title: Random field assessment of inhomogeneous bone mineral density from DXA scans can enhance the differentiation between postmenopausal women with and without hip fractures.
abstract: Bone mineral density (BMD) measurements from Dual-energy X-ray Absorptiometry (DXA) alone cannot account for all factors associated with the risk of hip fractures. For example, the inhomogeneity of bone mineral density in the hip region also contributes to bone strength. In the stochastic assessment of bone inhomogeneity, the BMD map in the hip region is considered as a random field and stochastic predictors can be calculated by fitting a theoretical model onto the experimental variogram of the BMD map. The objective of this study was to compare the ability of bone mineral density and stochastic assessment of inhomogeneous distribution of bone mineral density in predicting hip fractures for postmenopausal women. DXA scans in the hip region were obtained from postmenopausal women with hip fractures (N=47, Age: 71.3±11.4 years) and without hip fractures (N=45, Age: 66.7±11.4 years). Comparison of BMD measurements and stochastic predictors in assessing bone fragility was based on the area under the receiver operating characteristic curves (AUC) from logistic regression analyses. Although stochastic predictors offered higher accuracy (AUC=0.675) in predicting the risk of hip fractures than BMD measurements (AUC=0.625), this difference was not statistically significant (p=0.548). Nevertheless, the combination of stochastic predictors and BMD measurements had significantly (p=0.039) higher prediction accuracy (AUC=0.748) than BMD measurements alone. This study demonstrates that stochastic assessment of bone mineral distribution from DXA scans can serve as a valuable tool in enhancing the prediction of hip fractures for postmenopausal women in addition to BMD measurements.
authors: Department of Health and Kinesiology, The University of Texas at Tyler, 3900 University Boulevard, Tyler, TX 75799, USA. Electronic address: ndong@uttyler.edu.
authors: Xuanliang Neil
authors: XN
authors: Dong
authors: Department of Electrical Engineering, The University of Texas at Tyler, Tyler, TX 75799, USA.
authors: Rajeshwar
authors: R
authors: Pinninti
authors: Department of Health and Kinesiology, The University of Texas at Tyler, 3900 University Boulevard, Tyler, TX 75799, USA.
authors: Timothy
authors: T
authors: Lowe
authors: Department of Radiology, UT Health Northeast, Tyler, TX 75708, USA.
authors: Patricia
authors: P
authors: Cussen
authors: Department of Health and Kinesiology, The University of Texas at Tyler, 3900 University Boulevard, Tyler, TX 75799, USA.
authors: Joyce E
authors: JE
authors: Ballard
authors: Department of Health and Kinesiology, The University of Texas at Tyler, 3900 University Boulevard, Tyler, TX 75799, USA; Department of Radiology, UT Health Northeast, Tyler, TX 75708, USA.
authors: David
authors: D
authors: Di Paolo
authors: Department of Electrical Engineering, The University of Texas at Tyler, Tyler, TX 75799, USA.
authors: Mukul
authors: M
authors: Shirvaikar
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis / Q000503:physiopathology*; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D012372:ROC Curve; D013269:Stochastic Processes
keywords: Bone mineral density (BMD); DXA; Experimental variogram; Osteoporosis; Stochastic method