D
mapping of hipcortical thinningcorrelates withincident fracturesinpostmenopausal
women from the
GERICO cohort.

[2019]
Available here

796
Postmenopausal
women atbaseline.
Follow-up 5.7 ±1.5 yrs.
100 women(13%) withlowtrauma
clinical fracture,
44 with MOF

DXA-based 3Dmodeling
parameters areassociated withall types andmajor
osteoporotic
fractures
The associationsof trabecular
vBMD withfractures are ofgreatermagnitude thanthose of thecorticalparameters.

Switzerland
Biver E,
Hars M,
Winzenrieth R,
Rizzoli R,
Ferrari S.
•

Predicting incidence of low-trauma fractures:
Risk increased by 23-40%•

Prediction of MOF: Risk increased by 36-63%

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
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9PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Cortical andtrabecular boneof patients withprevalent major
osteoporotic
fracture: a casecontrol study
using DXA-based
3D modelling.

1,848 womenfrom 50,
including 105
fracturedindividuals (MOF)

The authors
concluded thatthe trabecularvolumetric BMD
is the strongest
parameter todiscriminate
fractured fromnon-fractured
individual, andthat assessing
3D boneparameters
could be usefulfor fracture
discrimination inclinical practice[2018]
Available here

DXA-Based 3D
Analysis of theCortical andTrabecular Boneof Hip Fracture
Postmenopausal
Women: A CaseControl Study.

[2018]
Available here••

64 hipfracture postmenopausal
women
64 controls

This case-control
study showed
the associationof DXA-derived
3D
measurementswith hip fracture.
Hip fracturegroup had lower
cortical sBMD
and trabecularvBMD,
compared tocontrols

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

USA
Spine aBMD, Total Femur aBMD and all 3D
measurements significantly lower in fractured
subjects (fx);
Adjusted for age: only TF aBMD & trabecular
vBMD remain significant discriminating factors forfx adjusted for age and weight, trabecular vBMD
remains the only significant discriminator of fx

Winzenrieth R,
Humbert L,
Leib E.

Spain

•

•

•

Total hip aBMD of hip fracture group as measured
by DXA was 10.7% lower compared to control
group.
Differences in vBMD were more pronounced in thetrabecular compartment (-23.3%) than in the cortex(-8.2%).
Differences in the cortex more pronounced at themedial aspect of the shaft, the lateral aspect of thegreater trochanter, and the superolateral aspect of
the neck.

Humbert L,
Bagué A,Di Gregorio S,
Winzenrieth R,
Sevillano X,
González BallesterMÁ,Del Rio L.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

10PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Treatment Monitoring
The effect of various pharmacological agents on bone health and density is well known regarding
the specific impact to Bone Mineral Density as assessed with DXA, and many with specific regionalchanges as assessed by QCT. But QCT is not routinely used clinically as it’s expensive, time
consuming and exposes patients to large doses of radiation. In research, the problems with QCT
are the same: exposing patients to large radiation doses, higher research costs and difficult image
acquisition.
Using 3D-Shaper, researchers and clinicians now have the ability to review the impact of specifictherapies on each bone compartment, without the need for QCT or alternative imaging methods;
3D-Shaper completely simplifies the longitudinal monitoring of patients.
Below are some of the recent highlights and key projects using 3D-Shaper for this purpose.

To date, there have been a total of 50 studies across 6 countries related to ‘Treatment
Monitoring’

KEY PUBLICATIONSTUDYCOHORTOUTCOMES

Differential effects of
abaloparatide andteriparatide on hipcortical volumetric
BMD by DXA-based
3D modeling.

750 patients

Similar significant
increases intrabecularvolumetric BMD(vBMD, + 9%) andcortical thickness(+ 1.5%) wereobserved with ABL
and TPTD by 3DDXA at 18 months.
In contrast, only
ABL significantly
increased cortical
vBMD versus
baseline (+ 1.3%),
and changes inboth cortical vBMD
and cortical surface
BMD weresignificantly greaterwith ABL versus
TPTD.

[2021]
Available here

3 treatment
arms:
• 250
ABL
• 250
TPTD
• 250
Placebo

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORSUSA

Spatial changes in 3D-DXA cortical endpoints and crosssectional representations of spatial changes in vBMD atmonth 18.

Winzenrieth R,
Ominsky MS,
Wang Y,
Humbert L,
Weiss RJ.

Increases in cortical sBMD, cortical vBMD, and cortical
thickness are presented in blue-green colors while
decreases are presented in yellow-red colors.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Cortical andTrabecularBoneimprovements
withRomosozumab
followed by
Denosumab or
Alendronate
assessed using
3D Modelingfrom DXA
images.

377 patients in
FRAME
• 190
women
PBO
• 187
women
ROMO

3D-SHAPER
analysis provides analternative to QCT
to estimate changes
in cortical andtrabecularparameters fromstandard DXA
images.

[2022]
Abstract not
currently
Available

368 patients in
ARCH• 185 womenALN• 183 women
ROMO

RESULTS & VISUALIZATIONSCUSAM. Lewiecki,
D. Betah,L. Humbert,
C. Libanati,
M. Oates,Y. Shi,R.Winzenrieth,
S. Ferrari,
F. Omura.

Results from the
3D-SHAPER
analysis of FRAME
and ARCH
complement
extensive evidence
demonstrating thattreatment with
ROMO results insubstantial gains in
hip cortical andtrabecular bonecompartments
within 1 year, andthat transition to an
antiresorptive canmaintain oraugment thosegains.
Supports evidence
that patients at highrisk for fracture may
benefit fromtreatment withromosozumab first,
followed by anantiresorptive.

COUNTRY &AUTHORSAt month 12, treatment with ROMO vs PBO in
FRAME and ROMO vs ALN in ARCH resulted insignificantly greater increases with ROMO in
cortical thickness, cortical vBMD, cortical sBMD,
and trabecular vBMD.
At month 24, culmative gains in these parameters
remained significantly greater in ROMO-DMAB
and ROMO-ALN switch groups when comparedagainst ROMO-PBO and ALN-ALN groups.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
www.3d-shaper.com

12PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Proximal Femur
Responses to
Sequential
Therapy with
Abaloparatide
Followed by
Alendronate in
Postmenopausal
Women with
Osteoporosis by
3D Modeling of
Hip DXA.

406 patients

These results, which
are among the firstto describe skeletal
responses toalendronate after
treatment with a
PTHR1 agonist that iscurrently approved
for the treatment of
PMO, indicate
significant
improvements in
aBMD, Ct.vBMD, and
Tb.vBMD of the total
hip and hip
subregions with
ABL/ALN versus
PBO/ALN.

[2022]
Available here

2 treatment
arms:
• 204
ABL/ALN• 202
PBO/ALN

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORSUSA
R.Winzenrieth,
P.Kostenuik
J.I.Boxberger,
Y.Wang,L.Humbert

For most 2D-DXA
and 3D-DXA
parameters,
particularly thecortical measures,
alendronate effects
were relatively similar
whether alendronate
was administeredafter abaloparatide
or after placebo.

Cross- Total hip trabecular and cortical 3D-DXA
parameters increased from baseline in both groups(all P<0.001), with greater average increases for
ABL/ALN versus PBO/ALN (trabecular vBMD:
10.87% vs 4.3%; Cortical thickness: 2.32% vs 1.14%;
Ct.vBMD: 3.41% vs 1.86%; cortical surface BMD:
5.82% vs 3.0%; all P<0.001).

These results support
the use of
abaloparatide as theinitial treatment insequential therapy
with alendronate in
women with PMO atvery high fracturerisk.

In the ABL/ALN group, collagen type I N-terminal
propeptide (PINP) levels at the time of alendronate
initiation correlated with subsequent percent
changes in all 3D-DXA parameters with 24 monthsof alendronate therapy.

Strength indices in the ABL/ALN group improved inall subregions versus baseline (all P<0.0001) andversus PBO/ALN (all P<0.02).

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Comparison of
Romosozumab
and Teriparatide
effects on
Cortical andTrabecular boneusing 3D
Modeling fromDXA images in
Postmenopausal
womentransitioningfrom
Bisphosphonate
Therapy.

Women fromthe STRUCTURE
phase 3 clinical
trial.

Use of DXA-based
3D modeling by
3D-SHAPER
analysis allowed
advancedassessment of thecortical andtrabecular bonechanges using
standard hip DXA
scans.

[2022]
Abstract not
currently
Available

308
Postmenopausal
women
2 treatmentarms:• 148 TPTD
• 160 ROMORESULTS & VISUALIZATIONSCOUNTRY &AUTHORSUSA
M. Lewiecki,
D. Betah,L. Humbert,
C. Libanati,
M. Oates,Y. Shi,R.Winzenrieth,
S. Ferrari,
F. Omura.

3D-SHAPER
analysis provides
an alternative to
QCT to deriveuseful cortical andtrabecularparameters fromstandard DXA
imagesResults obtained by DXA-based 3D modeling wereconsistent with results obtained by QCT in STRUCTURE
for cortical vBMD but not for trabecular vBMD.
Both DXA-based 3D modeling and QCT showed
increases in cortical vBMD with romosozumab and loss
with teriparatide, with the difference between the twotreatments reaching statistical significance for bothmethods.
Both DXA-based 3D modeling and QCT showed greater
increases in trabecular vBMD with romosozumab vsteriparatide; however, gains were statistically greater with
DXA-based 3D modeling, but not with QCT.
3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Abaloparatide
Effects on
CorticalVolumetric BMD
and EstimatedStrength Indicesof HipSubregions by
3D-DXA in
Women with
Postmenopausal
Osteoporosis.

750 patients

3D-DXA show that 6
and 18 mo of ABL or
TPTD similarly
increased Tb.vBMD
at the femoral neck,trochanter, andfemoral shaft vsbaseline and PBO,
whereas the ABLgroup showed
greater increases in
Ct.vBMD vs TPTD
and PBO at mo 18
for all 3 hipsubregions ofinterest.

[2021]
Available here

3 treatment
arms:• 250 ABL
• 250
TPTD
• 250
Placebo

Cortical thickness ofthe femoral neck,intertrochanteric,and shaft regions
was similarly
increased with ABL
and TPTD, andCt.sBMD of thefemoral neck andintertrochantericsubregions showed
greater increases at
mo 18 with ABL than
TPTD.

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORSUSA
R.Winzenrieth,
L.Humbert,
J.I.Boxberger,
R.J.Weiss,
Y.Wang,P.Kostenuik

Cross-sectional views depicting average vBMD changes
at months 6 and 18 for each group.
Data reflect absolute vBMD changes from baseline.
Blue/green represents increased vBMD, yellow/orange
represents decreased vBMD, black represents no change.
Central compartments (FN & intertrochanteric slices) are
noticeably bluer at mo 6 & 18 in ABL and TPTD examples
vs PBO (consistent with observed treatment effects of
ABL and TPTD on Tb.vBMD).
The outermost peripheral aspects of the FN & shaft
appear blue and green in ABL & TPTD groups, especiallyat mo 18 (consistent with observed increases frombaseline in Ct.vBMD).
Yellow rings are evident within the femoral shaft of the
ABL & TPTD groups at mo 6 (may reflect reductions in
vBMD of the deep cortex). Reduced vBMD remains
evident at mo 18 with TPTD but not with ABL.

3D-Shaper Medical, S.L. Rambla Catalunya 53, 4ºH, 08007 Barcelona (Spain)
info@3d-shaper.com
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

STUDY
Trabecular andcortical bonehealth inpostmenopausal
women
receivingaromataseinhibitors forearly breast
cancertreatment: The
B-ABLEprospective
cohort study.

COHORT
464 women
366 withbisphosphonates (BP+)
98 without bisph.
(BP-)
bone evaluation
by DXA atbaseline, 12 and24 months

OUTCOMESRESULTS & VISUALIZATIONSThis study
highlights thepossibility tobetter manage
patients withearly breast
cancer in termsof boneassessment,
monitoring, andtreatment
recommendation.

Spain

•

•

[2019]

Effects ofosteoporosis
drug treatmentson cortical andtrabecular bonein the femur
using DXAbased 3Dmodelling.

[2018]
Available here

AI impaired both trabecular and corticalcompartments in BP- subjects while BP compensate
for the deleterious AI effects on bone;
Consistently with aBMD at spine, BP- had a moremarked decrease of the trabecular compartment at
femur;

3D analysis showed that BP protective treatment
stops to overcome the negative effect of AI on
trabecular bone after 12 months, suggesting a
possible decrease of the trabecular bone after 24months of AI.

Available here

155 subjects;• 16 males
139 females

COUNTRY &AUTHORSThis study
highlights thepossibility andadded value tomonitor TTT
effects through a
3D analysis, as
TTTs havedifferent effects
at the corticaland trabecularcompartments.
Such analysis
required, until
now, the use of
QCT(cost+radiation➚)and is now
possible from
DXA

Nogués X,
Rodriguez R,
Rodríguez-Sanz M,
Winzenrieth R,
Humbert L,
Pineda-Moncusí M,
Servitja S,
Garcia-Giralt N,
Martos T,
Tusquets I,
Martínez-García M,
Rodríguez Morera R,
A Dies Perez,
Albanell J.

Spain
Winzenrieth R,
Humbert L,
Di Gregorio S,
Bonel E,
García M,
Del Rio LM

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Secondary Osteoporosis
Secondary Osteoporosis is defined as low bone mass with microarchitectural alterations in boneleading to fragility fractures in the presence of an underlying disease or medication. This topic has
been attracting a lot of attention globally and researchers have been doing a fantastic job looking
into how these diseases/ medications are impacting bone density and what we can do to limit andstop them.
3D-Shaper has been playing a pivotal role by providing researchers with a tool to explore theirdata in a way only previously possible with QCT. Now, with a standard 2D-DXA image, researchers
can visualise bone impact in full 3D, assess local fragilities and monitor how each bonecompartment is impacted over time.
Below outlines a few key studies exploring the effects of secondary osteoporosis.

To date, there have been a total of 76 studies across 13 countries related to ‘Secondary
Osteoporosis

Hyperparathyroidism

Acromegaly

Diabetes

Hypo-

Cancerphosphatasia

Rheumatoid

Glucocorticoids

Arthritis

Neurology

Cardiovascular Disease

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYHyperparathyroidism
STUDY

COHORTOUTCOMES

Analysis of Bone
Impairment by 3D
DXA Hip Measures inPatients With PrimaryHyperparathyroidism:
A Pilot Study.

80 adults (59.5

The trabecular± 9.1 yrs)

bone is relatively[2020]•

COUNTRY &AUTHORS

preserved while

40 withcortical bone is

PHPT•RESULTS & VISUALIZATIONS

largely affected.

40 ageand sex-Patients withmatched

PHPT andhealthydiagnosed with

controls.

osteoporosis or

Spain
Gracia-Marco, L.
García-Fontana, B.
Ubago-Guisado, E.
Vlachopoulos, D.
García-Martín, A.
Muñoz-Torres, M.

osteopenia had

Available here

significantly
lower cortical
vBMD comparedwith those who
had normal bonevalues.
3D-DXA findings
are consistent
with those

PHPT have lower aBMD at the hip sites and reduced
cortical 3D parameters compared with an age- andsex-matched healthy control group. In addition, thevBMD of the trabecular compartment seems to beaffected, although to a lesser extent.

reported instudies using
HRpQCT.
Primary
Hyperparathyroidism(PHPT) impaired 3D
cortical density at
femur as assessedfrom 2D DXA

81 adults (59.4

Negative effect± 13.5 yrs) withof PTH level on

PHPT.

the Cortical

aBMD

vBMD and mean
CorticalThickness.

Trabecular vBMD

No effects were[2017]

Guglielmi, G.
Winzenrieth, R.
Battista, C.
Scillitani, A.

observed in theTrabecularcompartment.

Abstract not
currently Available

Italy

Cortical vBMD

Differences incortical vBMD
betweensubjects from PTH
level 1st quatileand 4th quartile

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

ObesitySTUDY

COHORTOUTCOMES

Modification ofbone mineraldensity, bonegeometry andvolumetric BMD inyoung women withobesity.

220 adolescent

Young womenand youngwith obesity

women from 18

presented higher

to 35 years old

aBMD, better hip•

128 patientswith•

92 age-controls.

(±6 months)

Cortical andnormal-trabecularweightcompartments

controls

measured by 3DSHAPER® were

Subjects with obesity presented significantly higher

favourably andaBMD at all bone sites.

concomitantly

Bone size & strength estimates were higher at all

modified.

COUNTRY &AUTHORSFrancegreater strengthnormal-weightmatchedAvailable here

geometry andcompared withobesity[2021]RESULTS & VISUALIZATIONS

femoral subregions in young women with obesity.
vBMD was higher in subjects with obesity, but thedifference between groups was greater for corticalMaïmoun L,
Renard E,
Humbert L,
Aouinti S,
Mura T,
Boudousq V,
Lefebvre P,
Mahadea K,
Philibert P,
de Santa-Barbara P,
Avignon A,
Guillaume S,
Sultan A,
Nocca D,
Mariano-Goulart D.

vBMD compared with trabecular vBMD

Diabetes
STUDY
Relationship Between
Insulin Resistance(HOMA-IR),
Trabecular BoneScore (TBS), andThree-Dimensional
Dual-Energy X-ray
Absorptiometry (3DDXA) in Non-Diabetic
Postmenopausal
Women.

[2020]OUTCOMESRESULTS &VISUALIZATIONS

381

In non-diabetic postmenopausal

Women located in quartile 4

postmenopausal

women there was a direct(Q4) of HOMA-IR had higher

women

relationship between insulinvalues of volumetric bone

resistance and vBMD, whosemineral density (vBMD) but noteffect is directly related toTBS.

COHORT

greater weight.

The increase was higher in theThis might be explained by thetrabecular compartment

formation of advanced(16.4%) than in the corticalglycosylation products (AGEs) incompartment (6.4%). Similar

the bone matrix, which reduces

results were obtained forbone deformation capacity andinsulin.

resistance, as well as increases
fragility.

Available here

COUNTRY &AUTHORS

Spain
Campillo-Sánchez F,
Usategui-Martín R,
Ruiz-de Temiño A,
Gil J,
Ruiz-Mambrilla M,
Fernández-Gómez
JM,
Dueñas-Laita A,
Pérez-Castrillón JL.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

CancerSTUDY
The effect of an
online exercise
programme onbone health inpaediatriccancersurvivors(iBoneFIT):
study protocolof a multicentre
randomized
controlled trial.

COHORT
116 Subjects•

Aged 6 to 18•

Intervention(n=58)•

Control(n=58)OUTCOMESRESULTS & VISUALIZATIONSThis article
describes thedesign, rationale
and methods of astudy intended toSpaintest the effect ofa rigorous online

Gil-Cosano JJ,
Ubago-Guisado E,
Sánchez MJ,
Ortega-Acosta MJ,
Mateos ME,
Benito-Bernal AI,
Llorente-Cantarero
FJ,
Ortega FB,
Ruiz JR,Labayen I,
Martinez-Vizcaino V,
Vlachopoulos D,
Arroyo-Morales M,
Muñoz-Torres M,
Pascual-Gázquez JF,
Vicho-González MC,
Gracia-Marco L.

exerciseprogramme onbone health inpaediatric cancer
survivors. If
successful, the[2020]

iBoneFIT study
will contribute to

Available here

COUNTRY &AUTHORSdecrease chronic
health conditionsin this population
and will have apositive impact inthe society.

Glucocorticoids
STUDY
Daily low doseof
glucocorticoids
inducestrabecular andcortical bones
impairment at
the femur: a 3D
analysis using
DXA-based
modelling.

COHORT402 patients(females andmales) treated

OUTCOMES

both cortical andtrabecular bone iswith low dose ofobserved in

GC (>5mg/d forpatients treated>3 months);

with GC, even with

Versus 1,087
gender-, ageand BMImatched controls• Effect on the

low dose, with:cortical bone at
the total femur
trabecular bone
localized at the

Available here

COUNTRY &AUTHORS

An impairment of• Effect on the[2018]RESULTS & VISUALIZATIONS

femoral neckUSA
• On 2D: significantly lower aBMD at total femur in GC(while no significant difference at lumbar spine)• On 3D: significantly lower cortical surface BMD at total
femur & lower trabecular volumetric BMD localized at
the femoral neckIn a sub-analysis of fractured subjects, lower corticalsBMD and trabecular vBMD observed at the total femur,
and significantly lower in GC-treated Fx vs GC-treated
without fx.

