title: Predicting Trabecular Bone Stiffness from Clinical Cone-Beam CT and HR-pQCT Data; an In Vitro Study Using Finite Element Analysis.
abstract: Stiffness and shear moduli of human trabecular bone may be analyzed in vivo by finite element (FE) analysis from image data obtained by clinical imaging equipment such as high resolution peripheral quantitative computed tomography (HR-pQCT). In clinical practice today, this is done in the peripheral skeleton like the wrist and heel. In this cadaveric bone study, fourteen bone specimens from the wrist were imaged by two dental cone beam computed tomography (CBCT) devices and one HR-pQCT device as well as by dual energy X-ray absorptiometry (DXA). Histomorphometric measurements from micro-CT data were used as gold standard. The image processing was done with an in-house developed code based on the automated region growing (ARG) algorithm. Evaluation of how well stiffness (Young's modulus E3) and minimum shear modulus from the 12, 13, or 23 could be predicted from the CBCT and HR-pQCT imaging data was studied and compared to FE analysis from the micro-CT imaging data. Strong correlations were found between the clinical machines and micro-CT regarding trabecular bone structure parameters, such as bone volume over total volume, trabecular thickness, trabecular number and trabecular nodes (varying from 0.79 to 0.96). The two CBCT devices as well as the HR-pQCT showed the ability to predict stiffness and shear, with adjusted R2-values between 0.78 and 0.92, based on data derived through our in-house developed code based on the ARG algorithm. These findings indicate that clinically used CBCT may be a feasible method for clinical studies of bone structure and mechanical properties in future osteoporosis research.
authors: Department of Medical and Health Science, Division of Radiology, Linköping University, Linköping, Sweden.|Center for medical Image Science and Visualization, Linköping University, Linköping, Sweden.
authors: Eva
authors: http://orcid.org/0000-0003-0884-899X
authors: E
authors: Klintström
authors: Center for medical Image Science and Visualization, Linköping University, Linköping, Sweden.
authors: Benjamin
authors: B
authors: Klintström
authors: KTH Royal Institute of Technology, School of Technology and Health, Huddinge, Stockholm, Sweden.
authors: Rodrigo
authors: R
authors: Moreno
authors: Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Stockholm, Sweden.|Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors: Torkel B
authors: TB
authors: Brismar
authors: Institute of Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria.
authors: Dieter H
authors: DH
authors: Pahr
authors: Department of Medical and Health Science, Division of Radiology, Linköping University, Linköping, Sweden.|KTH Royal Institute of Technology, School of Technology and Health, Huddinge, Stockholm, Sweden.
authors: Örjan
authors: Ö
authors: Smedby
mesh_terms: D015502:Absorptiometry, Photon; D000465:Algorithms; D015519:Bone Density; D000071556:Cancellous Bone / Q000000981:diagnostic imaging* / Q000473:pathology*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D020342:Finite Element Analysis; D006801:Humans; D066298:In Vitro Techniques; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000473:pathology; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*