title: Texture analysis, bone mineral density, and cortical thickness of the proximal femur: fracture risk prediction.
abstract: OBJECTIVE
  The objectives of this study were to perform a clinical study analyzing bone quality in multidetector computed tomographic images of the femur using bone mineral density (BMD), cortical thickness, and texture algorithms in differentiating osteoporotic fracture and control subjects; to differentiate fracture types.
  
  
  METHODS
  Femoral head, trochanteric, intertrochanteric, and upper and lower neck were segmented (fracture, n = 30; control, n = 10). Cortical thickness, BMD, and texture analysis were obtained using co-occurrence matrices, Minkowski dimension, and functional and scaling index method.
  
  
  RESULTS
  Bone mineral density and cortical thickness performed best in the neck region, and texture measures performed best in the trochanter. Only cortical thickness and texture measures differentiated femoral neck and intertrochanteric fractures.
  
  
  CONCLUSIONS
  This study demonstrates that differentiation of osteoporotic fracture subjects and controls is achieved with texture measures, cortical thickness, and BMD; however, performance is region specific.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94131, USA.
authors.forename: Ana Elvira
authors.initials: AE
authors.lastname: Rodríguez-Soto
authors.forename: Karl D
authors.initials: KD
authors.lastname: Fritscher
authors.forename: Benedikt
authors.initials: B
authors.lastname: Schuler
authors.forename: Ahi S
authors.initials: AS
authors.lastname: Issever
authors.forename: Tobias
authors.initials: T
authors.lastname: Roth
authors.forename: Florian
authors.initials: F
authors.lastname: Kamelger
authors.forename: Christian
authors.initials: C
authors.lastname: Kammerlander
authors.forename: Michael
authors.initials: M
authors.lastname: Blauth
authors.forename: Rainer
authors.initials: R
authors.lastname: Schubert
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed