3-D Visualization and Prediction of Spine Fractures

脊柱骨折的 3D 可视化和预测

• 批准号: 8259847
• 负责人: Elise F Morgan
• 金额: $ 30.56万
• 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 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8259847
• 关键词: 3-Dimensional; Accounting; Age; Anisotropy; Anterior; Area; Behavior; Bone Density; Bone Tissue; Clinical; Clinical assessments; Coupled; Data; Diagnosis; Elderly; Elements; Failure; Finite Element Analysis; Fracture; Future; Generic Drugs; Goals; Gold; Heterogeneity; High Prevalence; Human; Image; Imagery; Imaging Device; Individual; Measurement; Measures; Mechanics; Methods; Modeling; Pain; Patients; Pattern; Performance; Population; Prevention; Property; Quality of life; Regression Analysis; Resolution; Risk; Risk Estimate; Scanning; Series; Specimen; Speed; Spinal Fractures; 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; mechanical behavior; men; mortality; osteoporosis with pathological fracture; research clinical testing; research study; spine bone structure; substantia spongiosa; theories; tool

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. 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.

脊椎骨折是最常见的脊椎骨骨折类型，约三分之一的人患有脊椎骨折。 女性和六分之一的50岁以上男性。尽管其流行率很高， 脊椎骨折的风险仍然难以捉摸。这在很大程度上是由于有限的准确度和精度 目前评估脊椎强度的方法。骨矿物质密度（BMD）的平均测量值解释了 只有50-70%的椎骨强度的变化，考虑到异质性， 分布在整个椎骨中的骨组织。越来越多令人信服的证据表明 这种异质性在控制椎骨的机械行为中的重要性。的最新进展 定量计算机断层扫描（QCT）允许无创测量骨密度分布 甚至是整个骨骼中的骨小梁各向异性。我们建议这些额外的测量可以用于 建立一个新的椎体骨折风险临床评估标准。我们的总体假设是CT- 的方法，占密度和小梁各向异性的不均匀分布， 椎骨提供了比仅基于平均值方法更精确的椎骨强度预测 BMD。提出了四个具体目标。目标1将测试基于CT的椎体内测量是否 密度不均匀性是椎体强度的独立预测因子。目标#2-#4紧密相连 实验和计算研究，将测试纳入特定的生物， 在椎骨的基于QCT的有限元（FE）模型中的各向异性材料特性。这些研究将 研究这种材料属性分配对椎体有限元预测准确性的影响， 强度和破坏行为。目标#2将使用微观有限元分析来量化各向异性弹性 整个中心的财产。目标3将使用材料进行基于QCT的FE分析 在目标#2中获得的特性，并且还使用纯粹从基于BMD或基于 骨密度和骨小梁各向异性。椎体力学行为的有限元预测的准确性将 通过目标#4中进行的实验进行评价。这些实验将使用三维故障可视化 我们在过去几年中开发的技术。这些技术使我们能够 评估FE模型预测骨强度以及真实变形的保真度， 椎骨的失效行为。这种评估对于衡量这些模型的性能至关重要，因为 确定改进其预测的手段，并使其能够在世界范围内广泛实施， 临床竞技场。综合起来，建议的研究构成了一套具体和相应的步骤 我们的长期目标是开发高度准确的，患者特异性的预测技术， 从临床可行的测量脊椎强度。因此，这项工作有很大的潜力， 如何更好地诊断、治疗和预防脊柱骨折。超过50岁的女性中有三分之一，男性中有六分之一， 剩余寿命。该项目的重点是开发方法，以获得更准确的 脊柱骨强度的预测。