1
|
Atkins PR, Morris A, Elhabian SY, Anderson AE. A Correspondence-Based Network Approach for Groupwise Analysis of Patient-Specific Spatiotemporal Data. Ann Biomed Eng 2023; 51:2289-2300. [PMID: 37357248 PMCID: PMC11047278 DOI: 10.1007/s10439-023-03270-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023]
Abstract
Methods for statistically analyzing patient-specific data that vary both spatially and over time are currently either limited to summary statistics or require elaborate surface registration. We propose a new method, called correspondence-based network analysis, which leverages particle-based shape modeling to establish correspondence across a population and preserve patient-specific measurements and predictions through statistical analysis. Herein, we evaluated this method using three published datasets of the hip describing cortical bone thickness of the proximal femur, cartilage contact stress, and dynamic joint space between control and patient cohorts to evaluate activity- and group-based differences, as applicable, using traditional statistical parametric mapping (SPM) and our proposed spatially considerate correspondence-based network analysis approach. The network approach was insensitive to correspondence density, while the traditional application of SPM showed decreasing area of the region of significance with increasing correspondence density. In comparison to SPM, the network approach identified broader and more connected regions of significance for all three datasets. The correspondence-based network analysis approach identified differences between groups and activities without loss of subject and spatial specificity which could improve clinical interpretation of results.
Collapse
Affiliation(s)
- Penny R Atkins
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Alan Morris
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Shireen Y Elhabian
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
| | - Andrew E Anderson
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA.
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
2
|
Dynamic multi feature-class Gaussian process models. Med Image Anal 2023; 85:102730. [PMID: 36586395 DOI: 10.1016/j.media.2022.102730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 08/30/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
In model-based medical image analysis, three relevant features are the shape of structures of interest, their relative pose, and image intensity profiles representative of some physical properties. Often, these features are modelled separately through statistical models by decomposing the object's features into a set of basis functions through principal geodesic analysis or principal component analysis. However, analysing articulated objects in an image using independent single object models may lead to large uncertainties and impingement, especially around organ boundaries. Questions that come to mind are the feasibility of building a unique model that combines all three features of interest in the same statistical space, and what advantages can be gained for image analysis. This study presents a statistical modelling method for automatic analysis of shape, pose and intensity features in medical images which we call the Dynamic multi feature-class Gaussian process models (DMFC-GPM). The DMFC-GPM is a Gaussian process (GP)-based model with a shared latent space that encodes linear and non-linear variations. Our method is defined in a continuous domain with a principled way to represent shape, pose and intensity feature-classes in a linear space, based on deformation fields. A deformation field-based metric is adapted in the method for modelling shape and intensity variation as well as for comparing rigid transformations (pose). Moreover, DMFC-GPMs inherit properties intrinsic to GPs including marginalisation and regression. Furthermore, they allow for adding additional pose variability on top of those obtained from the image acquisition process; what we term as permutation modelling. For image analysis tasks using DMFC-GPMs, we adapt Metropolis-Hastings algorithms making the prediction of features fully probabilistic. We validate the method using controlled synthetic data and we perform experiments on bone structures from CT images of the shoulder to illustrate the efficacy of the model for pose and shape prediction. The model performance results suggest that this new modelling paradigm is robust, accurate, accessible, and has potential applications in a multitude of scenarios including the management of musculoskeletal disorders, clinical decision making and image processing.
Collapse
|
3
|
Holcombe SA, Derstine BA. Rib cortical bone thickness variation in adults by age and sex. J Anat 2022; 241:1344-1356. [PMID: 36004686 DOI: 10.1111/joa.13751] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022] Open
Abstract
Rib fractures are a common and serious outcome of blunt thoracic trauma and their likelihood is greater in older individuals. Osteoporotic bone loss is a well-documented aging phenomenon with sex-specific characteristics, but within rib bones, neither baseline maps of regional thickness nor the rates of bone thinning with age have been quantified across whole ribs. This study presents such data from 4014 ribs of 240 adult subjects aged 20-90. A validated cortical bone mapping technique was applied to clinical computed tomography scans to obtain local rib cortical bone thickness measurements over the surfaces of ribs 2 through 11. Regression models to age and sex gave rates of cortex thinning in local zones and aggregated across whole ribs. The statistical parametric mapping provided these relationships regionally as a function of rib surface location. All models showed significant reductions in bone thickness with age (p < 0.01). Average whole-rib thinning occurred at between 0.011 to 0.032 mm/decade (males) and 0.035 to 0.043 mm/decade (females), with sex and age accounting for up to 37% of population variability (R2 ). Rates of thinning differed regionally and by rib, with the highest bone loss of up to 0.074 mm/decade occurring in mid-rib cutaneous and superior regions of ribs 2-6. Rates were consistently higher in females than males (significantly so across whole ribs but not all local regions) and were more pronounced in cutaneous, superior, and inferior rib aspects (average 0.025 mm/decade difference in ribs 4-8) compared to pleural aspects which had the thickest cortices but saw only minor differences in thinning rates by sex (0.045 mm/decade for females and 0.040 mm/decade for males). Regional analysis showed male and female bone thickness differences that were not statistically significant at 20 years of age (p > 0.05 across practically all regions) but subsequent cortex thinning meant that substantial pleural and cutaneous regions were thinner (p < 0.05) in females than males by 55 years of age. The techniques and results from this study can be applied to assess rib bone content loss in clinical settings across wide populations. Additionally, average cortex thickness results can be mapped directly to finite element models of the thorax, and regression results are used to modify such models to represent the ribs of men and women across their full adult lifespan.
Collapse
Affiliation(s)
- Sven A Holcombe
- Morphomics Analysis Group, University of Michigan, Ann Arbor, Michigan, USA
| | - Brian A Derstine
- Morphomics Analysis Group, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
4
|
Turmezei TD, Low SB, Rupret S, Treece GM, Gee AH, MacKay JW, Lynch JA, Poole KES, Segal NA. Multiparametric 3-D analysis of bone and joint space width at the knee from weight bearing computed tomography. OSTEOARTHRITIS IMAGING 2022; 2:100069. [PMID: 36249485 PMCID: PMC9559750 DOI: 10.1016/j.ostima.2022.100069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Computed tomography (CT) can deliver multiple parameters relevant to osteoarthritis. In this study we demonstrate that a 3-D multiparametric approach at the weight bearing knee with cone beam CT is feasible, can include multiple parameters from across the joint space, and can reveal stronger relationships with disease status in combination. DESIGN 33 participants with knee weight bearing CT (WBCT) were analysed with joint space mapping and cortical bone mapping to deliver joint space width (JSW), subchondral bone plate thickness, endocortical thickness, and trabecular attenuation at both sides of the joint. All data were co-localised to the same canonical surface. Statistical parametric mapping (SPM) was applied in uni- and multivariate models to demonstrate significant dependence of parameters on Kellgren & Lawrence grade (KLG). Correlation between JSW and bony parameters and 2-week test-retest repeatability were also calculated. RESULTS SPM revealed that the central-to-posterior medial tibiofemoral joint space was significantly narrowed by up to 0.5 mm with significantly higher tibial trabecular attenuation up to 50 units for each increment in KLG as single features, and in a wider distribution when combined (p<0.05). These were also more strongly correlated with worsening KLG grade category. Test-retest repeatability was subvoxel (0.37 mm) for nearly all thickness parameters. CONCLUSIONS 3-D JSW and tibial trabecular attenuation are repeatable and significantly dependent on radiographic disease severity at the weight bearing knee joint not just alone, but more strongly in combination. A quantitative multiparametric approach with WBCT may have potential for more sensitive investigation of disease progression in osteoarthritis.
Collapse
Affiliation(s)
- Tom D Turmezei
- Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - Samantha B Low
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - Simon Rupret
- University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough Street, Bristol, UK
| | - Graham M Treece
- Cambridge University Engineering Department, Trumpington Street, Cambridge, UK
| | - Andrew H Gee
- Cambridge University Engineering Department, Trumpington Street, Cambridge, UK
| | - James W MacKay
- Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - John A Lynch
- University of California San Francisco, 550 16th Street, San Francisco, USA
| | - Kenneth ES Poole
- University of Cambridge Department of Medicine, Hills Road, Cambridge, UK
| | - Neil A Segal
- University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, USA
| |
Collapse
|
5
|
Castillo-Barnes D, Jimenez-Mesa C, Martinez-Murcia FJ, Salas-Gonzalez D, Ramírez J, Górriz JM. Quantifying Differences Between Affine and Nonlinear Spatial Normalization of FP-CIT Spect Images. Int J Neural Syst 2022; 32:2250019. [PMID: 35313792 DOI: 10.1142/s0129065722500198] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Spatial normalization helps us to compare quantitatively two or more input brain scans. Although using an affine normalization approach preserves the anatomical structures, the neuroimaging field is more common to find works that make use of nonlinear transformations. The main reason is that they facilitate a voxel-wise comparison, not only when studying functional images but also when comparing MRI scans given that they fit better to a reference template. However, the amount of bias introduced by the nonlinear transformations can potentially alter the final outcome of a diagnosis especially when studying functional scans for neurological disorders like Parkinson's Disease. In this context, we have tried to quantify the bias introduced by the affine and the nonlinear spatial registration of FP-CIT SPECT volumes of healthy control subjects and patients with PD. For that purpose, we calculated the deformation fields of each participant and applied these deformation fields to a 3D-grid. As the space between the edges of small cubes comprising the grid change, we can quantify which parts from the brain have been enlarged, compressed or just remain the same. When the nonlinear approach is applied, scans from PD patients show a region near their striatum very similar in shape to that of healthy subjects. This artificially increases the interclass separation between patients with PD and healthy subjects as the local intensity is decreased in the latter region, and leads machine learning systems to biased results due to the artificial information introduced by these deformations.
Collapse
Affiliation(s)
- Diego Castillo-Barnes
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain
| | - Carmen Jimenez-Mesa
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain
| | - Francisco J Martinez-Murcia
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain
| | - Diego Salas-Gonzalez
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain
| | - Javier Ramírez
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain
| | - Juan M Górriz
- Department of Signal Theory, Telematics and Communications, University of Granada, Periodista Daniel Saucedo Aranda, 18071 Granada, Spain.,Department of Psychiatry, University of Cambridge, Herchel Smith Buidling for Brain & Mind Sciences, Forvie Site Robinson Way, Cambridge CB2 0SZ, UK
| |
Collapse
|
6
|
Fuchs RK, Carballido-Gamio J, Keyak JH, Kersh ME, Warden SJ. Physical activity induced adaptation can increase proximal femur strength under loading from a fall onto the greater trochanter. Bone 2021; 152:116090. [PMID: 34175500 PMCID: PMC8316435 DOI: 10.1016/j.bone.2021.116090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
Physical activity enhances proximal femur bone mass, but it remains unclear whether the benefits translate into an enhanced ability to resist fracture related loading. We recently used baseball pitchers as a within-subject controlled model to demonstrate physical activity induced proximal femur adaptation in regions associated with weight bearing and increased strength under single-leg stance loading. However, there was no measurable benefit to resisting common injurious loading (e.g. a fall onto the greater trochanter). A lack of power and a small physical activity effect size may have contributed to the latter null finding. Softball pitchers represent an alternative within-subject controlled model to explore adaptation of the proximal femur to physical activity, exhibiting greater dominant-to-nondominant (D-to-ND) leg differences than baseball pitchers. The current study used quantitative computed tomography, statistical parametric mapping, and subject-specific finite element (FE) modeling to explore adaptation of the proximal femur to physical activity in female softball pitchers (n = 25). Female cross-country runners (n = 15) were included as symmetrically loaded controls, showing very limited D-to-ND leg differences. Softball pitchers had D-to-ND leg differences in proximal femur, femoral neck, and trochanteric volumetric bone mineral density and content, and femoral neck volume. Voxel-based morphometry analyses and cortical bone mapping showed D-to-ND leg differences within a large region connecting the superior femoral head, inferior femoral neck and medial intertrochanteric region, and within the greater trochanter. FE modeling revealed pitchers had 19.4% (95%CI, 15.0 to 23.9%) and 4.9% (95%CI, 1.7 to 8.2%) D-to-ND leg differences in predicted ultimate strength under single-leg stance loading and a fall onto the greater trochanter, respectively. These data affirm the spatial and strength adaptation of the proximal femur to weight bearing directed loading and demonstrate that the changes can also have benefits, albeit smaller, on resisting loads associated with a sideways fall onto the greater trochanter.
Collapse
Affiliation(s)
- Robyn K Fuchs
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America.
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
| | - Joyce H Keyak
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, United States of America; Department of Mechanical and Aerospace Engineering, University of California, Irvine, Irvine, CA, United States of America; Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States of America.
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, United States of America.
| | - Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
| |
Collapse
|
7
|
Turmezei TD, B Low S, Rupret S, Treece GM, Gee AH, MacKay JW, Lynch JA, Poole KES, Segal NA. Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT. Radiology 2021; 299:649-659. [PMID: 33847516 DOI: 10.1148/radiol.2021203928] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Imaging of structural disease in osteoarthritis has traditionally relied on MRI and radiography. Joint space mapping (JSM) can be used to quantitatively map joint space width (JSW) in three dimensions from CT images. Purpose To demonstrate the reproducibility, repeatability, and feasibility of JSM of the knee using weight-bearing CT images. Materials and Methods Two convenience samples of weight-bearing CT images of left and right knees with radiographic Kellgren-Lawrence grades (KLGs) less than or equal to 2 were acquired from 2014 to 2018 and were analyzed retrospectively with JSM to deliver three-dimensional JSW maps. For reproducibility, images of three sets of knees were used for novice training, and then the JSM output was compared against an expert's assessment. JSM was also performed on 2-week follow-up images in the second cohort, yielding three-dimensional JSW difference maps for repeatability. Statistical parametric mapping was performed on all knee imaging data (KLG, 0-4) to show the feasibility of a surface-based analysis in three dimensions. Results Reproducibility (in 20 individuals; mean age, 58 years ± 7 [standard deviation]; mean body mass index, 28 kg/m2 ± 6; 14 women) and repeatability (in nine individuals; mean age, 53 years ± 6; mean body mass index, 26 kg/m2 ± 4; seven women) reached their lowest performance at a smallest detectable difference less than ±0.1 mm in the central medial tibiofemoral joint space for individuals without radiographically demonstrated disease. The average root mean square coefficient of variation was less than 5% across all groups. Statistical parametric mapping (33 individuals; mean age, 57 years ± 7; mean body mass index, 27 kg/m2 ± 6; 23 women) showed that the central-to-posterior medial joint space was significantly narrower by 0.5 mm for each incremental increase in the KLG (threshold P < .05). One knee (KLG, 2) demonstrated a baseline versus 24-month change in its three-dimensional JSW distribution that was beyond the smallest detectable difference across the lateral joint space. Conclusion Joint space mapping of the knee using weight-bearing CT images is feasible, demonstrating a relationship between the three-dimensional joint space width distribution and structural joint disease. It is reliably learned by novice users, can be personalized for disease phenotypes, and can be used to achieve a smallest detectable difference that is at least 50% smaller than that reported to be achieved at the highest performance level in radiography. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Roemer in this issue.
Collapse
Affiliation(s)
- Tom D Turmezei
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Samantha B Low
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Simon Rupret
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Graham M Treece
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Andrew H Gee
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - James W MacKay
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - John A Lynch
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Kenneth E S Poole
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Neil A Segal
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| |
Collapse
|
8
|
DeMars LJD, Stephens NB, Saers JPP, Gordon A, Stock JT, Ryan TM. Using point clouds to investigate the relationship between trabecular bone phenotype and behavior: An example utilizing the human calcaneus. Am J Hum Biol 2020; 33:e23468. [PMID: 32790125 DOI: 10.1002/ajhb.23468] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES The objective of this study is to demonstrate a new method for analyzing trabecular bone volume fraction and degree of anisotropy in three dimensions. METHODS We use a combination of automatic mesh registration, point-cloud correspondence registration, and P-value corrected univariate statistical tests to compare bone volume fraction and degree of anisotropy on a point by point basis across the entire calcaneus of two human groups with different subsistence strategies. RESULTS We found that the patterns of high and low bone volume fraction and degree of anisotropy distribution between the Black Earth (hunter-gatherers) and Norris Farms (mixed-strategy agriculturalists) are very similar, but differ in magnitude. The hunter-gatherers exhibit higher levels of bone volume fraction and less anisotropic trabecular bone organization. Additionally, patterns of bone volume fraction and degree of anisotropy in the calcaneus correspond well with biomechanical expectations of relative forces experienced during walking and running. CONCLUSIONS We conclude that comparing site-specific, localized differences in trabecular bone variables such as bone volume fraction and degree of anisotropy in three-dimensions is a powerful analytical tool. This method makes it possible to determine where similarities and differences between groups are located within the whole skeletal element of interest. The visualization of multiple variables also provides a way for researchers to see how the trabecular bone variables interact within the morphology, and allows for a more nuanced understanding of how they relate to one another and the broader mechanical environment.
Collapse
Affiliation(s)
- Lily J D DeMars
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Nicholas B Stephens
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jaap P P Saers
- Department of Archaeology, Cambridge University, Cambridge, UK
| | - Adam Gordon
- Department of Anthropology, University at Albany, SUNY, Albany, New York, USA
| | - Jay T Stock
- Department of Archaeology, Cambridge University, Cambridge, UK.,Department of Anthropology, Western University, London, Ontario, Canada
| | - Timothy M Ryan
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| |
Collapse
|
9
|
Warden SJ, Carballido-Gamio J, Weatherholt AM, Keyak JH, Yan C, Kersh ME, Lang TF, Fuchs RK. Heterogeneous Spatial and Strength Adaptation of the Proximal Femur to Physical Activity: A Within-Subject Controlled Cross-Sectional Study. J Bone Miner Res 2020; 35:681-690. [PMID: 31826314 PMCID: PMC7145739 DOI: 10.1002/jbmr.3939] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/06/2019] [Accepted: 12/03/2019] [Indexed: 11/10/2022]
Abstract
Physical activity (PA) enhances proximal femur bone mass, as assessed using projectional imaging techniques. However, these techniques average data over large volumes, obscuring spatially heterogeneous adaptations. The current study used quantitative computed tomography, statistical parameter mapping, and subject-specific finite element (FE) modeling to explore spatial adaptation of the proximal femur to PA. In particular, we were interested in adaptation occurring at the superior femoral neck and improving strength under loading from a fall onto the greater trochanter. High/long jump athletes (n = 16) and baseball pitchers (n = 16) were utilized as within-subject controlled models as they preferentially load their take-off leg and leg contralateral to their throwing arm, respectively. Controls (n = 15) were included but did not show any dominant-to-nondominant (D-to-ND) leg differences. Jumping athletes showed some D-to-ND leg differences but less than pitchers. Pitchers had 5.8% (95% confidence interval [CI] 3.9%-7.6%) D-to-ND leg differences in total hip volumetric bone mineral density (vBMD), with increased vBMD in the cortical compartment of the femoral neck and trochanteric cortical and trabecular compartments. Voxel-based morphometry analyses and cortical bone mapping showed pitchers had D-to-ND leg differences within the regions of the primary compressive trabeculae, inferior femoral neck, and greater trochanter but not the superior femoral neck. FE modeling revealed pitchers had 4.1% (95% CI 1.4%-6.7%) D-to-ND leg differences in ultimate strength under single-leg stance loading but no differences in ultimate strength to a fall onto the greater trochanter. These data indicate the asymmetrical loading associated with baseball pitching induces proximal femur adaptation in regions associated with weight bearing and muscle contractile forces and increases strength under single-leg stance loading. However, there were no benefits evident at the superior femoral neck and no measurable improvement in ultimate strength to common injurious loading during aging (ie, fall onto the greater trochanter), raising questions as to how to better target these variables with PA. © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Stuart J. Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Alyssa M. Weatherholt
- Department of Kinesiology and Sport, Pott College of Science, Engineering, and Education, University of Southern Indiana, Evansville, IN
| | - Joyce H. Keyak
- Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California Irvine, Irvine CA
| | - Chenxi Yan
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Mariana E. Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Thomas F. Lang
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Robyn K. Fuchs
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN
| |
Collapse
|
10
|
Turmezei TD, Treece GM, Gee AH, Sigurdsson S, Jonsson H, Aspelund T, Gudnason V, Poole KES. Quantitative 3D imaging parameters improve prediction of hip osteoarthritis outcome. Sci Rep 2020; 10:4127. [PMID: 32139721 PMCID: PMC7058047 DOI: 10.1038/s41598-020-59977-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/03/2020] [Indexed: 11/29/2022] Open
Abstract
Osteoarthritis is an increasingly important health problem for which the main treatment remains joint replacement. Therapy developments have been hampered by a lack of biomarkers that can reliably predict disease, while 2D radiographs interpreted by human observers are still the gold standard for clinical trial imaging assessment. We propose a 3D approach using computed tomography—a fast, readily available clinical technique—that can be applied in the assessment of osteoarthritis using a new quantitative 3D analysis technique called joint space mapping (JSM). We demonstrate the application of JSM at the hip in 263 healthy older adults from the AGES-Reykjavík cohort, examining relationships between 3D joint space width, 3D joint shape, and future joint replacement. Using JSM, statistical shape modelling, and statistical parametric mapping, we show an 18% improvement in prediction of joint replacement using 3D metrics combined with radiographic Kellgren & Lawrence grade (AUC 0.86) over the existing 2D FDA-approved gold standard of minimum 2D joint space width (AUC 0.73). We also show that assessment of joint asymmetry can reveal significant differences between individuals destined for joint replacement versus controls at regions of the joint that are not captured by radiographs. This technique is immediately implementable with standard imaging technologies.
Collapse
Affiliation(s)
- T D Turmezei
- Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK.
| | - G M Treece
- Cambridge University Engineering Department, Cambridge, UK
| | - A H Gee
- Cambridge University Engineering Department, Cambridge, UK
| | | | - H Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, Reykjavik, Iceland
| | - T Aspelund
- Department of Medicine, University of Iceland, Reykjavik, Iceland
| | - V Gudnason
- Department of Medicine, University of Iceland, Reykjavik, Iceland
| | - K E S Poole
- Department of Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
11
|
Warden SJ, Carballido-Gamio J, Avin KG, Kersh ME, Fuchs RK, Krug R, Bice RJ. Adaptation of the proximal humerus to physical activity: A within-subject controlled study in baseball players. Bone 2019; 121:107-115. [PMID: 30634064 PMCID: PMC6391178 DOI: 10.1016/j.bone.2019.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/18/2018] [Accepted: 01/07/2019] [Indexed: 11/29/2022]
Abstract
The proximal humerus is a common, yet understudied site for osteoporotic fracture. The current study explored the impact of prolonged physical activity on proximal humerus bone health by comparing bone properties between the throwing and nonthrowing arms within professional baseball players. The proximal humerus in throwing arms had 28.1% (95% CI, 17.8 to 38.3%) greater bone mass compared to nonthrowing arms, as assessed using dual-energy x-ray absorptiometry. At the level of the surgical neck, computed tomography revealed 12.0% (95% CI, 8.2 to 15.8%) greater total cross-sectional area and 31.0% (95% CI, 17.8 to 44.2%) greater cortical thickness within throwing arms, which contributed to 56.8% (95% CI, 44.9 to 68.8%) greater polar moment of inertia (i.e., estimated ability to resist torsional forces) compared to nonthrowing arms. Within the humeral head and greater tubercle regions, throwing arms had 3.1% (95% CI, 1.1 to 5.1%) more trabecular bone, as assessed using high-resolution magnetic resonance imaging. Three-dimensional mapping of voxel- and vertex-wise differences between arms using statistical parametric mapping techniques revealed throwing arms had adaptation within much of the proximal diaphysis, especially the posterolateral cortex. The pattern of proximal diaphysis adaptation approximated the pattern of strain energy distribution within the proximal humerus during a fastball pitch derived from a musculoskeletal and finite element model in a representative player. These data demonstrate the adaptive ability of the proximal humerus to physical activity-related mechanical loads. It remains to be established how they translate to exercise prescription to improve bone health within the proximal humerus; however, they provide unique insight into the relationship between prolonged loading and skeletal adaptation at a clinically relevant osteoporotic site.
Collapse
Affiliation(s)
- Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America.
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, United States of America
| | - Keith G Avin
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, IL, United States of America
| | - Robyn K Fuchs
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Ryan J Bice
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW Cortical bone mapping (CBM) is a technique for measuring localised skeletal changes from computed tomography (CT) images. It can provide measurements with accuracy surpassing the underlying imaging resolution. CBM can detect changes in several properties of the cortex, with no prior assumptions about the likely location of said changes. This paper summarises the theory behind CBM, discusses its strengths and limitations, and reviews some studies in which it has been applied. RECENT FINDINGS CBM has revealed associations between fracture risk and cortical properties in specific regions of the proximal femur which present feasible therapeutic targets. Analyses of several pharmaceutical and exercise interventions quantify effects that are distinct both in location and in the nature of the micro-architectural changes. CBM has illuminated age-related changes in the proximal femur and has recently been applied to other bones, as well as to the assessment of cartilage. The CBM processing pipeline is designed primarily for large cohort studies. Its main impact thus far has not been in the realm of clinical practice, but rather to improve our fundamental understanding of localised bone structure and changes.
Collapse
Affiliation(s)
- Graham Treece
- Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK.
| | - Andrew Gee
- Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
| |
Collapse
|
13
|
Marques EA, Carballido-Gamio J, Gudnason V, Sigurdsson G, Sigurdsson S, Aspelund T, Siggeirsdottir K, Launer L, Eiriksdottir G, Lang T, Harris TB. Sex differences in the spatial distribution of bone in relation to incident hip fracture: Findings from the AGES-Reykjavik study. Bone 2018; 114:72-80. [PMID: 29777918 PMCID: PMC6137723 DOI: 10.1016/j.bone.2018.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/11/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
Abstract
In this case-cohort study, we used data-driven computational anatomy approaches to assess within and between sex spatial differences in proximal femoral bone characteristics in relation to incident hip fracture. One hundred male and 234 female incident hip fracture cases, and 1047 randomly selected noncase subcohort participants (562 female) were chosen from the population-based AGES-Reykjavik study (mean age of 77 years). The baseline -i.e. before hip fracture- hip quantitative computed tomography scans of these subjects were analyzed using voxel-based morphometry, tensor-based morphometry, and surface-based statistical parametric mapping to assess the spatial distribution of volumetric bone mineral density (vBMD), internal structure, and cortical bone properties (thickness, vBMD and trabecular vBMD adjacent to the endosteal surface) of the proximal femur, respectively, in relation to incident hip fracture. Results showed that in both men and women: 1) the superior aspect of the femoral neck and the trochanteric region (except for cortical bone thickness) were consistently identified as being associated with incident hip fracture, and 2) differences in bone properties between noncases and incident hip fracture cases followed similar trends, were located at compatible regions, and manifested heterogeneity in the spatial distribution of their magnitude with focal regions showing larger differences. With respect to sex differences, most of the regions with a significant interaction between fracture group and sex showed: 1) differences of greater magnitude in men between noncases and incident hip fracture cases with different spatial distributions for all bone properties with the exception of cortical bone thickness, and 2) that while most of these regions showed better bone quality in male cases than in female cases, female cases showed higher vBMD in the principal compressive group and higher endotrabecular vBMD at several regions including the anterior, posterior, and lateral aspects of the proximal femur. These findings indicate the value of these image analysis techniques by providing unique information about the specific patterns of bone deterioration associated with incident hip fracture and their sex differences, highlighting the importance of looking to men and women separately in the assessment of hip fracture risk.
Collapse
Affiliation(s)
- Elisa A Marques
- National Institute on Aging, Intramural Research Program, Laboratory of Epidemiology and Population Sciences, Bethesda, MD, USA.
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kópavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Gunnar Sigurdsson
- Icelandic Heart Association Research Institute, Kópavogur, Iceland; University of Iceland, Reykjavik, Iceland; Landspitalinn University Hospital, Reykjavik, Iceland
| | | | - Thor Aspelund
- Icelandic Heart Association Research Institute, Kópavogur, Iceland; Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kristin Siggeirsdottir
- Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA
| | - Lenore Launer
- National Institute on Aging, Intramural Research Program, Laboratory of Epidemiology and Population Sciences, Bethesda, MD, USA
| | | | - Thomas Lang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Tamara B Harris
- National Institute on Aging, Intramural Research Program, Laboratory of Epidemiology and Population Sciences, Bethesda, MD, USA
| |
Collapse
|
14
|
Stephens NB, Kivell TL, Pahr DH, Hublin JJ, Skinner MM. Trabecular bone patterning across the human hand. J Hum Evol 2018; 123:1-23. [PMID: 30072187 DOI: 10.1016/j.jhevol.2018.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 02/06/2023]
Abstract
Hand bone morphology is regularly used to link particular hominin species with behaviors relevant to cognitive/technological progress. Debates about the functional significance of differing hominin hand bone morphologies tend to rely on establishing phylogenetic relationships and/or inferring behavior from epigenetic variation arising from mechanical loading and adaptive bone modeling. Most research focuses on variation in cortical bone structure, but additional information about hand function may be provided through the analysis of internal trabecular structure. While primate hand bone trabecular structure is known to vary in ways that are consistent with expected joint loading differences during manipulation and locomotion, no study exists that has documented this variation across the numerous bones of the hand. We quantify the trabecular structure in 22 bones of the human hand (early/extant modern Homo sapiens) and compare structural variation between two groups associated with post-agricultural/industrial (post-Neolithic) and foraging/hunter-gatherer (forager) subsistence strategies. We (1) establish trabecular bone volume fraction (BV/TV), modulus (E), degree of anisotropy (DA), mean trabecular thickness (Tb.Th) and spacing (Tb.Sp); (2) visualize the average distribution of site-specific BV/TV for each bone; and (3) examine if the variation in trabecular structure is consistent with expected joint loading differences among the regions of the hand and between the groups. Results indicate similar distributions of trabecular bone in both groups, with those of the forager sample presenting higher BV/TV, E, and lower DA, suggesting greater and more variable loading during manipulation. We find indications of higher loading along the ulnar side of the forager sample hand, with high site-specific BV/TV distributions among the carpals that are suggestive of high loading while the wrist moves through the 'dart-thrower's' motion. These results support the use of trabecular structure to infer behavior and have direct implications for refining our understanding of human hand evolution and fossil hominin hand use.