Manasanch BerenguéA,
Winzenrieth R,
Humbert L,
Leib E.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Down Syndrome
STUDY
Volumetric
BMD by 3DDXA andTrabecularBone Score in
Adults With
Down
Syndrome.

COHORTOUTCOMESCOUNTRY &AUTHORSRESULTS & VISUALIZATIONS

297 Adult

Trabecular vBMD at

subjects withtotal hip and femoral

Down Sydrome.

neck was lower inMales & Females

males than infemales.

Spain

Trabecular andCosta R,
Real de Asúa D,
Gullón A,
De Miguel R,
Bautista A,
García Emilia RoyC,
García-Vadillo J,
Suárez C,
Moldenhauer F,
Castañeda S.

cortical vBMD
decreased with age,
but age decline in[2021]

trabecular vBMD wasmore pronounced inmales.

Available here

Both 3D-DXA & TBS
could be used ascomplementary tools
to areal BMD

Spinal Cord Injury
STUDY
Analysis of theevolution ofcortical andtrabecular bonecompartmentsin the proximal
femur after
spinal cord
injury by 3DDXA.

COHORT
16 Subjects
•

Male

•

SCI <3months since•

OUTCOMES
Marked trabecularvBMD

and cortical boneloss was observedat the proximal
femur short-term

injuryafter SCI. 3D-DXA

Without anti-measured vBMD

osteoporotic

evolution at both

treatment

COUNTRY &AUTHORSRESULTS & VISUALIZATIONS

Spain

femoralcompartments andcortical thinning,providing better[2018]

knowledge of theirdifferential
contributory role to

Available herebone strength andsignificantly decreased at integral, trabecular, and corticalprobably of thecompartments at 6 months, with a further decrease at 12

effect of therapy inmonths. Resulting in an overall decrease of - 16.6, - 21.9, andthese patients.

- 5.0%, respectively.

Gifre L,
Humbert L,
Muxi A,del Rio L,
Vidal J,
Portell E,
Monegal A,
Guañabens N,
Peris P.

Cortical thickness also decreased at 6 and 12 with the
maximal decrease being observed during the first 6 months.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Rheumatoid Arthritis
STUDY

COHORTOUTCOMES

Trabecular andcortical bone
involvement inrheumatoid
arthritis by DXA
and DXA-based
3D modelling.

205 Adults

3D-DXA•

105 RApatients•

100
controls
group

COUNTRY &AUTHORSRESULTS & VISUALIZATIONS
c-allowed us tofind changes intrabecular andcortical bone

Argentina

compartments
in RA patients
otherwise notapparent using[2020]

standard DXADMARD (n = 75) group showed significantly lower trabecularand cortical vBMD than the CG.
Despite the lower values, the b-DMARD group (n = 30) showed

Available here

no significant differences in most parameters compared with
the CG.
The trabecular and cortical 3D parameters were significantly
lower in the group with an RA disease duration of 1 to 5 years
than in the CG, and the trabecular vBMD was significantly lower
in the group with a duration of corticosteroid therapy of 1 to
5 years than in the CG.

Brance ML,
Pons-Estel BA,
Quagliato NJ,
Jorfen M,
Berbotto G,
Cortese N,
Raggio JC,
Palatnik M,
Chavero I,
Soldano J,
Dieguez C,
Sánchez A,
Del Rio L,
Di Gregorio S,
Brun LR.

Hypophosphatasia
STUDY

COHORTOUTCOMES

Evaluation ofbone mineraldensity and3D-Shaperparameters incongenital
hypophosphata-sia of theadult.

33 Adults with

No differences in

HPP with

BMD between

heterozygous
mutation
•

21
women

•

12 menRESULTS & VISUALIZATIONS

subjects with andwithout stressfractures

Spain

3D-Shaper
showed adecrease incortical thickness
between patients[2021]

with stressfractures vswithout them andthose with

Available here

COUNTRY &AUTHORS

traumatic
fractures

Decrease in cortical thickness (mm) in patients with stressfractures [1.8 (1.77-1.89)] compared to subjects without them
[1.94 (1.87-2.03, p=0.03)] and compared to those with traumatic
fractures [1.97 (1.88-2.04), p=0.03].

Tornero C,
Coronado M,
Humbert L,
Navarro-Compán V,
García Carazo S,
Lancha Hernández
C,
Balsa A,
Aguado Acín P.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Acromegaly
STUDY
3D DXA Hip
Differences inPatients with
Acromegaly or
Adult GrowthHormoneDeficiency.

COHORT
67 Subjects•

20
Acromegaly•

14 AGHD•

33 Controls[2021]

Available here

OUTCOMES
3D-DXA
provided useful
information
about thecharacteristics ofboneinvolvement ingrowth hormone(GH)-relateddisorders.
Patients with
AGHD showeddistinct
involvement of
the corticalstructure.

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORSSpain

The mean-adjusted 3D-DXA parameters did not differ
between acromegaly patients and the controls (p > 0.05)

Gracia-Marco L,
Gonzalez-Salvatierra
S,
Garcia-Martin A,
Ubago-Guisado E,
Garcia-Fontana B,
Juan Gil-Cosano J,
Muñoz-Torres M.

Cortical bone impairment (−7.3% to −8.4%; effect size(ES) = 0.78) in AGHD patients (p < 0.05).
Differences in the cortical bone parameters were moreevident when comparing AGHD patients (−8.5% to−16.2%; ES = 1.22 to 1.24) with acromegaly patients (p <0.05).

Vertebral
Fractures Occur
Despite Controlof Acromegaly
and ArePredicted by
CorticalVolumetric
Bone Mineral
Density.

[2021]

70 Acromegaly
Subjects•

26 Active
Acromegaly

The most
sensitive andspecific predictor
of incident VF
was TH corticalvBMD,suggesting thatcortical bone isinvolved in
fracturedevelopment.

In 13 patients, 9 with controlled disease, VF wasobserved. A decrease in TBS, sBMD, necktrabecular vBMD, TH, and neck cortical vBMD in VF
compared with non-VF subjects was observed (P <.05).
Multivariate analysis of fracture prediction showed
TH cortical vBMD as the best fracture prediction
parameter with area under the curve of 0.774.
TBS was negatively associated with fasting plasma
glucose and glycated hemoglobin (HBA1c) at eachtime point during the follow-up.

Available here

SlovakiaKužma M,Vaňuga P,
Ságová I,
Pávai D,
Jackuliak P,
Killinger Z,
Binkley NC,
Winzenrieth R,
Genant HK,
Payer J.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSport, exercise, muscle & bone
There’s a lot of interest in the field on how non-pharmacological therapies can impact bonehealth and density and reduce a patient’s chance of fracture. Using 3D-Shaper, clinicians andresearchers have been able to fully explore the specific effects that lifestyle changes are having on
the bone at a local level (cortical, trabecular and integral bone compartments).
Understanding the Physiological effects of a healthy lifestyle carries great significance, and 3DShaper’s technology enables users to better understand their patients, thus identifying the best
way to manage and treat them.

Below are examples of how 3D-Shaper has been used to generate insights into the effect of sport& exercise on bone health and density:

To date, there has been a total of 18 studies across 5 countries:

KEY PUBLICATIONSTUDYCOHORTOUTCOMES

Femur 3D-DXA
assessment infemale football
players,swimmers andsedentarycontrols.

Elite female
athletes (fromFC Barcelona& Spanishnational
swimming
teams);

3D-DXA modelling
could provide
insight into bone
remodelling insports field,
allowing toevaluate femoral
trabecular andcortical strengthfrom standard DXA
scans.

[2022]
Available here

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

Spain

Football (Soccer) players showed 20% higher
cortical sBMD and 17% higher trabecular vBMD.
3D-DXA modelling revealed statistical differences incortical thickness and vBMD between athletes
engaged in weight-bearing (football) and nonweight bearing (swimming) sports.

Amani A,
Bellver M,
Del Rio L,
Ramon Torrella, J
Lizarraga A,
Humbert L,
Drobnic F.

No differences between the non-weight bearing
sport and the sedentary controls.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Assessment offemoral neckstrength andbone mineraldensitychangesfollowing
exercise using
3D-DXA
images.

10 females and26 males3D-DXAtechnology canassess the effectof exercise
interventions inlarge cohorts

The exercise group had a mean bone accrual exceeding
repeatability values in the femoral head and corticalregions. The case with the highest vBMD change (6.4%)
caused 18% and −7% strength changes under single-leg
stance and sideways fall.

Available here[2020]

Available here

93 Men withlower than
average aBMD

Findings indicatethat supervised
HiRIT provides a
positive stimulus
to cortical boneat the medial FN
compared withsupervised IAC
exercise
Both HiRIT and
IAC preservebone strength atthe distal tibia
and distal radius.
Effects may
translate into a
reduced risk oflower and upper
extremity fracturein middle-aged
and older men
with low bone
mass.

COUNTRY &AUTHORS

Australia

In the repeated images, the total hip vBMD difference
was 0.5 ± 2.5%. Element-by-element BMD differences
reached 30 ± 50%.

[2021]

Effects ofSupervised
High-Intensity
Resistance andImpact Trainingor MachineBased Isometric
Training on
Regional Bone
Geometry andStrength inMiddle-Agedand Older Men
With Low Bone
Mass: The
LIFTMOR-M
SemiRandomised
Controlled
Trial.

RESULTS & VISUALIZATIONSO'Rourke D,
Beck B,
Harding A,
Watson S,
Pivonka P,
Martelli S.

Australia

HiRIT improved medial FN cortical thickness
compared with CON (5.6 ± 1.7% versus−0.1 ± 1.9%, p = 0.028) and IAC (5.6 ± 1.7% versus
0.7 ± 1.7%, p = 0.044). Distal tibia total BMC, vBMD,
area and bone strength index, and trabecular BMC
and bone strength index all declined for CON
compared with maintenance for both HiRIT and
IAC (all p < 0.05). HiRIT maintained distal tibia
trabecular area compared with a loss in CON(0.2 ± 0.5% versus −1.6 ± 0.5%, p = 0.013)

Harding A,
Weeks B,
Lambert C,
Watson S,
Weis L,
Beck B.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSTUDYCOHORTOUTCOMES

Cortical andtrabecular bone
analysis ofprofessional
dancers using
3D-DXA: acase-control
study.

80 Subjects•
40
Professional
dancers•
40 Controls

Elite ballet dancing
does not appear tohave a deleterious
effect on bonehealth.

[2018]
Available here

Professional balletdancers havehigher BMD for
both cortical andtrabecular bonecompartments.

RESULTS & VISUALIZATIONSCOUNTRY &AUTHORS

Portugal

Compared to non-exercising participants, dancers
exhibited significantly higher volumetric density for
integral, cortical and trabecular bone, and thicker
cortex at the femur.

Freitas L, Amorim T,
Humbert L, Fonollá R,
Flouris AD, Metsios
GS, Jamurtas AZ,
Koutedakis Y.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY

Full Study Bibliography
Technical & Validation
1.
2.

3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

13.

14.
15.

16.
17.
18.

19.

Martin, D. et al. Clinical Physician Assessment during total hip arthroplasty correlates with DXA
parameters. ISCD Annual Meeting 2023.
López Picazo, M., Humbert, L., Winzenrieth, R., Black, D. Accuracy of Femoral Shape, Trabecular andCortical bone measurements using DXA-based 3D modelling in subjects from the US. ASBMR 2022
Annual Meeting.
Qasim, M. et al. 3D-Shaper Based Finite Element Analyses as an Alternative to QCT Based Analyses for
Femur Strength Estimation. ASBMR 2022 Annual Meeting.
Kai, K. et al. Assessment of proximal femoral bone structure by DXA: Recent advances and clinicalapplications. Japanese Society for Bone Morphometry Annual Meeting 2022.
Suzuki, Y. et al. Comparison of bone structure with different YAM values of the proximal femur using 3DShaper. Japanese Society for Bone Morphometry Annual Meeting 2022.
Suzuki, Y. et al. Verification of possible errors in automated 3D-SHAPER analysis. Japanese Society forBone Morphometry Annual Meeting 2022.
Di Gregorio, S., Brance, L., Romero Martinez, S., Solé Massana, C., Del Rio, L., Lopez Medina, M. Is theevaluation of 3D-DXA parameters useful in clinical practice? WCO-IOF-ESCEO 2022.
Di Gregorio, S., Brance, L., Lopez Medina, M., Romero Martinez, S., Brun, L., Del Rio, L. Which are thefactors that influence at hip bone 3D-DXA volumetric parameters. WCO-IOF-ESCEO 2022.
T. Sone, L. Humbert, M. Lopez, R. Winzenrieth, K. Ohnaru. Assessment of femoral shape, trabecular andcortical bone in Japanese subjects using DXA-Based 3D modelling. ASBMR 2021 Annual Meeting.
E Spector, G Yardley, D Krueger, H Goel, N Binkley, J Sibonga. Validation of a Modified DXA Software to
Identify Astronauts at Risk for Persistent Spaceflight-induced Bone Loss. ISCD 2021.
Yusuke Suzuki, Motokazu Kai, Ikuko Tanaka, et.al. Hip Structural Analysis (HSA) using DXA and 3DSHAPER. JOS & JSBMR 2021.
Del Rio Barquero L., et al. Cambios locales de densidades volumétricas cortical y trabecular con la edaden población española, utilizando modelos 3D de fémur proxmial basados en dxa: proyecto seiomm 3D-Shaper. SEIOMM 2021.
Di Gregorio S., Brance M. L., Lopez Medina M. , Romero Martínez S., Solé C. Brun L. Parámetros 3d decadera. Utilidad clínica en la interpretación de respuestas terapéuticas al tratamiento para osteoporosis.
SEIOMM 2021.
DI Gregorio S., Ortiz S., Del Rio Barquero L. Evaluación de potenciales factores determinantesde loscomponentes de cadera volumétricos (3D-DXA). Estudio poblacional. SEIOMM 2021.
Antonia García Martín, et al. New technologies in the evaluation of bone fragility and their application in
endocrinology. Endocrinol Diabetes Nutr (Engl Ed). 2020 Nov;67(9):602-610. DOI :10.1016/j.endinu.2020.01.005.
Del Rio LM, Di Gregorio S, Brance L, Brun L. 3D-DXA parameters in lumbar spine: changes throughout
life in female population - preliminary results. WCO-IOF-ESCEO 2020.
Brance M, et al. References values of three-dimensional proximal femur parameters from bonedensitometry images in healthy subjects from Argentina. WCO-IOF-ESCEO 2020.
López Picazo M, Bejarano López L, Humbert L, Cons Molina F. Anatomical distribution of the differencesin DXA-derived vBMD at the lumbar spine between subjects with L1 vertebra fracture and controls. WCOIOF-ESCEO 2020.
Di Gregorio S, et al. Are vertebral 3D-DXA parameters useful to discriminate vertebral fractures? WCOIOF-ESCEO 2020.

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20. Mann A, et al. Hip areal BMD by DXA (aBMD) and hip volumetric BMD by 3D modeling of hip DXA(vBMD) are highly correlated in both fracture prevalent and fracture non-prevalent osteoporosis patients.
WCO-IOF-ESCEO 2020.
21. Ruiz Wills C, et al. 3D patient-specific finite element models of the proximal femur based on DXA towards
the classification of fracture and non-fracture cases. Bone. 2019 Apr;121:89-99. DOI :10.1016/j.bone.2019.01.001.
22. Humbert L, et al. 3D Analysis of Cortical and Trabecular Bone From Hip DXA: Precision and Trend
Assessment Interval in Postmenopausal Women. J Clin Densitom. 2019 Apr - Jun;22(2):214-218. DOI :10.1016/j.jocd.2018.05.001.
23. Casado Burgos E, et al. Datos de referencia de mediciones óseas en modelos 3d de fémur proximal en
población español con DXA: PROYECTO SEIOMM - 3D-SHAPER. SEIOMM 2019.
24. Gerganova A, et al. Comparison between 3D-SHAPER® analysis and standard 2D DXA scan of theproximal femur. WCO-IOF-ESCEO 2019.
25. Clotet J, et al. Structural Parameters of the Proximal Femur by 3-Dimensional Dual-Energy X-ray
Absorptiometry Software: Comparison With Quantitative Computed Tomography. J Clin Densitom. 2018
Oct - Dec;21(4):550-562. DOI : 10.1016/j.jocd.2017.05.002.
26. Di Gregorio et al. Evaluación de los componentes cadera mediante parámetros 3D y sus potenciales
factores determinantes. AAOMM-SAO 2018.
27. Humbert l, Di Gregorio S. Simposio: Utilidad de la reconstrucción 3D de cadera: de la investigación a laaplicación clínica. AAOMM-SAO 2018.
28. Humbert L, Del Río Barquero LM, Malouf J, Winzenrieth R. Sponsored SEIOMM Symposium: 3D-SHAPER:
Analyzing the Proximal Femur in 3D from Hip DXA Scan. ECTS 2018.
29. Ruiz Wills C, et al. Major Principal Stress (MPS) derived through DXA-based 3D modelling as a highpredictive new variable for hip fracture. WCO-IOF-ESCEO 2018.
30. Humbert L, et al. 3D-DXA: Assessing the Femoral Shape, the Trabecular Macrostructure and the Cortex
in 3D from DXA images. IEEE Trans Med Imaging. 2017 Jan;36(1):27-39. DOI : 10.1109/TMI.2016.2593346.
31. Humbert L, et al. Precision assessment of cortical thickness and volumetric bone mineral density measured
by 3D-DXA. SEIOMM 2017.
32. Humbert L, et al. Precision assessment of cortical thickness and volumetric bone mineral density derived
from hip DXA scans using 3D DXA. ASBMR 2017 Annual Meeting.
33. Humbert L, Di Gregorio S, Del Río Barquero LM. Short-term precision assessment and monitoring timeinterval to assess bone status in postmenopausal women by 3D-DXA. WCO-IOF-ESCEO 2017.
34. Humbert L, et al. Technical Note: Cortical thickness and density estimation from clinical CT using a priorthickness-density relationship. Medical Physics 2016 Apr;43(4):1945. DOI : 10.1118/1.4944501.
35. López Picazo M, et al. 3D-Shaper Spine: Modelling the lumbar Spine in 3D from DXA images. ASBMR
2016 Annual Meeting.
36. Magallón Baro A, et al. Medidas sobre la geometría y la densidad mineral ósea de la columna lumbar
obtenidas mediante la tecnología 3D-DXA. SEIOMM 2016.
37. Fonollà R, et al. Datos de referencia para medidas del hueso cortical y trabecular mediante la tecnología
3D-DXA. SEIOMM 2016.
38. Humbert L, et al. Structural parameters computed by 3D-DXA: accuracy evaluation against quantitative
computed tomography. WCO-IOF-ESCEO 2016.
39. Camargos BM, Silva BC, Humbert L, Del Río Barquero LM. Clinical Applicability of 3D-DXA in Individuals
with Small Bone Size and Low Bone Mineral Density: a Case Report. WCO-IOF-ESCEO 2016.
40. Fonollà R, et al. 3D-DXA Validation using Hologic DXA images. WCO-IOF-ESCEO 2015.
41. Del Río Barquero LM. Densitometría ósea volumétrica: ¿Es el futuro? SEIOMM 2015.
42. Humbert L, Whitmarsh T, del Río Barquero LM, Frangi AF. Computing structural parameters from Dualenergy X-ray Absorptiometry using a 3D reconstruction method. WCO-IOF-ESCEO 2015.
43. Humbert L, Martelli Y, Di Gregorio S, del Río Barquero LM. 3D-DXA: a 3D Modelling Method of theProximal Femur Integrated in DMS DXA Device. WCO-IOF-ESCEO 2014.
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44. Whitmarsh T, et al. 3D Reconstruction of the Lumbar Vertebrae from Anteroposterior and Lateral Dual-energy X-ray Absorptiometry. Medical Image Analysis, 2013 May;17(4):475-87. DOI :10.1016/j.media.2013.02.002.
45. Humbert L, et al. Comparison between Single and Multi-view Simulated DXA Configurations for
Reconstructing the 3D Shape and Bone Mineral Density Distribution of the Proximal Femur. Medical
Physics, 2012 Aug;39(8):5272-6. DOI : 10.1118/1.4736540.
46. Humbert L, et al. Femoral Strength Prediction using a 3D Reconstruction Method from Dual-Energy Xrays Absorptiometry. IEEE International Symposium on Biomedical Imaging 2012, 1451-1454. DOI :10.1109/ISBI.2012.6235844.
47. Humbert L, et al. Femoral Strength Prediction using a 3D Reconstruction Method from Dual-Energy Xray Absorptiometry. ISBI 2012.
48. Martelli Y, et al. A software framework for 3D reconstruction and fracture risk assessment of the proximal
femur from dual-energy x-ray absorptiometry. VPH conference 2012.
49. Spinelli M, et al. FE prediction of strains for patient-specific proximal femurS generated from a single DXA.
ESB 2012.
50. Del Río Barquero LM, et al. Densitometria ósea en 3D. Nuevos avances en estimación del riesgo de
fractura. Densitometría ósea en ortopedia. V Curso de densitometría clínica de SOVEMO 2012.
51. Humbert L, et al. 3D Reconstruction of Bony Structures from DXA Images. III Jornades R+D+I en TIC I
Salut 2012.
52. Whitmarsh T, et al. Reconstructing the 3D Shape and Bone Mineral Density Distribution of the Proximal
Femur from Dual-energy X-ray Absorptiometry. IEEE Transactions on Medical Imaging, 2011
Dec;30(12):2101-14. DOI : 10.1109/TMI.2011.2163074.
53. Whitmarsh T, Humbert L, Del Río Barquero LM, Frangi AF. Volumetric Bone Mineral Density Estimation
using a 3D Reconstruction Method from Dual-energy X-ray Absorptiometry. ASBMR 2011 Annual Meet
54. Humbert L, et al. 3D reconstruction of both shape and bone mineral density distribution of the femur
from dxa images. ISBI 2010.
55. Whitmarsh T, et al. 3D Bone Mineral Density Distribution and Shape Reconstruction of the Proximal Femurfrom a Single DXA Image. SPIE 2010

