Opportunistic application of phantom-less calibration methods for fracture risk prediction using QCT/FEA.
Bone density
Finite element analysis
Phantom-less
Quantitative computed tomography
Spine
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
22
01
2021
accepted:
11
05
2021
revised:
30
04
2021
pubmed:
29
5
2021
medline:
17
11
2021
entrez:
28
5
2021
Statut:
ppublish
Résumé
Quantitative computed tomography (QCT)-based finite element analysis (FEA) implements a calibration phantom to estimate bone mineral density (BMD) and assign material properties to the models. The objectives of this study were to (1) propose robust phantom-less calibration methods, using subject-specific tissues, to obtain vertebral fracture properties estimations using QCT/FEA; and (2) correlate QCT/FEA predictions to DXA values of areal BMD. Eighty of a cohort of 111 clinical QCT scans were used to obtain subject-specific parameters using a phantom calibration approach and for the development of the phantom-less calibration equations. Equations were developed based on the HU measured from various soft tissues and regions, and using multiple linear regression analyses. Thirty-one additional QCT scans were used for cross-validation of QCT/FEA estimated fracture loads from the L Overall, 217 QCT/FEA models from 31 subjects (20 females, 11 men) with mean ages of 69.6 (13.1) and 67.3 (14) were used to cross-validate the phantom-less equations and assess bone strength. The proposed phantom-less equations showed high correlations with phantom-based estimates of BMD (99%). Cross-validation of QCT/FEA-predicted fracture loads from phantom-less equations and phantom-specific outcomes resulted in high correlations for all proposed methods (0.94-0.99). QCT/FEA correlation outcomes from the phantom-less equations and DXA-aBMD were moderately high (0.64-0.68). The proposed QCT/FEA subject-specific phantom-less calibration methods demonstrated the potential to be applied to both prospective and retrospective applications in the clinical setting. • QCT/FEA overcomes the disadvantages of DXA and improves fracture properties predictions of vertebrae. • QCT/FEA fracture estimates using the phantom-less approach highly correlated to values obtained using a calibration phantom. • QCT/FEA prediction using a phantom-less approach is an accurate alternative over phantom-based methods.
Identifiants
pubmed: 34047849
doi: 10.1007/s00330-021-08071-w
pii: 10.1007/s00330-021-08071-w
pmc: PMC8595493
mid: NIHMS1728040
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
9428-9435Subventions
Organisme : NIAMS NIH HHS
ID : R01 AR027065
Pays : United States
Organisme : NIH HHS
ID : AR027065
Pays : United States
Organisme : NIH HHS
ID : AR027065
Pays : United States
Informations de copyright
© 2021. European Society of Radiology.
Références
Johannesdottir F, Allaire B, Bouxsein ML (2018) Fracture prediction by computed tomography and finite element analysis: current and future perspectives. Curr Osteoporos Rep 16(4):411–422. https://doi.org/10.1007/s11914-018-0450-z
doi: 10.1007/s11914-018-0450-z
pubmed: 29846870
Kaesmacher J, Liebl H, Baum T, Kirschke JS (2017) Bone mineral density estimations from routine multidetector computed tomography: a comparative study of contrast and calibration effects. J Comput Assist Tomogr 41(2):217–223. https://doi.org/10.1097/RCT.0000000000000518
doi: 10.1097/RCT.0000000000000518
pubmed: 27798444
pmcid: 5359785
Schreiber JJ, Anderson PA, Hsu WK (2014) Use of computed tomography for assessing bone mineral density. Neurosurg Focus 37(1):E4. https://doi.org/10.3171/2014.5.FOCUS1483
doi: 10.3171/2014.5.FOCUS1483
pubmed: 24981903
Valentinitsch A, Trebeschi S, Kaesmacher J et al (2019) Opportunistic osteoporosis screening in multi-detector CT images via local classification of textures. Osteoporos Int 30(6):1275–1285. https://doi.org/10.1007/s00198-019-04910-1
doi: 10.1007/s00198-019-04910-1
pubmed: 30830261
pmcid: 6546649
Engelke K, Lang T, Khosla S et al (2015) Clinical use of quantitative computed tomography-based advanced techniques in the management of osteoporosis in adults: the 2015 ISCD Official Positions-Part III. J Clin Densitom 18(3):393–407. https://doi.org/10.1016/j.jocd.2015.06.010
doi: 10.1016/j.jocd.2015.06.010
pubmed: 26277853
Lee YH, Kim JJ, Jang IG (2019) Patient-specific phantomless estimation of bone mineral density and its effects on finite element analysis results: a feasibility study. Comput Math Methods Med 2019:4102410. https://doi.org/10.1155/2019/4102410
doi: 10.1155/2019/4102410
pubmed: 30719069
pmcid: 6335860
Brett AD, Brown JK (2015) Quantitative computed tomography and opportunistic bone density screening by dual use of computed tomography scans. J Orthop Translat 3(4):178–184. https://doi.org/10.1016/j.jot.2015.08.006
doi: 10.1016/j.jot.2015.08.006
pubmed: 30035056
pmcid: 5986997