Collapse
Affiliation(s)
- Nicholas B Stephens
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany.
| | - Tracy L Kivell
- Skeletal Biology Research Centre, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NZ, United Kingdom; Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| | - Dieter H Pahr
- Institute for Lightweight Design and Structural Biomechanics, Vienna University of Technology, Getreidemarkt 9, A-1060 Vienna, Austria
| | - Jean-Jacques Hublin
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| | - Matthew M Skinner
- Skeletal Biology Research Centre, School of Anthropology and Conservation, University of Kent, Canterbury CT2 7NZ, United Kingdom; Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| |
Collapse
|
15
|
Gee AH, Treece GM, Poole KES. How does the femoral cortex depend on bone shape? A methodology for the joint analysis of surface texture and shape. Med Image Anal 2018; 45:55-67. [PMID: 29414436 PMCID: PMC5842044 DOI: 10.1016/j.media.2018.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/24/2017] [Accepted: 01/12/2018] [Indexed: 11/19/2022]
Abstract
In humans, there is clear evidence of an association between hip fracture risk and femoral neck bone mineral density, and some evidence of an association between fracture risk and the shape of the proximal femur. Here, we investigate whether the femoral cortex plays a role in these associations: do particular morphologies predispose to weaker cortices? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm2) in a cohort of 125 females. Principal component analysis of the femoral surfaces identified three modes of shape variation accounting for 65% of the population variance. We then used statistical parametric mapping (SPM) to locate regions of the cortex where CMSD depends on shape, allowing for age. Our principal findings were increased CMSD with increased gracility over much of the proximal femur; and decreased CMSD at the superior femoral neck, coupled with increased CMSD at the calcar femorale, with increasing neck-shaft angle. In obtaining these results, we studied the role of spatial normalization in SPM, identifying systematic misregistration as a major impediment to the joint analysis of CMSD and shape. Through a series of experiments on synthetic data, we evaluated a number of registration methods for spatial normalization, concluding that only those predicated on an explicit set of homologous landmarks are suitable for this kind of analysis. The emergent methodology amounts to an extension of Geometric Morphometric Image Analysis to the domain of textured surfaces, alongside a protocol for labelling homologous landmarks in clinical CT scans of the human proximal femur.
Collapse
Affiliation(s)
- A H Gee
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB2 1PZ, UK.
| | - G M Treece
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB2 1PZ, UK.
| | - K E S Poole
- Department of Medicine, University of Cambridge, Level 5, Addenbrooke's Hospital, Box 157, Hills Road, Cambridge CB2 2QQ, UK.
| |
Collapse
|
16
|
Narra N, Abe S, Dimitrov V, Nikander R, Kouhia R, Sievänen H, Hyttinen J. Ricci-flow based conformal mapping of the proximal femur to identify exercise loading effects. Sci Rep 2018; 8:4823. [PMID: 29555952 PMCID: PMC5859094 DOI: 10.1038/s41598-018-23248-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/07/2018] [Indexed: 11/26/2022] Open
Abstract
The causal relationship between habitual loading and adaptive response in bone morphology is commonly explored by analysing the spatial distribution of mechanically relevant features. In this study, 3D distribution of features in the proximal femur of 91 female athletes (5 exercise loading groups representing habitual loading) is contrasted with 20 controls. A femur specific Ricci-flow based conformal mapping procedure was developed for establishing correspondence among the periosteal surfaces. The procedure leverages the invariance of the conformal mapping method to isometric shape differences to align surfaces in the 2D parametric domain, to produce dense correspondences across an isotopological set of surfaces. This is implemented through a multi-parametrisation approach to detect surface features and to overcome the issue of inconsistency in the anatomical extent present in the data. Subsequently, the group-wise distribution of two mechanically relevant features was studied – cortical thickness and surface principal strains (simulation results of a sideways fall). Statistical inferences over the surfaces were made by contrasting the athlete groups with the controls through statistical parametric mapping. With the aid of group-wise and composite-group maps, proximal femur regions affected by specific loading groups were identified with a high degree of spatial localisation.
Collapse
Affiliation(s)
- Nathaniel Narra
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland.
| | - Shinya Abe
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Vassil Dimitrov
- Department of Electrical and Computer Engineering, University of Calgary, Calgary, Canada.,Geometric Energy Corporation, Calgary, Canada
| | - Riku Nikander
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland.,Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Reijo Kouhia
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Hyttinen
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| |
Collapse
|
17
|
Yu A, Carballido-Gamio J, Wang L, Lang TF, Su Y, Wu X, Wang M, Wei J, Yi C, Cheng X. Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures. J Bone Miner Res 2017; 32:1672-1680. [PMID: 28407298 PMCID: PMC5550343 DOI: 10.1002/jbmr.3150] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/21/2017] [Accepted: 04/10/2017] [Indexed: 01/08/2023]
Abstract
There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for trochanteric fractures in Chinese women. © 2017 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Aihong Yu
- Department of Radiology, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | | | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Thomas F Lang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Yongbin Su
- Department of Radiology, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Xinbao Wu
- Department of Traumatology and Orthopedic Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Manyi Wang
- Department of Traumatology and Orthopedic Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Jie Wei
- Department of Traumatology and Orthopedic Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Chen Yi
- Department of Traumatology and Orthopedic Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| |
Collapse
|
18
|
Tsegai ZJ, Skinner MM, Gee AH, Pahr DH, Treece GM, Hublin JJ, Kivell TL. Trabecular and cortical bone structure of the talus and distal tibia in Pan and Homo. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 163:784-805. [PMID: 28542704 DOI: 10.1002/ajpa.23249] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/20/2017] [Accepted: 05/03/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Internal bone structure, both cortical and trabecular bone, remodels in response to loading and may provide important information regarding behavior. The foot is well suited to analysis of internal bone structure because it experiences the initial substrate reaction forces, due to its proximity to the substrate. Moreover, as humans and apes differ in loading of the foot, this region is relevant to questions concerning arboreal locomotion and bipedality in the hominoid fossil record. MATERIALS AND METHODS We apply a whole-bone/epiphysis approach to analyze trabecular and cortical bone in the distal tibia and talus of Pan troglodytes and Homo sapiens. We quantify bone volume fraction (BV/TV), degree of anisotropy (DA), trabecular thickness (Tb.Th), bone surface to volume ratio (BS/BV), and cortical thickness and investigate the distribution of BV/TV and cortical thickness throughout the bone/epiphysis. RESULTS We find that Pan has a greater BV/TV, a lower BS/BV and thicker cortices than Homo in both the talus and distal tibia. The trabecular structure of the talus is more divergent than the tibia, having thicker, less uniformly aligned trabeculae in Pan compared to Homo. Differences in dorsiflexion at the talocrural joint and in degree of mobility at the talonavicular joint are reflected in the distribution of cortical and trabecular bone. DISCUSSION Overall, quantified trabecular parameters represent overall differences in bone strength between the two species, however, DA may be directly related to joint loading. Cortical and trabecular bone distributions correlate with habitual joint positions adopted by each species, and thus have potential for interpreting joint position in fossil hominoids.