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Association with Fracture
56. M. Iki, et al. Predictive ability of novel volumetric and geometric indices derived from dual-energy X-ray

absorptiometric images of the proximal femur for hip fracture compared with conventional areal bonemineral density: the Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporos Int. 2021
May 26. DOI :10.1007/s00198-020-05806-1.
57. M. Iki, et al. Performance of Fracture Prediction with a Novel Bone Index based on 3D Modeling of the
DXA hip images - JPOS Cohort Study. JOS & JSBMR 2021.
58. López Picazo M, et al. Association between osteoporotic femoral neck fractures and DXA-derived 3D
measurements at lumbar spine: a case-control study. Arch Osteoporos. 2020 Jan 3;15(1):8. DOI :10.1007/s11657-019-0680-4.
59. López Picazo M, et al. Discrimination of osteoporosis-related vertebral fractures by DXA-derived 3D
measurements: a retrospective case-control study. Osteoporos Int. 2019 May;30(5):1099-1110. DOI :10.1007/s00198-019-04894-y.
60. Montoya MJ, et al. Mediciones óseas en modelos 3D de fémur proximal con DXA, en pacientes con
fracturas por fragilidad. SEIOMM 2019.
61. Di Gregorio S, et al. Análisis tipos de fractura fémur proximal mediante mediciones óseas DXA-3D.
SEIOMM 2019.
62. Del Río Barquero LM, et al. Local bone density defects in patients with femoral neck fracture. SEIOMM
2019.
63. López Picazo M, et al. Association between osteoporosis-related vertebral fractures and DXA-derived 3D
measurements at lumbar spine. ASBMR2019 Annual Meeting.
64. Di Gregorio S, Brance L, Humbert L, Del Río Barquero LM. 3D-DXA measurements in lumbar spine inpatients with vertebral fractures. ASBMR2019 Annual Meeting.
65. Biver E, et al. DXA-based 3D mapping of hip cortical thinning correlates with incident fractures inpostmenopausal women from the GERICO cohort. ASBMR2019 Annual Meeting.
66. Di Gregorio S, et al. 3D analysis of local bone density defects in patients with femoral neck fracture. WCOIOF-ESCEO 2019.
67. Gerganova A, et al. 3D-SHAPER® Analysis of volumetric BMD at proximal femur during menopausal
transition. WCO-IOF-ESCEO 2019.
68. Di Gregorio S, et al. Analysis of bone structural parameters by DXA-3D in cervical and trochanteric hip
fractures. WCO-IOF-ESCEO 2019.
69. Biver E, et al. DXA-based 3D analysis of proximal femur cortical and trabecular bone for fracture risk
assessment: a prospective study in postmenopausal women. WCO-IOF-ESCEO 2019.
70. Humbert L, et al. DXA-Based 3D Analysis of the Cortical and Trabecular Bone of Hip Fracture
Postmenopausal Women: A Case-Control Study. J Clin Densitom. 2018 Nov 13. DOI :10.1016/j.jocd.2018.11.004.
71. López Picazo M, et al. 3D Subject-Specific Shape and Density Estimation of the Lumbar Spine from aSingle Anteroposterior DXA Image Including Assessment of Cortical and Trabecular Bone. IEEE
Transactions on Medical Imaging, 2018 Dec; 37(12):2651-2662. DOI : 10.1109/TMI.2018.2845909.
72. López Picazo M, et al. Can DXA-derived 3D measurements at the lumbar spine predict thoracic spine
fractures? SEIOMM 2018.
73. Di Gregorio et al. Factores estructurales óseos en fémur y masa magra evaluados por 3D-DXA en
pacientes con fractura de cadera. Datos preliminares. AAOMM-SAO 2018.
74. López Picazo M, et al. Can DXA-derived 3D measurements at the lumbar spine predict thoracic spine
fractures? ASBMR 2018 Annual Meeting.
75. Winzenrieth R, Humbert L, Leib E. Cortical and trabecular bone of patients with prevalent major
osteoporotic fracture: a case-control study using DXA-based 3D modelling. ASBMR 2018 Annual Meeting.
76. Guardiola S, et al. Supervised Machine Learning Techniques for Hip Fracture Prediction from DXA-based
3D Patient-Specific Femur Model Fall Simulations. ASBMR 2018 Annual Meeting.
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77. Del Río Barquero LM, Di Gregorio S, Sanchez P. Bone structural components and lean mass assessed by

3D-DXA in Hip Fracture Patients. ECTS 2018.
78. Ruiz Wills C, et al. Pedicting the risk of hip fracture from DXA-based 3D finite element simulations. ECTS

2018.
79. Galich AM, et al. Analyzing the cortical and trabecular bone of the femur of patients with vertebral
fractures using DXA-based 3D modelling. WCO-IOF-ESCEO 2018.
80. Galich AM, et al. Análisis por 3D-DXA del hueso cortical y trabecular del fémur en pacientes con fracturas
previas. XX Congreso SAEM 2017.
81. Galich AM, et al. Análisis por 3D-DXA del hueso cortical y trabecular del fémur en pacientes con fracturas
previas. AAOMM 2017.
82. Del Río Barquero LM, et al. 3D-DXA. Aplicación del análisis de elementos finitos en sujetos con fracturade cadera. SEIOMM 2017.
83. Galich AM, et al. Analyzing the cortical and trabecular bone of the femur of patients with vertebral
fractures by 3D-DXA. ASBMR 2017 Annual Meeting.
84. Del Río Barquero LM, et al. Finite Element Analysis of 3D-Shaper Femur Reconstructions to Predict Hip
Fracture. ASBMR 2017 Annual Meeting.
85. Del Río Barquero LM, Di Gregorio S, Sanchez P. Bone structural components and lean mass assessed by
3D-DXA in Hip Fracture Patients. ASBMR 2016 Annual Meeting.
86. Humbert L, et al. Cortical and Trabecular Bone Analysis of Patients with Hip Fracture and Controls using
3D-DXA. WCO-IOF-ESCEO 2015.
87. Humbert L, et al. Vertebral Fracture Risk using a 3D Reconstruction Method from DXA. WCO-IOFESCEO 2015.
88. Bagué A, et al. Discrimination of hip fracture in postmenopausal women using a 3D reconstruction
method from 2D DXA. WCO-IOF-ESCEO 2014.
89. Bagué A, et al. Discrimination of Hip Fracture event using a 3D reconstruction method from 2D DXA. A
case control study. CARS 2014.
90. Whitmarsh T, et al. Hip Fracture Discrimination from Dual-energy X-ray Absorptiometry by Statistical
Model Registration. Bone, 2012 Nov;51(5):896-901. DOI : 10.1016/j.bone.2012.08.114.
91. Whitmarsh T, et al. A Statistical Model of Shape and Bone Mineral Density Distribution of the Proximal
Femur for Fracture Risk Assessment. Medical Imaging Computing and Computer Assisted Intervention(MICCAI), 2011, 14 (Pt 2):393-400. DOI : 10.1007/978-3-642-23629-7_48.
92. Whitmarsh T, et al. Hip Fracture Discrimination using 3D Reconstructions from Dual-energy X-ray
Absorptiometry. ISBI 2011.
93. Whitmarsh T, et al. A Statistical Model of Shape and Bone Mineral Density Distribution of the Proximal
Femur for Fracture Risk Assessment. MICCAI 2011.

