[New methods for the evaluation of bone quality. DXA-based analysis of bone quality:trabecular bone score(TBS).]

Trabecular bone score(TBS)is a texture measure that evaluates pixel gray-level variations in lumbar spine DXA images, and provides skeletal information distinct from the standard BMD measurement. Recent clinical evidences show that TBS is associated with fracture risk in primary and secondary osteoporosis, and can be used together with FRAXR and BMD to adjust FRAX-probability of fracture in postmenopausal women and older men. However, athough treatment-related increases are reflected in the TBS, these are considerably smaller than the changes in BMD and there is insufficient evidence that TBS can be used to assess response to pharmacologic treatment.