Are CT-Based Finite Element Model Predictions of Femoral Bone Strength Clinically Useful?
Are CT-Based Finite Element Model Predictions of Femoral Bone Strength Clinically Useful?
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DOI：
10.1007/s11914-018-0438-8
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发表时间：
2018-06
影响因子：
4.3
通讯作者：
Li X
中科院分区：
文献类型：
--
作者：
Viceconti M;Qasim M;Bhattacharya P;Li X
这项研究回顾了现有的文献，以比较双X射线骨密度(DXA-aBMD)和定量计算机断层扫描(QCT-SSFE)得出的受试者特定的有限元模型在预测身体骨骼实验测量的骨强度方面的准确性，以及它们在区分和预测方面的临床准确性。基于这些信息，我们进行了一些基本的成本-效果计算，以探索在(A)以股骨强度为终点的临床研究中使用QCT-SSFE而不是DXA-aBMD，(B)预测低骨量患者髋部骨折的风险。最近的改进包括使用平滑的边界网格、更好的近端扫描的解剖学参考、多个侧倾方向和改进的边界条件提高了QCT-SSFE的预测准确性。如果采用这些改进，在以股骨强度为终点的临床研究中，QCT-SSFE总是比DXA-aBMD更可取，尽管结合QCT-SSFE和DXA-aBMD的途径很有希望，但作为髋部骨折风险预测指标，QCT-SSFE和DXA-aBMD并不划算。
This study reviews the available literature to compare the accuracy of areal bone mineral density derived from dual X-ray absorptiometry (DXA-aBMD) and of subject-specific finite element models derived from quantitative computed tomography (QCT-SSFE) in predicting bone strength measured experimentally on cadaver bones, as well as their clinical accuracy both in terms of discrimination and prediction. Based on this information, some basic cost-effectiveness calculations are performed to explore the use of QCT-SSFE instead of DXA-aBMD in (a) clinical studies with femoral strength as endpoint, (b) predictor of the risk of hip fracture in low bone mass patients. Recent improvements involving the use of smooth-boundary meshes, better anatomical referencing for proximal-only scans, multiple side-fall directions, and refined boundary conditions increase the predictive accuracy of QCT-SSFE. If these improvements are adopted, QCT-SSFE is always preferable over DXA-aBMD in clinical studies with femoral strength as the endpoint, while it is not yet cost-effective as a hip fracture risk predictor, although pathways that combine both QCT-SSFE and DXA-aBMD are promising.
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影响因子：
2.4
作者：
Schileo, Enrico;Balistreri, Luca;Taddei, Fulvia
通讯作者：
Taddei, Fulvia
影响因子：
6.2
作者：
Kopperdahl, David L.;Aspelund, Thor;Hoffmann, Paul F.;Sigurdsson, Sigurdur;Siggeirsdottir, Kristin;Harris, Tamara B.;Gudnason, Vilmundur;Keaveny, Tony M.
通讯作者：
Keaveny, Tony M.
DOI：
10.1007/s00198-015-3277-9
发表时间：
2016-02
期刊：
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
影响因子：
--
作者：
Leal J;Gray AM;Prieto-Alhambra D;Arden NK;Cooper C;Javaid MK;Judge A;REFReSH study group
通讯作者：
REFReSH study group
DOI：
10.1080/10255842.2015.1006209
发表时间：
2016
影响因子：
1.6
作者：
Rossman T;Kushvaha V;Dragomir-Daescu D
通讯作者：
Dragomir-Daescu D
影响因子：
4.1
作者：
Cheng, XG;Lowet, G;Dequeker, J
通讯作者：
Dequeker, J