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Treatment Monitoring
94. Boxberger, J. et al. Abaloparatide Increases Bone Mineral Density in Regions Corresponding to Gruen

Zones 1,2,6 and 7 in Postmenopausal Women with Osteoporosis. ISCD Annual Meeting 2023.
95. Boxberger, J. et al. Effects of Abaloparatide or Placebo on Bone Mineral Density in Acetabular Regions

Corresponding to DeLee and Charnley Zones in Postmenopausal Women with Osteoporosis. ISCD
Annual Meeting 2023.
96. Lewiecki, M. et al. Comparison of Romosozumab and Teriparatide Effects on Cortical and TrabecularBone Using 3D Modeling From DXA Images in Postmenopausal Women Transitioning From
Bisphosphonate Therapy. ASBMR Annual Meeting 2022.
97. Lewiecki, M. et al. Cortical and Trabecular Bone Improvements With Romosozumab Followed by
Denosumab or Alendronate Assessed Using 3D Modeling From DXA Images. ASBMR Annual Meeting2022.
98. Goel, H., Winzenrieth, R., Humbert, L., Borchardt, G., Binkley, N. Compared with Daily Teriparatide, Cyclic
Teriparatide and Raloxifene Has Favorable Effects on Proximal Femur Geometry and Regional Volumetric
BMD. ASBMR Annual Meeting 2022.
99. Tanaka, I. et al. Examination of bone structure related to changes in the proximal femur before and after
Romosozumab treatment measured by 3D-Shaper and HR-pQCT. Japanese College of Rheumatology
Annual Meeting 2022.
100. Suzuki, Y. et al. Analysis of the proximal femur structural analysis (HSA) using DXA and 3D-Shaper inpatients treated with Romosozumab. Japanese College of Rheumatology Annual Meeting 2022.
101. Tanaka, I. et al. Investigation of bone structure related to the therapeutic effect of Romosozumab.
Japanese College of Rheumatology Annual Meeting 2022.
102. Asada, T. et al. Investigation of bone mass changes after Romosozumab administration using DXA image
analysis software 3D-SHAPER. JOS Annual Meeting 2022.
103. Ruiz Wills, M. et al. Evaluation of pharmacological treatments for osteoporosis using dxa-based 3d finite
element models. European Society of Biomechanics 2022.
104. Qasim, M., Wills, C., Winzenrieth, R., Di Gregorio, S., Del Rio, L., Humbert, L., Noailly, J. Effects ofosteoporosis pharmacological treatments on bone strength using 3D-Shaper based finite element
analyses. QMSKI 2022.
105. Qasim, M., Wills, C., Winzenrieth, R., Di Gregorio, S., Del Rio, L., Humbert, L., Noailly, J. Effects ofosteoporosis drug treatments on femur strength using 3D-Shaper based finite element analyses. WCOIOF-ESCEO 2022.
106. Winzenrieth, R., Kostenuik, P., Boxberger, J., Wang, Y. and Humbert, L. Proximal Femur Responses to
Sequential Therapy with Abaloparatide Followed by Alendronate in Postmenopausal Women with
Osteoporosis by 3D Modeling of Hip DXA. JBMR Plus, 2022 Jan, Accepted Author Manuscript e10612. DOI: 10.1002/jbm4.10612
107. R. Winzenrieth, L. Humbert, J.I. Boxberger, R.J. Weiss, Y. Wang, P. Kostenuik. Abaloparatide Effects on
Cortical Volumetric BMD and Estimated Strength Indices of Hip Subregions by 3D-DXA in Women with
Postmenopausal Osteoporosis. J Clin Densitom. 2021 Aug 31st, JOCD 1292, S1094-6950(21)00098-6. DOI: 10.1016/j.jocd.2021.11.007.
108. M. Lopez Picazo, L. Humbert, R. Winzenrieth, D. Black. The effects of Parathyroid hormone andalendronate alone or in combination on trabecular and cortical bone using DXA-based 3D- modelling.
ASBMR 2021 Annual Meeting.
109. Winzenrieth R, et al. Differential effects of abaloparatide and teriparatide on hip cortical volumetric BMD
by DXA-based 3D modeling. Osteoporos Int. 2021 Jan 26. DOI : 10.1007/s00198-020-05806-1
110. Tomoaki Kato, Motokazu Kai, Ikuko Tanaka, et.al. Investigation of therapeutic effect of Romosozumab
using 3D – SHAPER. JOS & JSBMR 2021.
111. Yohei Asada, et.al. Change of bone mass after 1 year treatment with Romosozumab evaluated by 3DSHAPER, a novel image analysis software. JOS & JSBMR 2021.
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3D-SHAPER TECHNOLOGY112. Hiroaki Mizuno, Motokazu Kai, Ikuko Tanaka, et.al. Evaluation of hip structure using 3D-SHAPER inpatients with severe osteoporosis treated by Romosozumab. JOS & JSBMR 2021.
113. Lopez Picazo M., Humbert L., Winzenrieth R., Black D. M. Efectos del tratamiento con hormonaparatiroidea y alendronato, solos o en combinación, en la densidad volumétrica trabecular y corticalevaluados mediante modelos 3D-DXA. SEIOMM 2021.
114. M. Lopez Picazo, L. Humbert, R. Winzenrieth, D. Black. The effects of Parathyroid hormone andalendronate alone or in combination on trabecular and cortical bone using DXA-based 3D- modelling.
SEIOMM 2021.
115. Winzenrieth R, et al. Heterogeneity in the cortical response to abaloparatide and teriparatide in theproximal femur by DXA-based 3D modeling. ASBMR2020 Annual Meeting.
116. Pasha P, et al. Greater increase of hip trabecular vBMD by 3D modeling of hip DXA in patients treatedwith denosumab as compared to bisphosphonates. WCO-IOF-ESCEO 2020.
117. Winzenrieth R, et al. Differential effects of abaloparatide and teriparatide on cortical volumetric BMD andbone strength indices in the proximal femur by DXA-based 3D modeling. WCO-IOF-ESCEO 2020.
118. Winzenrieth R, et al. Differential Effects of Abaloparatide and Teriparatide on Hip Cortical Volumetric BMD
by DXA-Based 3d Modeling. ENDO 2020.
119. Arboiro Pinel R, et al. Efectos del tratamiento con denosumab en 3D-DXA. SEIOMM 2019.
120. Tomatsu E, et al. Analysis of 2D-DXA image by 3D-SHAPER gives additional information for the treatment
with denosumab in post-kidney transplant recipients. ASBMR2019 Annual Meeting.
121. Goel H, Krueger D, Borchardt G, Binkley N. Compared with Daily Teriparatide, Cycles of Teriparatide andRaloxifene Favorably Influence Hip BMD and Cortical Thickness While Comparably Increasing Spine BMD.
ASBMR2019 Annual Meeting.
122. Tomatsu E, et al. DXA-based 3D modeling using 3D-SHAPER gives additional information in post-kidneytransplant patient treated with denosumab. ASBMR2019 Annual Meeting.
123. Almohaya M, Winzenrieth R, Kendler D. The Distribution of Increases in Hip Cortical Volumetric BMD in
Patients Treated with Denosumab and Bisphosphonates by 3D Modeling of Hip DXA. WCO-IOF-ESCEO
2019.
124. Guagnelli M, et al. Tibolone effect on bone components using 3D-Shaper technology compared tohormone replacement therapy and placebo in postmenopausal women. WCO-IOF-ESCEO 2019.
125. Kendler D, Almohaya M, Sami N, Winzenrieth R. Greater increases of cortical and trabecular vBMD by 3D
modeling of hip DXA in patients treated with Dmab vs bisphosphonates (extension of study with 4Y
monitoring). WCO-IOF-ESCEO 2019.
126. Winzenrieth R, et al. Effects of osteoporosis drug treatments on cortical and trabecular bone in the femur
using DXA-based 3D modeling. Osteoporos Int. 2018 Oct;29(10):2323-2333. DOI : 10.1007/s00198-0184624-4.
127. Nogués X, et al. Trabecular and cortical bone health in postmenopausal women receiving aromataseinhibitors for early breast cancer treatment: The B-ABLE prospective cohort study. SEIOMM 2018.
128. Cons-Molina F, et al. Respuesta ósea cortical y trabecular en fémur proximal de mujeres con osteoporosis
tratadas con Denosumab utilizando técnicas de modelado 3D obtenidas por DXA. AAOMM-SAO 2018.
129. Almohaya M, Sami N, Winzenrieth R, Kendler D. 3D Modelling of hip DXA indicates cortical vBMD superior
efficacy of denosumab versus alendronate. ASBMR 2018 Annual Meeting.
130. Cons Molina F, et al. Cortical and Trabecular Bone Response in Proximal Femur from Women with
Osteoporosis Treated with Denosumab or Zolendronic Acid using 3D Modelling Techniques obtained
from DXA. ASBMR 2018 Annual Meeting.
131. Almohaya M, et al. Hip DXA 3D Modeling Shows Increased Cortical Bone Density after treatment with
Denosumab versus Bisphosphonate in Postmenopausal Women. WCO-IOF-ESCEO 2018.
132. Cons Molina FF, et al. Cortical and Trabecular Bone Response in Proximal Femur from Women with
Osteoporosis Treated with Denosumab or Zolendronic Acid using 3D Modelling Techniques Obtained
from DXA. PANLAR 2018.
133. Winzenrieth R, et al. Cortical and trabecular compartments behavior in patients under bone treatments
using 3D parameters obtained from DXA. SEIOMM 2017.
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY134. López Picazo M, et al. Changes in volumetric BMD and cortical thickness measured by 3D-DXA in the

lumbar spine after 24 months of Denosumab treatment. ASBMR 2017 Annual Meeting.
135. Winzenrieth R, et al. Cortical and trabecular compartments behaviour in patients under bone treatments

using 3D parameters obtained from DXA. ASBMR 2017 Annual Meeting.
136. Güerri‑Fernandez R, et al. Analyzing the cortical and trabecular bone of tenofovir-treated HIV patientsusing 3D-DXA. WCO-IOF-ESCEO 2017.
137. Güerri-Fernandez R, et al. Bone density, microarchitecture, and bone strength after 1 year of TDF. CROI
2017 - Conference on Retroviruses and Opportunistic Infections.
138. Güerri-Fernández R, et al. Analyzing the cortical and trabecular bone of tenofovir-treated HIV patientsusing 3D-DXA. ASBMR 2016 Annual Meeting.
139. Malouf J, et al. Cortical and Trabecular Bone Mineral Content changes at the Proximal Femur assessedby 3D-DXA after PTH (1-84) treatment. WCO-IOF-ESCEO 2015.
140. Del Río Barquero LM, Di Gregorio S, Martelli Y, Humbert L. Volumetric Bone Mineral Content changes
assessed by 3D-DXA after two years of Denosumab Treatment. WCO-IOF-ESCEO 2015.
141. Malouf J, et al. Cambios en el contenido mineral óseo cortical y trabecular en el fémur proximal evaluados
por 3D-DXA tras tratamiento con PTH (1-84). SEIOMM 2015.
142. Del Río Barquero LM, Di Gregorio S, Humbert L, Martelli Y. Volumetric Bone Mineral Content changes
assessed by 3D-DXA after two years of Alendronate Treatment. ASBMR 2014 Annual Meeting.
143. Del Río Barquero LM, Di Gregorio S, Humbert L, Martelli Y. Cambios de densidad mineral óseavolumétrica tras dos años de tratamiento con Alendronato evaluado por 3D-DXA. SEIOMM 2014.

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Secondary Osteoporosis
144. Kai, K. et al. Investigation of bone microstructure of the proximal femur of patients with Rheumatoid

Arthritis using 3D-Shaper. Japanese College of Rheumatology Annual Meeting 2022.
145. Borba, V., Winzenrieth, R., Humbert, L., Nalevaiko, J., Aguilar Moreira, C. Effect of the anticoagulants(DOACS) on cortical and trabecular bone in the femur using DXA-based 3D modeling. WCO-IOF-ESCEO
2022.
146. Kužma M, Vaňuga P, Ságová I, Pávai D, Jackuliak P, Killinger Z, Binkley NC, Winzenrieth R, Genant HK,
Payer J. Vertebral Fractures Occur Despite Control of Acromegaly and Are Predicted by CorticalVolumetric Bone Mineral Density. J Clin Endocrinol Metab. 2021 Jul 16;dgab259. DOI :10.1210/clinem/dgab259.
147. Atencio P. et al. Trabecular bone score and 3D-DXA in young, antiretroviral treatment-naïve patients in
Madrid. Arch Med Sci Civil Dis 2021; 6: e52–e60. DOI: https://doi.org/10.5114/amscd.2021.105843.
148. Rosa Arboiro-Pinel, Ignacio Mahíllo-Fernández, Manuel Díaz-Curiel. Bone Analysis Using Trabecular BoneScore and Dual-Energy X-Ray Absorptiometry-Based 3-Dimensional Modeling in Postmenopausal
Women With Primary Hyperparathyroidism. Endocr Pract. 2021 Aug 25;S1530-891X(21)01177-0. DOI :10.1016/j.eprac.2021.08.006.
149. Toussirot E, Winzenrieth R, Desmarets M, et al. AB0570 Bone Mineral Density, Trabecular Bone Score andProximal Femur 3D-DXA Analysis In Psoriatic Diseases. Annals of the Rheumatic Diseases 2021;80:1322.
150. Maïmoun L, et al. Modification of bone mineral density, bone geometry and volumetric BMD in young
women with obesity. Bone. 2021 May 14;150:116005. DOI : 10.1016/j.bone.2021.116005.
151. Costa R, et al. Volumetric BMD by 3D-DXA and Trabecular Bone Score in Adults With Down Syndrome.
J Clin Densitom. 2021 Jan 30;S1094-6950(21)00011-1. DOI : 10.1016/j.jocd.2021.01.010.
152. Gracia-Marco LM, et al. 3D DXA Hip Differences in Patients with Acromegaly or Adult Growth Hormone
Deficiency. J Clin Med. 2021 Feb 9;10(4):657. DOI : 10.3390/jcm10040657.
153. Masahiro Yamamoto, et.al. Lateral cortical bone of the femoral neck in type 2 diabetic patients withvertebral fractures is deteriorated. JOS & JSBMR 2021.
154. Motokazu Kai, Ikuko Tanaka. Effects of glucocorticoids on hip trabecular and cortical bone by using 3DSHAPER. JOS & JSBMR 2021.
155. A.P Barbosa, M.R. Mascarenhas, R. Winzenrieth. Hyperthyroid men have reduced global strength of theproximal femur in 3D-Shaper analysis. WCO-IOF-ESCEO 2021.
156. M.R. Ulla, C. Vrech, L.R. Brun, M.L. Brance, E. Peralta Lopez, M.J Castro, F. Martos, S. Mazzini, M.A. Rivoira.
Bone health in patients with multiple sclerosis: analysis of bone mineral density and 3D-Reconstruction ofproximal femur by DXA. WCO-IOF-ESCEO 2021.
157. M. L. Brance, et al. Bone Mineral Density and Proximal Femur 3D-DXA Analysis in Type I Diabetes:
Preliminary Study. WCO-IOF-ESCEO 2021.
158. M. L. Brance, et al. BMD and Proximal Femur 3D-DXA Analysis in Systemic Lupus Erythematosus andSpondyloarthritis. WCO-IOF-ESCEO 2021.
159. Tornero C, et al. Evaluation of bone mineral density and 3D-Shaper parameters in congenital
hypophosphatasia of the adult. Rev Osteoporos Metab Miner. 2020; 12 (4): 129-134. DOI : 10.4321/S1889836X2020000400004.
160. Gil-Cosano JJ, et al. The effect of an online exercise programme on bone health in paediatric cancer
survivors (iBoneFIT): study protocol of a multi-centre randomized controlled trial. BMC Public Health.
2020 Oct 8;20(1):1520. DOI : 10.1186/s12889-020-09607-3.
161. Brance ML, et al. Trabecular and cortical bone involvement in rheumatoid arthritis by DXA and DXAbased 3D modelling. Osteoporos Int. 2020 Sep 24. DOI : 10.1007/s00198-020-05641-4.
162. Campillo-Sánchez F, et al. Relationship Between Insulin Resistance (HOMA-IR), Trabecular Bone Score(TBS), and Three-Dimensional Dual-Energy X-ray Absorptiometry (3D-DXA) in Non-Diabetic
Postmenopausal Women. J Clin Med. 2020 Jun 3;9(6):E1732. DOI : 10.3390/jcm9061732.

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163. Gracia-Marco LM, et al. Analysis of bone impairment by 3D DXA hip measures in patients with primary

hyperparathyroidism: a pilot study. J Clin Endocrinol Metab 2020 Jan 1;105(1). DOI :10.1210/clinem/dgz060.
164. Toussirot E, et al. Bone mineral density, trabecular bone score and proximal femur 3D-DXA analysis in
psoriatic diseases. ASBMR2020 Annual Meeting.
165. Yoshino Y, et al. Comparison of hip structure analysis and 3D-Shaper® images in post-kidney transplant
recipients with denosumab treatment. ASBMR2020 Annual Meeting.
166. Muñoz-Torres M, et al. Analysis of bone status by 3D DXA measures in patients with acromegaly or
growth hormone deficiency. ASBMR2020 Annual Meeting.
167. Olascoaga-Gómez de León A, et al. Hip structural analysis and advanced glycation end products inpatients with diabetes. WCO-IOF-ESCEO 2020.
168. Di Gregorio S, Karlsbrum S, Costanzo P, Salerni H. 3D Shaper evaluation in normo and hypercalcemic
primary hyperparathyroidism. WCO-IOF-ESCEO 2020.
169. Mascarenhas M, Barbosa A, Winzenrieth R. Impact of the serum circulating 25-hydroxyvitamin D levels
and lean body mass on cortical and trabecular bone at the proximal femur of adult men using 3D analysis.
WCO-IOF-ESCEO 2020.
170. Casado E, et al. Usefulness of 3D-DXA in assessing fracture risk in 104 male patients with chronic
obstructive pulmonary disease. .WCO-IOF-ESCEO 2020.
171. Barbosa A, Mascarenhas M, Winzenrieth R. Trabecular and cortical bone measurements by 3D-Shaper inmen with hyperthyroidism. WCO-IOF-ESCEO 2020.
172. Rui Mascarenhas M, Barbosa A, Winzenrieth R. Testosterone, estradiol and 25-hydroxyvitamin D effects
at the proximal femur in 3D analysis from a standard 2D DXA scans of adult men. EECE 2020.
173. Kužma M, et al. Non-invasive DXA-derived bone structure assessment of acromegaly patients: a crosssectional study. Eur J Endocrinol. 2019 Mar 1;180(3):201-211. DOI : 10.1530/EJE-18-0881.
174. García Hoyos M, et al. Analysis of volumetric BMD in people with Down syndrome using DXA-based 3Dmodeling. Arch Osteoporos. 2019 Sep 7;14(1):98. DOI : 10.1007/s11657-019-0645-7.
175. Tornero C, et al. Bone mineral density and 3D DXA assessment in adult patients with a positive andnegative genetic testing for hypophosphatasia compared with a healthy control group. SEIOMM 2019.
176. Casado E, et al. Utilidad de la 3D-DXA en la valoración del riesgo de fractura en pacientes varones conenfermedad pulmonar obstructiva crónica. SEIOMM 2019.
177. Tornero C, et al. Evaluación densitométrica y mediante 3D-Shaper de pacientes adultos con fosfatasa
alcalina baja persistente y test genético positivo y negativo para hipofosfatasia en comparación con un
grupo de controles sanos. SEIOMM 2019.
178. Campillo-Sánchez F, et al. Asociación entre resistencia a la insulina (homa), trabecular bone score (TBS)y 3D-DXA en mujeres postmenopáusicas no diabéticas. SEIOMM 2019.
179. Campillo-Sánchez F, et al. Asociación entre ácido úrico, trabecular bone score (TBS) y 3D-DXA en mujeres
postmenopáusicas. SEIOMM 2019.
180. García-Fontana B, et al. Contribución de DXA-3D en la evaluación de la afectación ósea en pacientes con
hiperparatiroidismo primario. SEIOMM 2019.
181. Barceló-Bru M, et al. Estudio de los compartimentos cortical y trabecular mediante 3D-Shaper enpacientes trasplantados pulmonares. SEIOMM 2019.
182. Tornero C, et al. Bone mineral density and 3d-dxa assessment in adult patients with a positive andnegative genetical testing for hypophosphatasia compared with a healthy control group. ASBMR2019
Annual Meeting.
183. García-Fontana B, et al. Structural Parameters of Proximal Femur by 3D Dual-Energy X-ray
Absorptiometry in Patients with Primary Hyperparathyroidism. ASBMR2019 Annual Meeting.
184. Gundry M, et al. 3D Shape Modelling Analysis of the Hip using 3D-SHAPER Software – A Comparison
Between Contralateral, Ipsilateral, and Baseline Hips for RTKR, TKR, and Control Participants. ASBMR2019
Annual Meeting.
185. Barcelo-Bru M, Erra A, Espinet C. Study of cortical and trabecular compartments through 3d-shaper inlung transplanted patients. ECTS 2019.
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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGY186. Mascarenhas M, et al. Impact of hypogonadism on both cortical and trabecular compartments at theproximal femur using 3D DXA modeling approach. WCO-IOF-ESCEO 2019.
187. Usategui R, et al. Association between insulin resistance (HOMA), trabecular bone score (TBS) and DXA-