Collapse
Affiliation(s)
- Zewdi J Tsegai
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Matthew M Skinner
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.,Skeletal Biology Research Centre, School of Anthropology and Conservation, University of Kent, Canterbury, United Kingdom
| | - Andrew H Gee
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Dieter H Pahr
- Institute for Lightweight Design and Structural Biomechanics, Vienna University of Technology, Wien, Austria
| | - Graham M Treece
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Jean-Jacques Hublin
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Tracy L Kivell
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.,Skeletal Biology Research Centre, School of Anthropology and Conservation, University of Kent, Canterbury, United Kingdom
| |
Collapse
|
19
|
Poole KES, Skingle L, Gee AH, Turmezei TD, Johannesdottir F, Blesic K, Rose C, Vindlacheruvu M, Donell S, Vaculik J, Dungl P, Horak M, Stepan JJ, Reeve J, Treece GM. Focal osteoporosis defects play a key role in hip fracture. Bone 2017; 94:124-134. [PMID: 27777119 PMCID: PMC5135225 DOI: 10.1016/j.bone.2016.10.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/05/2016] [Accepted: 10/20/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hip fractures are mainly caused by accidental falls and trips, which magnify forces in well-defined areas of the proximal femur. Unfortunately, the same areas are at risk of rapid bone loss with ageing, since they are relatively stress-shielded during walking and sitting. Focal osteoporosis in those areas may contribute to fracture, and targeted 3D measurements might enhance hip fracture prediction. In the FEMCO case-control clinical study, Cortical Bone Mapping (CBM) was applied to clinical computed tomography (CT) scans to define 3D cortical and trabecular bone defects in patients with acute hip fracture compared to controls. Direct measurements of trabecular bone volume were then made in biopsies of target regions removed at operation. METHODS The sample consisted of CT scans from 313 female and 40 male volunteers (158 with proximal femoral fracture, 145 age-matched controls and 50 fallers without hip fracture). Detailed Cortical Bone Maps (c.5580 measurement points on the unfractured hip) were created before registering each hip to an average femur shape to facilitate statistical parametric mapping (SPM). Areas where cortical and trabecular bone differed from controls were visualised in 3D for location, magnitude and statistical significance. Measures from the novel regions created by the SPM process were then tested for their ability to classify fracture versus control by comparison with traditional CT measures of areal Bone Mineral Density (aBMD). In women we used the surgical classification of fracture location ('femoral neck' or 'trochanteric') to discover whether focal osteoporosis was specific to fracture type. To explore whether the focal areas were osteoporotic by histological criteria, we used micro CT to measure trabecular bone parameters in targeted biopsies taken from the femoral heads of 14 cases. RESULTS Hip fracture patients had distinct patterns of focal osteoporosis that determined fracture type, and CBM measures classified fracture type better than aBMD parameters. CBM measures however improved only minimally on aBMD for predicting any hip fracture and depended on the inclusion of trabecular bone measures alongside cortical regions. Focal osteoporosis was confirmed on biopsy as reduced sub-cortical trabecular bone volume. CONCLUSION Using 3D imaging methods and targeted bone biopsy, we discovered focal osteoporosis affecting trabecular and cortical bone of the proximal femur, among men and women with hip fracture.
Collapse
Affiliation(s)
- Kenneth E S Poole
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK.
| | - Linda Skingle
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - Andrew H Gee
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - Thomas D Turmezei
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - Fjola Johannesdottir
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - Karen Blesic
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - Collette Rose
- Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | | | - Simon Donell
- Department of Orthopaedics, Norfolk & Norwich University Hospital, Norwich, UK
| | - Jan Vaculik
- Department of Orthopaedics, Faculty of Medicine, Charles University and Bulovka Hospital, Prague, Czech Republic
| | - Pavel Dungl
- Department of Orthopaedics, Faculty of Medicine, Charles University and Bulovka Hospital, Prague, Czech Republic
| | - Martin Horak
- Department of Radiology, Homolka Hospital, Prague, Czech Republic
| | - Jan J Stepan
- Faculty of Medicine 1, Charles University and Institute of Rheumatology, Prague, Czech Republic
| | - Jonathan Reeve
- BOTNAR Research Institute, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, UK
| | - Graham M Treece
- Department of Engineering, University of Cambridge, Cambridge, UK
| |
Collapse
|
20
|
Gee AH, Treece GM, Tonkin CJ, Black DM, Poole KES. Association between femur size and a focal defect of the superior femoral neck. Bone 2015; 81:60-66. [PMID: 26142930 PMCID: PMC4640978 DOI: 10.1016/j.bone.2015.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 06/10/2015] [Accepted: 06/29/2015] [Indexed: 11/26/2022]
Abstract
Within each sex, there is an association between hip fracture risk and the size of the proximal femur, with larger femurs apparently more susceptible to fracture. Here, we investigate whether the thickness and density of the femoral cortex play a role in this association: might larger femurs harbour focal, cortical defects? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm(2)) in cohorts of 308 males and 125 females. Principal component analysis of the various femoral surfaces led to a measure of size that is linearly independent from shape. After mapping the data onto a canonical femur surface, we used statistical parametric mapping to identify any regions where CMSD depends on size, allowing for other confounding covariates including shape. Our principal finding was a focal patch on the superior femoral neck, where CMSD is reduced by around 1% for each 1% increase in proximal-distal size (p<0.000005 in the males, p<0.001 in the females). This finding appears to be consistent with models of functional adaptation, and may help with the design of interventional strategies for reducing fracture risk.
