title: Characterization of vertebral strength using digital radiographic analysis of bone structure.
abstract: Bone mineral densitometry (BMD) is useful in predicting fracture risk, but, unfortunately, there is a significant degree of overlap in BMD measurements of patients who have a high risk of fracture and patients with a low risk of fracture. In this study, a method of characterizing trabecular bone structure in digitized radiographs of vertebrae is proposed and assessed. A significant correlation between bone "structure" and the compressive strength of vertebral bodies was found. The utility of the parameter for distinguishing between "weak" and "strong" bone samples was assessed using receiver operating characteristic (ROC) analysis. Using this analysis, the structural parameter produced an area under the ROC of 0.88 +/- 0.05, while a bone density measure produced an area of 0.79 +/- 0.07. The results suggest that the addition of a measure of bone structure to the conventional measures of bone density may prove useful in predicting the quality of bone when considering surgical or medical intervention for osteoporotic conditions.
authors.affiliation: Department of Medical Biophysics, University of Toronto, Sunnybrook Health Science Centre, North York, Ontario, Canada.
authors.forename: C B
authors.initials: CB
authors.lastname: Caldwell
authors.forename: K
authors.initials: K
authors.lastname: Willett
authors.forename: A V
authors.initials: AV
authors.lastname: Cuncins
authors.forename: T C
authors.initials: TC
authors.lastname: Hearn
mesh_terms: D015519:Bone Density; D001842:Bone and Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology; D008433:Mathematics; D008962:Models, Theoretical; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging* / Q000502:physiology*; D013718:Tensile Strength; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology