title: Scattered image artifacts from cone beam computed tomography and its clinical potential in bone mineral density estimation.
abstract: BACKGROUND
  Image artifacts affect the quality of medical images and may obscure anatomic structure and pathology. Numerous methods for suppression and correction of scattered image artifacts have been suggested in the past three decades. In this paper, we assessed the feasibility of use of information on scattered artifacts for estimation of bone mineral density (BMD) without dual-energy X-ray absorptiometry (DXA) or quantitative computed tomographic imaging (QCT).
  
  
  METHODS
  To investigate the relationship between scattered image artifacts and BMD, we first used a forearm phantom and cone-beam computed tomography. In the phantom, we considered two regions of interest-bone-equivalent solid material containing 50 mg HA per cm(-3) and water-to represent low- and high-density trabecular bone, respectively. We compared the scattered image artifacts in the high-density material with those in the low-density material. The technique was then applied to osteoporosis patients and healthy subjects to assess its feasibility for BMD estimation.
  
  
  RESULTS
  The high-density material produced a greater number of scattered image artifacts than the low-density material. Moreover, the radius and ulna of healthy subjects produced a greater number of scattered image artifacts than those from osteoporosis patients.
  
  
  CONCLUSIONS
  Although other parameters, such as bone thickness and X-ray incidence, should be considered, our technique facilitated BMD estimation directly without DXA or QCT. We believe that BMD estimation based on assessment of scattered image artifacts may benefit the prevention, early treatment and management of osteoporosis.
authors: Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Hoon
authors: H
authors: Ko
authors: Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Kwanmoon
authors: K
authors: Jeong
authors: Department of Rheumatology Internal Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Chang-Hoon
authors: CH
authors: Lee
authors: Imaging Science Based Lung and Bone Disease Research Center, Wonkwang University, 460 Iksandeaero, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Hong Young
authors: HY
authors: Jun
authors: Imaging Science Based Lung and Bone Disease Research Center, Wonkwang University, 460 Iksandeaero, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Changwon
authors: C
authors: Jeong
authors: Department of Rheumatology Internal Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Myeung Su
authors: MS
authors: Lee
authors: Department of Computer Science, Soonchunhyang University, Cheonan, Chungnam 31538 Republic of Korea.
authors: Yunyoung
authors: Y
authors: Nam
authors: Department of Radiology, Wonkwang University School of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Kwon-Ha
authors: KH
authors: Yoon
authors: Department of Biomedical Engineering, Wonkwang University College of Medicine, Iksan Daero 460, Iksan, Jeonbuk 54538 Republic of Korea.
authors: Jinseok
authors: J
authors: Lee
keywords: Bone mineral density; Cone-beam computed tomography; Osteoporosis; Scattered artifact image