3-D Visualization and Prediction of Spine Fractures

脊柱骨折的 3D 可视化和预测

• 批准号: 7525627
• 负责人: Elise F Morgan
• 金额: $ 32.59万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-07 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7525627
• 关键词: 3-Dimensional; Accounting; Age; Anisotropy; Anterior; Area; Behavior; Bone Density; Bone Tissue; Clinical; Clinical assessments; Condition; Coupled; Data; Decompression Sickness; Diagnosis; Elderly; Elements; Failure; Finite Element Analysis; Fracture; Future; Generic Drugs; Goals; Gold; Heterogeneity; High Prevalence; Human; Image; Imagery; Imaging Device; Individual; Invasive; Measurement; Measures; Mechanics; Methods; Modeling; Muscle Rigidity; Pain; Patients; Pattern; Performance; Population; Prevention; Property; Public Health; Quality of life; Regression Analysis; Resolution; Risk; Risk Estimate; Scanning; Series; Specimen; Speed; Spinal Fractures; Standards of Weights and Measures; System; Techniques; Testing; Textiles; Vertebral column; Woman; Work; X-Ray Computed Tomography; base; bone; bone strength; clinically relevant; computer studies; density; detector; digital imaging; improved; in vivo; innovation; men; mortality; osteoporosis with pathological fracture; research clinical testing; research study; spine bone structure; substantia spongiosa; theories; tool

DESCRIPTION (provided by applicant): Vertebral fractures are the most common type of osteoporotic fracture, afflicting approximately one in three women and one in six men over the age of 50. Despite their high prevalence, sensitive and specific estimates of vertebral fracture risk have remained elusive. This is due in large part to the limited accuracy and precision of current methods of estimating vertebral strength. Average measures of bone mineral density (BMD) explain only 50-70% of the variance in vertebral strength, a result that is not surprising given the heterogeneous distribution of bone tissue throughout the vertebra. A growing and compelling amount of evidence points to importance of this heterogeneity in governing the mechanical behavior of the vertebra. Recent advances in quantitative computed tomography (QCT) allow non-invasive measurement of the distribution of bone density and even trabecular anisotropy in whole bones. We propose that these additional measurements can be used to establish a new standard for clinical evaluation of vertebral fracture risk. Our overall hypothesis is that CT- based methods that account for the heterogeneous distribution of density and trabecular anisotropy throughout the vertebra provide more accurate predictions of vertebral strength than do methods based solely on average BMD. Four specific aims are proposed. Aim #1 will test whether CT-based measures of the intra-vertebral heterogeneity in density are independent predictors of vertebral strength. Aims #2-#4 are closely coupled experimental and computational studies that will test the importance of incorporating specimen-specific, anisotropic material properties in QCT-based finite element (FE) models of the vertebra. These studies will investigate the effect of this material property assignment on the accuracy of the FE predictions of vertebral strength and failure behavior. Aim #2 will use micro-finite element analysis to quantify the anisotropic elastic properties throughout the centrum. Aim #3 will carry out the QCT-based FE analyses using the material properties obtained in Aim #2 and also using properties determined purely from estimates based on BMD or on BMD and trabecular anisotropy. The accuracy of the FE predictions of vertebral mechanical behavior will be evaluated through experiments performed in Aim #4. These experiments will use 3-D failure visualization techniques that we have developed over the past several years. These techniques afford us the unique ability to assess the fidelity with which the FE models predict bone strength as well as the true deformation and failure behavior of the vertebra. Such assessment is critical for gauging the performance of these models, for identifying means of improving their predictions, and for enabling their widespread implementation in the clinical arena. Taken together, the proposed studies constitute a set of concrete and consequential steps towards our long-term goal of developing techniques for highly accurate, patient-specific predictions of vertebral strength from clinically feasible measurements. As such, this work has strong potential for leading the way to better diagnosis, treatment, and prevention of spine fractures. PUBLIC HEALTH RELEVANCE. One in three women and one in six men over age 50 will suffer a spine fracture in their remaining lifetime. This project focuses on developing methods for obtaining more accurate predictions of bone strength in the spine.

描述(申请人提供)：脊椎骨折是最常见的骨质疏松性骨折类型，大约三分之一的女性和六分之一的男性超过50岁。尽管其发病率很高，但对脊椎骨折风险的敏感和具体估计仍然难以捉摸。这在很大程度上是由于目前估计脊椎强度的方法的精确度和精密度有限。骨密度(BMD)的平均测量只能解释椎体强度差异的50%-70%，考虑到骨组织在整个椎体的不均匀分布，这一结果并不令人惊讶。越来越多的令人信服的证据表明，这种异质性在控制椎骨的机械行为方面具有重要意义。定量计算机断层扫描(QCT)的最新进展使我们能够无创地测量整个骨骼中的骨密度分布，甚至骨小梁的各向异性。我们建议，这些额外的测量可以用来建立一个新的脊柱骨折风险的临床评估标准。我们的总体假设是，与单纯基于平均骨密度的方法相比，基于CT的方法能够解释椎体密度和骨小梁各向异性的不均匀分布，从而提供更准确的椎体强度预测。提出了四个具体目标。目的#1将测试基于CT的椎体内密度异质性测量是否为椎体强度的独立预测因素。AIMS#2-#4是紧密耦合的实验和计算研究，将测试在基于QCT的椎骨有限元(FE)模型中结合特定样本、各向异性材料属性的重要性。这些研究将调查这种材料特性分配对椎体强度和破坏行为有限元预测的准确性的影响。目的#2将使用微观有限元分析来量化整个椎体的各向异性弹性性质。Aim#3将使用在Aim#2中获得的材料特性以及纯粹基于BMD或BMD和骨小梁各向异性的估计确定的特性来执行基于QCT的有限元分析。椎体力学行为有限元预测的准确性将通过在Aim#4中进行的实验进行评估。这些实验将使用我们在过去几年中开发的三维故障可视化技术。这些技术为我们提供了独特的能力来评估有限元模型预测骨骼强度的保真度以及椎骨的真实变形和破坏行为。这样的评估对于衡量这些模型的性能、确定改进其预测的方法以及使其能够在临床领域广泛实施至关重要。综上所述，拟议的研究构成了一系列具体和相应的步骤，朝着我们的长期目标--开发技术，根据临床上可行的测量高度准确地、针对患者预测脊柱强度--迈进了一步。因此，这项工作对于更好地诊断、治疗和预防脊柱骨折具有很大的潜力。与公共卫生相关。1/3的女性和1/6的男性在50岁以上的余生中会遭受脊柱骨折。这个项目的重点是开发方法，以获得更准确的脊柱骨强度预测。