Vertebral Fracture Risk Thresholds from Phantom-Less Quantitative Computed Tomography-Based Finite Element Modeling Correlate to Phantom-Based Outcomes

IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Journal of Clinical Densitometry Pub Date : 2024-01-01 DOI:10.1016/j.jocd.2023.101465
Maria Prado , Sundeep Khosla , Hugo Giambini
{"title":"Vertebral Fracture Risk Thresholds from Phantom-Less Quantitative Computed Tomography-Based Finite Element Modeling Correlate to Phantom-Based Outcomes","authors":"Maria Prado ,&nbsp;Sundeep Khosla ,&nbsp;Hugo Giambini","doi":"10.1016/j.jocd.2023.101465","DOIUrl":null,"url":null,"abstract":"<div><p><em>Introduction</em><span><span>: Osteoporosis<span> indicates weakened bones and heightened fracture susceptibility due to diminished bone quality. Dual-energy x-ray absorptiometry is unable to assess bone strength. Volumetric bone mineral density (vBMD) from </span></span>quantitative computed tomography<span> (QCT) has been used to establish guidelines as equivalent measurements for osteoporosis. QCT-based finite element analysis (FEA) has been implemented using calibration phantoms to establish bone strength thresholds based on the established vBMD. The primary aim was to validate vertebral failure load thresholds using a phantom-less approach with previously established thresholds, advancing a phantom-free approach for fracture risk prediction.</span></span></p><p><em>Methodology</em><span>: A controlled cohort of 108 subjects (68 females) was used to validate sex-specific vertebral fracture load thresholds for normal, osteopenic, and osteoporotic subjects, obtained using a QCT/FEA-based phantom-less calibration approach and two material equations.</span></p><p><em>Results</em><span>: There were strong prediction correlations between the phantom-less and phantom-based methods (R2: 0.95 and 0.97 for males, and R2: 0.96 and 0.98 for females) based on the two equations. Bland Altman plots and paired t-tests showed no significant differences between methods. Predictions for bone strengths and thresholds using the phantom-less method matched those obtained using the phantom calibration and those previously established, with ≤4500 N (fragile) and ≥6000 N (normal) bone strength in females, and ≤6500 N (fragile) and ≥8500 N (normal) bone strength in males.</span></p><p><em>Conclusion</em>: Phantom-less QCT-based FEA can allow for prospective and retrospective studies evaluating incidental vertebral fracture risk along the spine and their association with spine curvature and/or fracture etiology. The findings of this study further supported the application of phantom-less QCT-based FEA modeling to predict vertebral strength, aiding in identifying individuals prone to fractures. This reinforces the rationale for adopting this method as a comprehensive approach in predicting and managing fracture risk.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101465"},"PeriodicalIF":1.7000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Densitometry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1094695023001154","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Osteoporosis indicates weakened bones and heightened fracture susceptibility due to diminished bone quality. Dual-energy x-ray absorptiometry is unable to assess bone strength. Volumetric bone mineral density (vBMD) from quantitative computed tomography (QCT) has been used to establish guidelines as equivalent measurements for osteoporosis. QCT-based finite element analysis (FEA) has been implemented using calibration phantoms to establish bone strength thresholds based on the established vBMD. The primary aim was to validate vertebral failure load thresholds using a phantom-less approach with previously established thresholds, advancing a phantom-free approach for fracture risk prediction.

Methodology: A controlled cohort of 108 subjects (68 females) was used to validate sex-specific vertebral fracture load thresholds for normal, osteopenic, and osteoporotic subjects, obtained using a QCT/FEA-based phantom-less calibration approach and two material equations.

Results: There were strong prediction correlations between the phantom-less and phantom-based methods (R2: 0.95 and 0.97 for males, and R2: 0.96 and 0.98 for females) based on the two equations. Bland Altman plots and paired t-tests showed no significant differences between methods. Predictions for bone strengths and thresholds using the phantom-less method matched those obtained using the phantom calibration and those previously established, with ≤4500 N (fragile) and ≥6000 N (normal) bone strength in females, and ≤6500 N (fragile) and ≥8500 N (normal) bone strength in males.

Conclusion: Phantom-less QCT-based FEA can allow for prospective and retrospective studies evaluating incidental vertebral fracture risk along the spine and their association with spine curvature and/or fracture etiology. The findings of this study further supported the application of phantom-less QCT-based FEA modeling to predict vertebral strength, aiding in identifying individuals prone to fractures. This reinforces the rationale for adopting this method as a comprehensive approach in predicting and managing fracture risk.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
无假体定量计算机断层扫描有限元建模得出的椎体骨折风险阈值与基于假体的结果相关联
导言:骨质疏松症是指骨骼质量下降导致骨骼变弱,易发生骨折。双能 X 射线吸收测量法无法评估骨强度。定量计算机断层扫描(QCT)的容积骨矿物质密度(vBMD)已被用于制定骨质疏松症的等效测量指南。基于 QCT 的有限元分析 (FEA) 已利用校准模型实施,以根据已建立的 vBMD 确定骨强度阈值。主要目的是使用无模型方法与之前建立的阈值验证椎体破坏载荷阈值,推进无模型方法用于骨折风险预测:方法:使用基于 QCT/FEA 的无模型校准方法和两种材料方程,对 108 名受试者(68 名女性)进行对照队列,以验证正常、骨质疏松和骨质疏松受试者的特定性别椎体骨折载荷阈值:基于两个方程的无模型方法和基于模型的方法之间具有很强的预测相关性(R2:男性为 0.95 和 0.97,女性为 0.96 和 0.98)。布兰德-阿尔特曼图和配对 t 检验表明,两种方法之间没有显著差异。使用无假体方法预测的骨强度和阈值与使用假体校准获得的结果以及之前确定的结果一致,女性骨强度≤4500 N(脆性)和≥6000 N(正常),男性骨强度≤6500 N(脆性)和≥8500 N(正常):基于无影 QCT 的有限元分析可用于前瞻性和回顾性研究,评估脊柱意外椎体骨折风险及其与脊柱弯曲和/或骨折病因的关联。这项研究的结果进一步支持了基于无模型 QCT 的有限元分析模型在预测椎体强度方面的应用,有助于识别易发生骨折的个体。这加强了采用这种方法作为预测和管理骨折风险的综合方法的合理性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Clinical Densitometry
Journal of Clinical Densitometry 医学-内分泌学与代谢
CiteScore
4.90
自引率
8.00%
发文量
92
审稿时长
90 days
期刊介绍: The Journal is committed to serving ISCD''s mission - the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics. Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management.
期刊最新文献
Corrigendum to "Follow-up bone mineral density testing: 2023 official positions of the international society for clinical densitometry" Journal of clinical densitometry: Assessment and management of musculoskeletal health vol 27(1), 101440,2024. Corrigendum to 'Executive Summary of the 2023 Adult Position Development Conference of the International Society for Clinical Densitometry: DXA Reporting, Follow-up BMD Testing and Trabecular Bone Score Application and Reporting' Journal of Clinical Densitometry Volume 27, Issue 1, January-March 2024, 101435. Associations between bone mineral density and WOMAC scores in healthy individuals: Insights from the Qatar Biobank. Predicting bone mineral content from smartphone digital anthropometrics: evaluation of an existing application and the development of new prediction models Moving towards an equitable future: Rethinking the use of race in pediatric densitometry
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1