derived 3D measurements of the cortical and trabecular bone in nondiabetic postmenopausal women.
WCO-IOF-ESCEO 2019.
188. Humbert L, et al. Changes in Femoral cortical and trabecular bone after bariatric surgery. WCO-IOFESCEO 2019.
189. Barceló-Bru M, Erra A, Espinet C. Study of cortical and trabecular compartments through 3D-SHAPER inlung transplanted patients. WCO-IOF-ESCEO 2019.
190. Nogués X, et al. Trabecular and cortical bone health in postmenopausal women receiving aromataseinhibitors for early breast cancer treatment: the B-ABLE prospective cohort study. WCO-IOF-ESCEO 2019.
191. Usategui R, et al. Association between insulin resistance (HOMA), trabecular bone score (TBS) and DXAderived 3D measurements of the cortical and trabecular bone in nondiabetic postmenopausal women.
WCO-IOF-ESCEO 2019.
192. Gifre L, et al. Analysis of the evolution of cortical and trabecular bone compartments in the proximal
femur after spinal cord injury by 3D-DXA. Osteoporos Int. 2018 Jan;29(1):201-209. DOI : 10.1007/s00198017-4268-9.
193. Orduna G, et al. Cortical and Trabecular Bone Analysis of Patients With High Bone Mass From theBarcelona Osteoporosis Cohort Using 3-Dimensional Dual-Energy X-ray Absorptiometry: A Case-Control
Study. J Clin Densitom. 2018 Oct - Dec;21(4):480-484. DOI : 10.1016/j.jocd.2017.05.012.
194. Valero C, et al. Estudio de la densidad mineral osea volumetrica en la cohorte CAMARGO: diferencias
relacionadas con la edad y sexo. SEIOMM 2018.
195. Tornero C, et al. Evaluación de la densidad mineral ósea volumetrica de pacientes adultos con
hipofosfatasia del adulto comparada con pacientes con hipofosfatasemia persistente y estudio genético
HPP negativo. SEIOMM 2018.
196. Montoya M, et al. Composición corporal y macro estructura de fémur proximal. SEIOMM 2018.
197. García Hoyos M, et al. Medición de la DMO volumétrica con métodos de modelado 3D a partir de la
DXA-3D en personas con Síndrome de Down. SEIOMM 2018.
198. Cortés-Berdonces M, et al. Análisis 3D de hueso cortical y trabecular en pacientes con diabetes mellitus
tipo 2. SEIOMM 2018.
199. Brance M, et al. Utilidad clínica de la reconstrucción 3D a partir de densitometría de cadera en pacientes
con artritis reumatoide tratados con diferentes esquemas terapéuticos. Datos preliminares. AAOMMSAO 2018.
200. Manasanch Berengué A, Winzenrieth R, Humbert L, Leib E. Low daily dose of glucocorticoids induces
trabecular and cortical bones impairment at the femur: a 3D analysis using DXA-based modelling. ASBMR
2018 Annual Meeting.
201. Winzenrieth R, Humbert L, Leib E. Assesment of chronic kidney disease impact at the proximal femur
using a DXA-based 3D modelling approach. WCO-IOF-ESCEO 2018.
202. Gifre L, et al. Análisis de la evolución de los compartimientos cortical y trabecular en fémur proximal
mediante 3D-DXA en pacientes con lesión medular. SEIOMM 2017.
203. Gifre L, et al. Analysis of the evolution of cortical and trabecular bone compartments in the proximal
femur after spinal cord injury by 3D-DXA. ASBMR 2017 Annual Meeting.
204. Almohaya M, et al. Volumetric Hip DXA Indicates Rapid Deterioration of Both Cortical and TrabecularBone Compartments After Allogeneic Hematologic Stem Cell Transplant. ASBMR 2017 Annual Meeting.
205. Koumakis E, et al. 3D femur assessment using DXA in patients with primary hyperparathyroidism (PHPT)
before and one year after parathyroidectomy. ASBMR 2017 Annual Meeting.
206. Gifre L, et al. Analysis of the evolution of cortical and trabecular bone compartments in the proximal
femur after spinal cord injury by 3D-DXA. EULAR 2017.
207. Gifre L, et al. Analysis of the evolution of cortical and trabecular bone compartments in the proximal
femur after spinal cord injury by 3D‐DXA. ECTS 2017.
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208. Clark P, et al. Effectiveness of 3D-DXA as a tool to differentiate bone components in two models of

diabetes compared to controls. WCO-IOF-ESCEO 2017.
209. Guglielmi G, et al. Primary hyperparathyroidism (PHPT) impaired 3D cortical density at femur as assessedfrom 2D DXA. WCO-IOF-ESCEO 2017.
210. Zanchetta MB, et al. 3D-DXA analysis of the changes in cortical and trabecular bone in patients with celiac
disease after 1-year on gluten-free diet. ASBMR 2016 Annual Meeting.
211. Humbert L, et al. Analyzing the cortical and trabecular bone of type 1 diabetes patients using 3D-DXA –a longitudinal study. ASBMR 2016 Annual Meeting.
212. Nogués X, et al. Cortical and Trabecular Bone Analysis of Patients with Early Breast Cancer under
Aromatase Inhibitors, B-ABLE Cohort, using 3D-DXA: a Longitudinal Study. WCO-IOF-ESCEO 2016.
213. Rodriguez-Morera J, et al. Cortical and Trabecular Bone Analysis of Patients with High Bone Mass fromthe BARCOS Cohort using 3D-DXA: A Case–Control Study. WCO-IOF-ESCEO 2016.
214. Guagnelli MA, et al. Cortical and trabecular bone analysis with 3D-DXA in patients with Type 2 Diabetes,
Long Latent Autoimmune Diabetes in adults (LADA) and healthy controls: a preliminary report. WCOIOF-ESCEO 2016.
215. Bagué A, et al. Cortical and Trabecular Bone Analysis of Hip Fracture Patients using 3D-DXA. ASBMR 2015
Annual Meeting.
216. Del Río Barquero LM, et al. Functional muscle-bone unit assessed by 3D-DXA: Study in a cohort of
postpolio syndrome patients. ASBMR 2015 Annual Meeting.
217. Del Río Barquero LM, et al. Assessment of sequels of Poliomyelitis in hips by 3D-DXA. WCO-IOFESCEO 2015.
218. Del Río Barquero LM, et al. Sindrome funcional post-polio, estudio DXA-3D y composición corporal.
SEIOMM 2015.
219. Malouf J, et al. Estudio volumétrico del hueso trabecular y cortical en pacientes acromegálicos mediante
3D-DXA. SEIOMM 2015.

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PUBLICATIONS BOOKLET v1.1
3D-SHAPER TECHNOLOGYSport, exercise, muscle & bone220. Amani A, et al. Femur 3D-DXA assessment in femail football players, swimmers and sedentary controls.

Int J Sports Med. Aug 2022. DOI : 10.1055/a-1928-9824.
221. O'Rourke D, et al. Assessment of femoral neck strength and bone mineral density changes following

exercise using 3D-DXA images. J Biomech. 2021 Feb 9;119:110315. DOI : 10.1016/j.jbiomech.2021.110315.
222. Harding A, et al. Effects of Supervised High-Intensity Resistance and Impact Training or Machine-Based
Isometric Training on Regional Bone Geometry and Strength in Middle-Aged and Older Men With Low
Bone Mass: The LIFTMOR-M Semi-Randomised Controlled Trial. Bone. 2020 Jul;136:115362. DOI :10.1016/j.bone.2020.115362.
223. Lambert C, et al. Regional Changes in Indices of Bone Strength of Upper and Lower Limbs in Response
to High-Intensity Impact Loading or High-Intensity Resistance Training. Bone. 2020 Mar;132:115192. DOI :10.1016/j.bone.2019.115192.
224. Ng CA, et al. Feasibility, safety and effectiveness of a pilot 16-week home-based, high-impact exercise
intervention in post-menopausal women with low bone mineral density. ASBMR2020 Annual Meeting.
225. Ng CA, et al. Feasibility, safety and effectiveness of a 16-week home-based hopping and jumping pilot
exercise intervention in post-menopausal women with low bone mineral density. WCO-IOF-ESCEO 2020.
226. Ng CA, et al. Associations between physical activity and bone structure in older adults: does the use of
self-reported versus objective assessments of physical activity influence the relationship? Osteoporos Int.
2019, 31(3):493-503. DOI : 10.1007/s00198-019-05208-y.
227. Gandham A, et al. Associations of Health-Related Quality of Life, Fear of Falling and Objective Measuresof Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass. J Clin Med. 2019
Sep 2;8(9). DOI : 10.3390/jcm8091370.
228. Freitas L, et al. Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case-control
study. J Sports Sci. 2019 Jan;37(1):82-89. DOI : 10.1080/02640414.2018.
229. Watson SL, et al. High-Intensity Resistance and Impact Training Improves Bone Mineral Density andPhysical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR
Randomized Controlled Trial. J Bone Miner Res. 2018 Feb;33(2):211-220. DOI : 10.1002/jbmr.3284.
230. Humbert L, et al. 3D analysis of the cortical and trabecular bone of elite female athletes involved in highand low-impact sports. SEIOMM 2018.
231. Humbert L, et al. 3D analysis of the cortical and trabecular bone of elite female athletes involved in highand low-impact sports. ASBMR 2018 Annual Meeting.
232. Buehring B, et al. Relationship of muscle function and mass with DXA-derived 3D parameters. WCO-IOFESCEO 2018.
233. Humbert L, et al. 3D analysis of the cortical and trabecular bone of elite female athletes involved in highand low-impact sports. WCO-IOF-ESCEO 2018.
234. Harding A, Weeks B, Watson S, Beck B. The LIFTMOR-M (Lifting Intervention For Training Muscle andOsteoporosis Rehabilitation for Men) trial: protocol for a semirandomised controlled trial of supervised
targeted exercise to reduce risk of osteoporotic fracture in older men with low bone mass. BMJ
Open. 2017 Jun 12;7(6):e014951. DOI : 10.1136/bmjopen-2016-014951.
235. Lambert C, et al. A protocol for a randomised controlled trial of the bone response to impact loading or
resistance training in young women with lower than average bone mass: the OPTIMA-Ex trial. BMJ Open.
2017 Sep 1;7(9):e016983. DOI : 10.1136/bmjopen-2017-016983.
236. Pasqualini M, et al. 3D-DXA analysis showed that moderate to high-magnitude whole body vibration
training over one year increased femoral cortical thickness in lowactive postmenopausal women. ASBMR
2016 Annual Meeting.
237. Amorim T, et al. Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case–control study. WCO-IOF-ESCEO 2016.

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