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Rayudu NM, Dieckmeyer M, Löffler MT, Noël PB, Kirschke JS, Baum T, Subburaj K. Predicting Vertebral Bone Strength Using Finite Element Analysis for Opportunistic Osteoporosis Screening in Routine Multidetector Computed Tomography Scans-A Feasibility Study. Front Endocrinol (Lausanne) 2021; 11:526332. [PMID: 33542701 PMCID: PMC7851077 DOI: 10.3389/fendo.2020.526332] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 11/30/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate the feasibility of using routine clinical multidetector computed tomography (MDCT) scans for conducting finite element (FE) analysis to predict vertebral bone strength for opportunistic osteoporosis screening. Methods Routine abdominal MDCT with and without intravenous contrast medium (IVCM) of seven subjects (five male; two female; mean age: 71.86 ± 7.40 years) without any bone disease were used. FE analysis was performed on individual vertebrae (T11, T12, L1, and L2) including the posterior elements to investigate the effect of IVCM and slice thickness (1 and 3 mm) on vertebral bone strength. Another subset of data from subjects with vs. without osteoporotic vertebral fractures (n = 9 age and gender-matched pairs) was analyzed for investigating the ability of FE-analysis to differentiate the two cohorts. Bland-Altman plots, box plots, and coefficient of correlation (R2) were calculated to determine the variations in FE-predicted failure loads for different conditions. Results The FE-predicted failure loads obtained from routine MDCT scans were strongly correlated with those from without IVCM (R2 = 0.91 for 1mm; R2 = 0.92 for 3mm slice thickness, respectively) and different slice thicknesses (R2 = 0.93 for 1mm vs. 3mm with IVCM). Furthermore, a good correlation was observed for 3mm slice thickness with IVCM vs. 1mm without IVCM (R2 = 0.87). Significant difference between FE-predicted failure loads of healthy and fractured patients was observed (4,705 ± 1,238 vs. 4,010 ± 1,297 N; p=0.026). Conclusion Routine clinical MDCT scans could be reliably used for assessment of fracture risk based on FE analysis and may be beneficial for patients who are at increased risk for osteoporotic fractures.
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Affiliation(s)
- Nithin Manohar Rayudu
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Maximilian T. Löffler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter B. Noël
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
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Rayudu NM, Anitha DP, Mei K, Zoffl F, Kopp FK, Sollmann N, Löffler MT, Kirschke JS, Noël PB, Subburaj K, Baum T. Low-dose and sparse sampling MDCT-based femoral bone strength prediction using finite element analysis. Arch Osteoporos 2020; 15:17. [PMID: 32088769 DOI: 10.1007/s11657-020-0708-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/06/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study aims to evaluate the impact of dose reduction through tube current and sparse sampling on multi-detector computed tomography (MDCT)-based femoral bone strength prediction using finite element (FE) analysis. FE-predicted femoral failure load obtained from MDCT scan data was not significantly affected by 50% dose reductions through sparse sampling. Further decrease in dose through sparse sampling (25% of original projections) and virtually reduced tube current (50% and 25% of the original dose) showed significant effects on the FE-predicted failure load results. PURPOSE To investigate the effect of virtually reduced tube current and sparse sampling on multi-detector computed tomography (MDCT)-based femoral bone strength prediction using finite element (FE) analysis. METHODS Routine MDCT data covering the proximal femur of 21 subjects (17 males; 4 females; mean age, 71.0 ± 8.8 years) without any bone diseases aside from osteoporosis were included in this study. Fifty percent and 75% dose reductions were achieved by virtually reducing tube current and by applying a sparse sampling strategy from the raw image data. Images were then reconstructed with a statistically iterative reconstruction algorithm. FE analysis was performed on all reconstructed images and the failure load was calculated. The root mean square coefficient of variation (RMSCV) and coefficient of correlation (R2) were calculated to determine the variation in the FE-predicted failure load data for dose reductions, using original-dose MDCT scan as the standard of reference. RESULTS Fifty percent dose reduction through sparse sampling showed lower RMSCV and higher correlations when compared with virtually reduced tube current method (RMSCV = 5.70%, R2 = 0.96 vs. RMSCV = 20.78%, R2 = 0.79). Seventy-five percent dose reduction achieved through both methods (RMSCV = 22.38%, R2 = 0.80 for sparse sampling; RMSCV = 24.58%, R2 = 0.73 for reduced tube current) could not predict the failure load accurately. CONCLUSION Our simulations indicate that up to 50% reduction in radiation dose through sparse sampling can be used for FE-based prediction of femoral failure load. Sparse-sampled MDCT may allow fracture risk prediction and treatment monitoring in osteoporosis with less radiation exposure in the future.
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Affiliation(s)
- Nithin Manohar Rayudu
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore
| | - D Praveen Anitha
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore
| | - Kai Mei
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Zoffl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Felix K Kopp
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Maximilian T Löffler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Peter B Noël
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore.
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
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Rayudu NM, Subburaj K, Mei K, Dieckmeyer M, Kirschke JS, Noël PB, Baum T. Finite Element Analysis-Based Vertebral Bone Strength Prediction Using MDCT Data: How Low Can We Go? Front Endocrinol (Lausanne) 2020; 11:442. [PMID: 32849260 PMCID: PMC7399039 DOI: 10.3389/fendo.2020.00442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To study the impact of dose reduction in MDCT images through tube current reduction or sparse sampling on the vertebral bone strength prediction using finite element (FE) analysis for fracture risk assessment. Methods: Routine MDCT data covering lumbar vertebrae of 12 subjects (six male; six female; 74.70 ± 9.13 years old) were included in this study. Sparsely sampled and virtually reduced tube current-based MDCT images were computed using statistical iterative reconstruction (SIR) with reduced dose levels at 50, 25, and 10% of the tube current and original projections, respectively. Subject-specific static non-linear FE analyses were performed on vertebra models (L1, L2, and L3) 3-D-reconstructed from those dose-reduced MDCT images to predict bone strength. Coefficient of correlation (R2), Bland-Altman plots, and root mean square coefficient of variation (RMSCV) were calculated to find the variation in the FE-predicted strength at different dose levels, using high-intensity dose-based strength as the reference. Results: FE-predicted failure loads were not significantly affected by up to 90% dose reduction through sparse sampling (R2 = 0.93, RMSCV = 8.6% for 50%; R2 = 0.89, RMSCV = 11.90% for 75%; R2 = 0.86, RMSCV = 11.30% for 90%) and up to 50% dose reduction through tube current reduction method (R2 = 0.96, RMSCV = 12.06%). However, further reduction in dose with the tube current reduction method affected the ability to predict the failure load accurately (R2 = 0.88, RMSCV = 22.04% for 75%; R2 = 0.43, RMSCV = 54.18% for 90%). Conclusion: Results from this study suggest that a 50% radiation dose reduction through reduced tube current and a 90% radiation dose reduction through sparse sampling can be used to predict vertebral bone strength. Our findings suggest that the sparse sampling-based method performs better than the tube current-reduction method in generating images required for FE-based bone strength prediction models.
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Affiliation(s)
- Nithin Manohar Rayudu
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
| | - Kai Mei
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter B. Noël
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- *Correspondence: Thomas Baum
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Lee Y, Ogihara N, Lee T. Assessment of finite element models for prediction of osteoporotic fracture. J Mech Behav Biomed Mater 2019; 97:312-320. [PMID: 31151004 DOI: 10.1016/j.jmbbm.2019.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/05/2019] [Accepted: 05/09/2019] [Indexed: 12/16/2022]
Abstract
With increasing life expectancy and mortality rates, the burden of osteoporotic hip fractures is continually on an upward trend. In terms of prevention, there are several osteoporosis treatment strategies such as anti-resorptive drug treatments, which attempt to retard the rate of bone resorption, while promoting the rate of formation. With respect to prediction, several studies have provided insights into obtaining bone strength by non-invasive means through the application of FE analysis. However, what valuable information can we obtain from FE studies that have focused on osteoporosis research, with respect to the prediction of osteoporotic fractures? This paper aims to fine studies that have used FE analysis to predict fractures in the proximal femur through a systematic search of literature using PUBMED, with the main objective of supporting the diagnosis of osteoporosis. The focus of these FE studies is first discussed, and the methodological aspects are summarized, by mainly comparing and contrasting their meshing properties, material properties, and boundary conditions. The implications of these methodological differences in FE modelling processes and propositions with the aim of consolidating or minimalizing these differences are further discussed. We proved that studies need to start converging in terms of their input parameters to make the FE method applicable to clinical settings. This, in turn, will decrease the time needed for in vitro tests. Current advancements in FE analysis need to be consolidated before any further steps can be taken to implement engineering analysis into the clinical scenario.
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Affiliation(s)
- Yeokyeong Lee
- Department of Architectural Engineering, Ewha Womans University, Republic of Korea
| | | | - Taeyong Lee
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Republic of Korea.
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Anitha D, Thomas B, Jan KS, Subburaj K. Risk of vertebral compression fractures in multiple myeloma patients: A finite-element study. Medicine (Baltimore) 2017; 96:e5825. [PMID: 28079810 PMCID: PMC5266172 DOI: 10.1097/md.0000000000005825] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to develop and validate a finite element (FE) model to predict vertebral bone strength in vitro using multidetector computed tomography (MDCT) images in multiple myeloma (MM) patients, to serve as a complementing tool to assess fracture risk. In addition, it also aims to differentiate MM patients with and without vertebral compression fractures (VCFs) by performing FE analysis on vertebra segments (T1-L5) obtained from in vivo routine MDCT imaging scans. MDCT-based FE models were developed from the in vitro vertebrae samples and were then applied to the in vivo vertebrae segments of MM patients (n = 4) after validation. Predicted fracture load using FE models correlated significantly with experimentally measured failure load (r = 0.85, P < 0.001). Interestingly, an erratic behavior was observed in patients with fractures (n = 2) and a more gradual change in FE-predicted strength values in patients without fractures (n = 2). Severe geometric deformations were also observed in models that have already attained fractures. Since BMD is not a reliable parameter for fracture risk prediction in MM subjects, it is necessary to use advanced tools such as FE analysis to predict individual fracture risk. If peaks are observed between adjacent segments in an MM patient, it can be safe to conclude that the spine is experiencing regions of structural instability. Such an FE visualization may have therapeutic consequences to prevent MM associated vertebral fractures.
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Affiliation(s)
- D. Anitha
- Engineering Product Development (EPD), Singapore University of Technology and Design (SUTD), Singapore
| | - Baum Thomas
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Kirschke S. Jan
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD), Singapore University of Technology and Design (SUTD), Singapore
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Effects of dose reduction on bone strength prediction using finite element analysis. Sci Rep 2016; 6:38441. [PMID: 27934902 PMCID: PMC5146932 DOI: 10.1038/srep38441] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/08/2016] [Indexed: 01/29/2023] Open
Abstract
This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2 = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk.
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Bilek LD, Waltman NL, Lappe JM, Kupzyk KA, Mack LR, Cullen DM, Berg K, Langel M, Meisinger M, Portelli-Trinidad A, Lang M. Protocol for a randomized controlled trial to compare bone-loading exercises with risedronate for preventing bone loss in osteopenic postmenopausal women. BMC WOMENS HEALTH 2016; 16:59. [PMID: 27576310 PMCID: PMC5004254 DOI: 10.1186/s12905-016-0339-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 08/19/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND In the United States, over 34 million American post-menopausal women have low bone mass (osteopenia) which increases their risk of osteoporosis and fractures. Calcium, vitamin D and exercise are recommended for prevention of osteoporosis, and bisphosphonates (BPs) are prescribed in women with osteoporosis. BPs may also be prescribed for women with low bone mass, but are more controversial due to the potential for adverse effects with long-term use. A bone loading exercise program (high-impact weight bearing and resistance training) promotes bone strength by preserving bone mineral density (BMD), improving bone structure, and by promoting bone formation at sites of mechanical stress. METHODS/DESIGN The sample for this study will be 309 women with low bone mass who are within 5 years post-menopause. Subjects are stratified by exercise history (≥2 high intensity exercise sessions per week; < 2 sessions per week) and randomized to a control or one of two treatment groups: 1) calcium + vitamin D (CaD) alone (Control); 2) a BP plus CaD (Risedronate); or 3) a bone loading exercise program plus CaD (Exercise). After 12 months of treatment, changes in bone structure, BMD, and bone turnover will be compared in the 3 groups. Primary outcomes for the study are bone structure measures (Bone Strength Index [BSI] at the tibia and Hip Structural Analysis [HSA] scores). Secondary outcomes are BMD at the hip and spine and serum biomarkers of bone formation (alkaline phosphase, AlkphaseB) and resorption (Serum N-terminal telopeptide, NTx). Our central hypothesis is that improvements in bone strength will be greater in subjects randomized to the Exercise group compared to subjects in either Control or Risedronate groups. DISCUSSION Our research aims to decrease the risk of osteoporotic fractures by improving bone strength in women with low bone mass (pre-osteoporotic) during their first 5 years' post-menopause, a time of rapid and significant bone loss. Results of this study could be used in developing a clinical management pathway for women with low bone mass at their peak period of bone loss that would involve lifestyle modifications such as exercises prior to medications such as BPs. TRIAL REGISTRATION Clinicaltrials.gov NCT02186600 . Initial registration: 7/7/2014.
