Automated 3D trabecular bone structure analysis of the proximal femur--prediction of biomechanical strength by CT and DXA.
Automated 3D trabecular bone structure analysis of the proximal femur--prediction of biomechanical strength by CT and DXA.
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DOI：
10.1007/s00198-009-1090-z
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发表时间：
2010-09
影响因子：
4
通讯作者：
Bauer, J. S.
中科院分区：
文献类型：
--
作者：
Baum, T.;Carballido-Gamio, J.;Huber, M. B.;Mueller, D.;Monetti, R.;Raeth, C.;Eckstein, F.;Lochmueller, E. M.;Majumdar, S.;Rummeny, E. J.;Link, T. M.;Bauer, J. S.
评估骨质疏松症的标准诊断技术是双能X线吸收法（DXA）测量骨量参数。在这项研究中，DXA和骨小梁结构参数（通过计算机断层扫描[CT]获取）的组合最准确地预测了股骨近端的生物力学强度，并且比单独使用DXA的预测效果更好。应用自动3D分割算法确定股骨近端CT图像中骨小梁的特定结构参数。这样做是为了评估这些参数的能力，预测生物力学股骨强度相比，骨矿物质含量（BMC）和骨矿物质密度（BMD）获得DXA作为标准诊断技术。从福尔马林固定的人类尸体上采集了187个股骨近端标本。用DXA测定BMC和BMD。小梁骨的结构参数（即，形态测量学、模糊逻辑、Minkowski泛函和缩放指数法[SIM]）。通过测量失效载荷（FL）的生物力学侧面碰撞试验评估股骨的绝对强度。通过将FL除以身高、体重或股骨头直径等影响变量，计算用于评价相对骨强度的调整后FL参数。预测FL和调整后FL参数的最佳单一参数是明显的小梁分离（形态测定）或DXA衍生的BMC或BMD，相关性高达r = 0.802。结合DXA，结构参数（最值得注意的SIM和形态学）在线性回归模型中增加了预测FL和所有调整后FL参数（R adj = 0.872）的重要信息，并允许比单独DXA更好的预测。骨质量（DXA）和结构参数的骨小梁（线性和非线性，全球和本地）的组合最准确地预测绝对和相对股骨强度。
The standard diagnostic technique for assessing osteoporosis is dual X-ray absorptiometry (DXA) measuring bone mass parameters. In this study, a combination of DXA and trabecular structure parameters (acquired by computed tomography [CT]) most accurately predicted the biomechanical strength of the proximal femur and allowed for a better prediction than DXA alone. An automated 3D segmentation algorithm was applied to determine specific structure parameters of the trabecular bone in CT images of the proximal femur. This was done to evaluate the ability of these parameters for predicting biomechanical femoral bone strength in comparison with bone mineral content (BMC) and bone mineral density (BMD) acquired by DXA as standard diagnostic technique. One hundred eighty-seven proximal femur specimens were harvested from formalin-fixed human cadavers. BMC and BMD were determined by DXA. Structure parameters of the trabecular bone (i.e., morphometry, fuzzy logic, Minkowski functionals, and the scaling index method [SIM]) were computed from CT images. Absolute femoral bone strength was assessed with a biomechanical side-impact test measuring failure load (FL). Adjusted FL parameters for appraisal of relative bone strength were calculated by dividing FL by influencing variables such as body height, weight, or femoral head diameter. The best single parameter predicting FL and adjusted FL parameters was apparent trabecular separation (morphometry) or DXA-derived BMC or BMD with correlations up to r = 0.802. In combination with DXA, structure parameters (most notably the SIM and morphometry) added in linear regression models significant information in predicting FL and all adjusted FL parameters (up to R adj = 0.872) and allowed for a significant better prediction than DXA alone. A combination of bone mass (DXA) and structure parameters of the trabecular bone (linear and nonlinear, global and local) most accurately predicted absolute and relative femoral bone strength.
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影响因子：
4.3
作者：
Carballido-Gamio, Julio;Majumdar, Sharmila
通讯作者：
Majumdar, Sharmila
影响因子：
2.2
作者：
Keyak, JH;Falkinstein, Y
通讯作者：
Falkinstein, Y
影响因子：
2.4
作者：
Bessho, Masahiko;Ohnishi, Isao;Nakamura, Kozo
通讯作者：
Nakamura, Kozo
影响因子：
5.9
作者：
Link, TM;Vieth, V;Majumdar, S
通讯作者：
Majumdar, S
影响因子：
2.5
作者：
Carballido-Gamio, Julio;Phan, Catherine;Majumdar, Sharmila
通讯作者：
Majumdar, Sharmila