Development of an open-source measurement system to assess the areal bone mineral density of the proximal femur from clinical CT images
Development of an open-source measurement system to assess the areal bone mineral density of the proximal femur from clinical CT images
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DOI：
10.1007/s11657-022-01063-3
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发表时间：
2022-12-01
影响因子：
3
通讯作者：
Sato, Yoshinobu
中科院分区：
文献类型：
--
作者：
Uemura, Keisuke;Otake, Yoshito;Sato, Yoshinobu
摘要通常需要商业软件来测量临床计算机断层扫描（CT）图像中股骨近端的面积骨矿物质密度（aBMD）。本研究开发并验证了一个开源的可重复的系统，以量化CT-aBMD筛选骨质疏松症使用临床CT images.Purpose现有的CT图像获得的各种原因以外的骨质疏松症，它可能是有益的，以估计面积骨密度评估双能X射线吸收法（DXA-based BMD），以确定基于DXA的骨状态。在这项研究中，我们的目的是（1）开发一个开源的可重复的测量系统，以量化DXA为基础的BMD从CT images.Methods验证其准确性本研究分析了75对髋关节CT和DXA图像的妇女，获得术前评估全髋关节置换术。根据CT图像，使用https://github.com/keisuke-uemura上提供的预训练代码/模型自动分割股骨和校准体模。通过手动选择的标志分离股骨近端区域，并投影到冠状面上以测量面密度（CT-aHU）。使用校准体模将CT-aHU转换为CT-aBMD。结果DXA骨密度与CT aHU、CT aBMD的相关系数分别为0.947、0.950（均P < 0.001），与CT aHU、CT aBMD的相关系数分别为0.947、0.950（均P < 0.001）。在DXA中量化T-分数的SEE分别为0.51和0.50 CT-aHU和CT-aBMD，foreign.Conclusion与本文开发的方法，CT允许估计的DXA为基础的股骨近端的BMD在标准DXA全髋关节感兴趣的区域与SEE为0.5的T-分数。CT采集的辐射剂量需要考虑;因此，我们的数据没有提供进行CT筛查骨质疏松症的依据。然而，在已经获得的用于骨质疏松症以外的临床适应症的CT图像上，研究人员可以使用该开源系统通过估计股骨近端基于DXA的BMD来调查骨质疏松症状态。
A Summary Commercial software is generally needed to measure the areal bone mineral density (aBMD) of the proximal femur from clinical computed tomography (CT) images. This study developed and verified an open-source reproducible system to quantify CT-aBMD to screen osteoporosis using clinical CT images.Purpose For existing CT images acquired for various reasons other than osteoporosis, it might be beneficial to estimate areal BMD as assessed by dual-energy X-ray absorptiometry (DXA-based BMD) to ascertain the bone status based on DXA. In this study, we aimed to (1) develop an open-source reproducible measurement system to quantify DXA-based BMD from CT images and (2) validate its accuracy.Methods This study analyzed 75 pairs of hip CT and DXA images of women that were acquired for the preoperative assessment of total hip arthroplasty. From the CT images, the femur and a calibration phantom were automatically segmented using pre-trained codes/models available at https://github.com/keisuke-uemura. The proximal femoral region was isolated by manually selected landmarks and was projected onto the coronal plane to measure the areal density (CT-aHU). The calibration phantom was employed to convert the CT-aHU into CT-aBMD. Each parameter was correlated with DXA-based BMD, and the residual errors of CT images to estimate the T-scores in DXA were calculated using the standard error of estimate (SEE).Results The correlation coefficients of DXA-based BMD with CT-aHU and CT-aBMD were 0.947 and 0.950, respectively (both p < 0.001). The SEE for quantifying the T-scores in DXA were 0.51 and 0.50 for CT-aHU and CT-aBMD, respectively.Conclusion With the method developed herein, CT permits estimation of the DXA-based BMD of the proximal femur within the standard DXA total hip region of interest with an SEE of 0.5 in T-scores. The radiation dose for CT acquisition needs consideration; therefore, our data do not provide a rationale for performing CT for screening osteoporosis. However, on CT images already acquired for clinical indications other than osteoporosis, researchers may use this open-source system to investigate osteoporosis status through the estimated DXA-based BMD of the proximal femur.