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Affiliation(s)
- Laura D Bilek
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Nancy L Waltman
- College of Nursing, University of Nebraska Medical Center, 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA.
| | - Joan M Lappe
- Creighton Osteoporosis Research Center, 601 North 30th, Omaha, NE, 68131, USA
| | - Kevin A Kupzyk
- Center for Nursing Science, University of Nebraska Medical Center, 4101 Dewey Avenue, Omaha, NE, 68198-5330, USA
| | - Lynn R Mack
- Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, 68198-4130, USA
| | - Diane M Cullen
- Biomedical Science, Creighton University, Omaha, NE, 68102, USA
| | - Kris Berg
- School of HPER, University of Nebraska at Omaha, Omaha, NE, 68162-0216, USA
| | - Meghan Langel
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Melissa Meisinger
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Ashlee Portelli-Trinidad
- Heartland Osteoporosis Research Study, College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - Molly Lang
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
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Takakuwa M, Iwamoto J. Five-Year Experience with Risedronate Therapy for Patients with Increased Fracture Risk: A Practice-Based Observational Study. Biol Pharm Bull 2015; 38:88-95. [DOI: 10.1248/bpb.b14-00592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - Jun Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine
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Anitha D, Lee T. Assessing bone quality in terms of bone mineral density, buckling ratio and critical fracture load. J Bone Metab 2014; 21:243-7. [PMID: 25489572 PMCID: PMC4255044 DOI: 10.11005/jbm.2014.21.4.243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 11/19/2014] [Accepted: 11/19/2014] [Indexed: 11/11/2022] Open
Abstract
Background Bone mineral density (BMD) is used as a sole parameter in the diagnosis of osteoporosis. Due to the ease of acquirement of BMD, clinical diagnosis still involves its usage although the limitations of BMD are quite well-established. Therefore, this preliminary study hoped to reduce the errors introduced by BMD alone by incorporating geometric and structural predictors simultaneously to observe if strength was implicitly dependent on the geometry and BMD. Hence, we illustrated the triadic relationship between BMD, buckling ratio (BR) and critical fracture load (Fcr). Methods The geometric predictor was the BR as it involves both the changes in the periosteum and the cortical thickness. Also, structural changes were monitored by finite element (FE) analysis-predicted Fcr. These BR and Fcr measurements were plotted with their respective femoral neck BMD values in elderly female patients (n=6) in a 3-year follow-up study, treated with ibandronate. Results In all the three-dimensional plots (baseline, mid and final year), high Fcr values were found at regions containing high BMD and low BR values. Quantitatively, this was also proven where an averaged highest Fcr across the three years had a relatively higher BMD (46%) and lower BR (19%) than that of the averaged lowest Fcr. The dependence of FE predicted strength on both the geometry and bone density was illustrated. Conclusions We conclude that use of triadic relationships for the evaluation of osteoporosis and hip fractures with the combination of strength, radiology-derived BR and bone density will lay the foundation for more accurate predictions in the future.
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Affiliation(s)
- D Anitha
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Taeyong Lee
- Department of Medical Biotechnology, Dongguk University, Seoul, Korea
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Anitha D, Kim KJ, Lim SK, Lee T. Comparison of Buckling Ratio and Finite Element Analysis of Femoral Necks in Post-menopausal Women. J Menopausal Med 2014; 20:52-6. [PMID: 25371894 PMCID: PMC4207002 DOI: 10.6118/jmm.2014.20.2.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/21/2014] [Accepted: 05/21/2014] [Indexed: 11/12/2022] Open
Abstract
Objectives Osteoporosis is a prevalent problem amongst the elderly. Bone mineral density (BMD) obtained from dual X-ray absorptiometry (DXA) is the gold standard in diagnosing osteopenia (-1.0 < t < -2.5) and osteoporosis (t > -2.5). However, following osteoporosis therapy, increases in BMD may be unreliable. Although hip fracture risk can be reduced with the aid of drugs, treated patients still face considerable risk as most people who sustain hip fracture do not have generalized osteoporosis. A study of the local distribution of bone mass was necessary as they contribute to the geometry and consequently the bone strength. Methods By identifying the respective regions in the femoral neck, the geometric changes were localized and differed between each patient, proving that drug treatment elicits local changes in mean outer radius and mean cortical thickness. Numerical analysis also validated the above findings, where critical strain regions were predicted at similar zones and this is coherent with the fact that reduced thickness of the cortical bone has been related to increased risk of fracture initiation. Results Hence, from individual radar plots, we can determine if the effect of drugs had outweighed the effect of aging. We can then propose a course of treatment drug better suited for the patient in the clinical scenario. Conclusion Clinically, little conclusion can be drawn from just the BMD in osteopenic / osteoporotic patients. This emphasizes the necessity of using geometry and structure to predict fracture risk. Focusing on a patient specific analysis at a local level will improve diagnosis of osteoporosis and ultimately fracture prediction.
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Affiliation(s)
- D Anitha
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Kwang Joon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Sung-Kil Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Taeyong Lee
- Department of Medical Biotechnology, Dongguk University, Seoul, Korea
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