Eggermont F, Verdonschot N, van der Linden Y, Tanck E (2019) Calibration with or without phantom for fracture risk prediction in cancer patients with femoral bone metastases using CT-based finite element models. PLoS One 14(7):e0220564. https://doi.org/10.1371/journal.pone.0220564
doi: 10.1371/journal.pone.0220564
pubmed: 31361790
pmcid: 6667162
Keaveny TM, Clarke BL, Cosman F et al (2020) Biomechanical computed tomography analysis (BCT) for clinical assessment of osteoporosis. Osteoporos Int 31(6):1025–1048. https://doi.org/10.1007/s00198-020-05384-2
doi: 10.1007/s00198-020-05384-2
pubmed: 32335687
pmcid: 7237403
Giambini H, Khosla S, Nassr A, Zhao C, An KN (2013) Longitudinal changes in lumbar bone mineral density distribution may increase the risk of wedge fractures. Clin Biomech (Bristol, Avon) 28(1):10–14. https://doi.org/10.1016/j.clinbiomech.2012.10.005
doi: 10.1016/j.clinbiomech.2012.10.005
Graffy PM, Lee SJ, Ziemlewicz TJ, Pickhardt PJ (2017) Prevalence of vertebral compression fractures on routine CT scans according to L1 trabecular attenuation: determining relevant thresholds for opportunistic osteoporosis screening. AJR Am J Roentgenol 209(3):491–496. https://doi.org/10.2214/AJR.17.17853
doi: 10.2214/AJR.17.17853
pubmed: 28639828
Pickhardt PJ, Pooler BD, Lauder T et al (2013) Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med 158(8):588–595. https://doi.org/10.7326/0003-4819-158-8-201304160-00003
doi: 10.7326/0003-4819-158-8-201304160-00003
pubmed: 23588747
pmcid: 3736840
Catano Jimenez S, Saldarriaga S, Chaput CD, Giambini H (2020) Dual-energy estimates of volumetric bone mineral densities in the lumbar spine using quantitative computed tomography better correlate with fracture properties when compared to single-energy BMD outcomes. Bone 130:115100. https://doi.org/10.1016/j.bone.2019.115100
doi: 10.1016/j.bone.2019.115100
pubmed: 31678491
Bevill G, Eswaran SK, Farahmand F, Keaveny TM (2009) The influence of boundary conditions and loading mode on high-resolution finite element-computed trabecular tissue properties. Bone 44(4):573–578. https://doi.org/10.1016/j.bone.2008.11.015
doi: 10.1016/j.bone.2008.11.015
pubmed: 19110082
Giambini H, Qin X, Dragomir-Daescu D, An KN, Nassr A (2016) Specimen-specific vertebral fracture modeling: a feasibility study using the extended finite element method. Med Biol Eng Comput 54(4):583–593. https://doi.org/10.1007/s11517-015-1348-x
doi: 10.1007/s11517-015-1348-x
pubmed: 26239163
Lee DC, Hoffmann PF, Kopperdahl DL, Keaveny TM (2017) Phantomless calibration of CT scans for measurement of BMD and bone strength-Inter-operator reanalysis precision. Bone 103:325–333. https://doi.org/10.1016/j.bone.2017.07.029
doi: 10.1016/j.bone.2017.07.029
pubmed: 28778598
pmcid: 5636218
Mao SS, Li D, Luo Y, Syed YS, Budoff MJ (2016) Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property. Clin Imaging 40(2):330–338. https://doi.org/10.1016/j.clinimag.2015.09.016
doi: 10.1016/j.clinimag.2015.09.016
pubmed: 26602163
Mueller DK, Kutscherenko A, Bartel H et al (2011) Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation. Eur J Radiol 79(3):375–381. https://doi.org/10.1016/j.ejrad.2010.02.008
doi: 10.1016/j.ejrad.2010.02.008
pubmed: 20223609
Boden SD, Goodenough DJ, Stockham CD et al (1989) Precise measurement of vertebral bone density using computed tomography without the use of an external reference phantom. J Digit Imaging 2(1):31–38. https://doi.org/10.1007/BF03168013
doi: 10.1007/BF03168013
pubmed: 2488150
Weaver AA, Beavers KM, Hightower RC, Lynch SK, Miller AN, Stitzel JD (2015) Lumbar bone mineral density phantomless computed tomography measurements and correlation with age and fracture incidence. Traffic Inj Prev 16(Suppl 2):S153–S160. https://doi.org/10.1080/15389588.2015.1054029
Riggs BL, Melton Iii LJ 3rd, Robb RA et al (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19(12):1945–1954. https://doi.org/10.1359/JBMR.040916
doi: 10.1359/JBMR.040916
pubmed: 15537436
Prado M, Rezaei A, Giambini H (2020) Density-dependent material and failure criteria equations highly affect the accuracy and precision of QCT/FEA-based predictions of osteoporotic vertebral fracture properties. Ann Biomed Eng. https://doi.org/10.1007/s10439-020-02595-w
Morgan EF, Bayraktar HH, Keaveny TM (2003) Trabecular bone modulus-density relationships depend on anatomic site. J Biomech 36(7):897–904
doi: 10.1016/S0021-9290(03)00071-X
Crawford RP, Cann CE, Keaveny TM (2003) Finite element models predict in vitro vertebral body compressive strength better than quantitative computed tomography. Bone 33(4):744–750. https://doi.org/10.1016/s8756-3282(03)00210-2
doi: 10.1016/s8756-3282(03)00210-2
pubmed: 14555280
Benca E, Amini M, Pahr DH (2020) Effect of CT imaging on the accuracy of the finite element modelling in bone. Eur Radiol Exp 4(1):51. https://doi.org/10.1186/s41747-020-00180-3
doi: 10.1186/s41747-020-00180-3
pubmed: 32869123
pmcid: 7458968