Collapse
Affiliation(s)
- A H Gee
- University of Cambridge Department of Engineering, Trumpington Street, Cambridge CB2 1PZ, UK.
| | - G M Treece
- University of Cambridge Department of Engineering, Trumpington Street, Cambridge CB2 1PZ, UK.
| | - C J Tonkin
- University of Cambridge Department of Medicine, Level 5, Addenbrooke's Hospital (Box 157), Hills Road, Cambridge CB2 2QQ, UK.
| | - D M Black
- University of California, San Francisco, Department of Epidemiology and Biostatistics, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107, USA.
| | - K E S Poole
- University of Cambridge Department of Medicine, Level 5, Addenbrooke's Hospital (Box 157), Hills Road, Cambridge CB2 2QQ, UK.
| |
Collapse
|
21
|
Treece GM, Gee AH, Tonkin C, Ewing SK, Cawthon PM, Black DM, Poole KES. Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study. J Bone Miner Res 2015; 30:2067-77. [PMID: 25982802 PMCID: PMC4657505 DOI: 10.1002/jbmr.2552] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/29/2015] [Accepted: 05/09/2015] [Indexed: 01/22/2023]
Abstract
Hip fracture risk is known to be related to material properties of the proximal femur, but fracture prediction studies adding richer quantitative computed tomography (QCT) measures to dual-energy X-ray (DXA)-based methods have shown limited improvement. Fracture types have distinct relationships to predictors, but few studies have subdivided fracture into types, because this necessitates regional measurements and more fracture cases. This work makes use of cortical bone mapping (CBM) to accurately assess, with no prior anatomical presumptions, the distribution of properties related to fracture type. CBM uses QCT data to measure the cortical and trabecular properties, accurate even for thin cortices below the imaging resolution. The Osteoporotic Fractures in Men (MrOS) study is a predictive case-cohort study of men over 65 years old: we analyze 99 fracture cases (44 trochanteric and 55 femoral neck) compared to a cohort of 308, randomly selected from 5994. To our knowledge, this is the largest QCT-based predictive hip fracture study to date, and the first to incorporate CBM analysis into fracture prediction. We show that both cortical mass surface density and endocortical trabecular BMD are significantly different in fracture cases versus cohort, in regions appropriate to fracture type. We incorporate these regions into predictive models using Cox proportional hazards regression to estimate hazard ratios, and logistic regression to estimate area under the receiver operating characteristic curve (AUC). Adding CBM to DXA-based BMD leads to a small but significant (p < 0.005) improvement in model prediction for any fracture, with AUC increasing from 0.78 to 0.79, assessed using leave-one-out cross-validation. For specific fracture types, the improvement is more significant (p < 0.0001), with AUC increasing from 0.71 to 0.77 for trochanteric fractures and 0.76 to 0.82 for femoral neck fractures. In contrast, adding DXA-based BMD to a CBM-based predictive model does not result in any significant improvement.
Collapse
Affiliation(s)
- Graham M Treece
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - Andrew H Gee
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - Carol Tonkin
- Research Scientist and Radiography Consultant, Granville Ferry, Nova Scotia, Canada
| | - Susan K Ewing
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Dennis M Black
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | | |
Collapse
|
22
|
Treece GM, Gee AH. Independent measurement of femoral cortical thickness and cortical bone density using clinical CT. Med Image Anal 2014; 20:249-64. [PMID: 25541355 DOI: 10.1016/j.media.2014.11.012] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/31/2014] [Accepted: 11/28/2014] [Indexed: 11/25/2022]
Abstract
The local structure of the proximal femoral cortex is of interest since both fracture risk, and the effects of various interventions aimed at reducing that risk, are associated with cortical properties focused in particular regions rather than dispersed over the whole bone. Much of the femoral cortex is less than 3mm thick, appearing so blurred in clinical CT that its actual density is not apparent in the data, and neither thresholding nor full-width half-maximum techniques are capable of determining its width. Our previous work on cortical bone mapping showed how to produce more accurate estimates of cortical thickness by assuming a fixed value of the cortical density for each hip. However, although cortical density varies much less over the proximal femur than thickness, what little variation there is leads to errors in thickness measurement. In this paper, we develop the cortical bone mapping technique by exploiting local estimates of imaging blur to correct the global density estimate, thus providing a local density estimate as well as more accurate estimates of thickness. We also consider measurement of cortical mass surface density and the density of trabecular bone immediately adjacent to the cortex. Performance is assessed with ex vivo clinical QCT scans of proximal femurs, with true values derived from high resolution HRpQCT scans of the same bones. We demonstrate superior estimation of thickness than is possible with alternative techniques (accuracy 0.12 ± 0.39 mm for cortices in the range 1-3mm), and that local cortical density estimation is feasible for densities >800 mg/cm(3).
Collapse
Affiliation(s)
- G M Treece
- University of Cambridge, Department of Engineering, Trumpington Street, Cambridge CB2 1PZ, UK.
| | - A H Gee
- University of Cambridge, Department of Engineering, Trumpington Street, Cambridge CB2 1PZ, UK.
| |
Collapse
|
23
|
Spatially varying registration using Gaussian processes. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2014; 17:413-20. [PMID: 25485406 DOI: 10.1007/978-3-319-10470-6_52] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In this paper we propose a new approach for spatially-varying registration using Gaussian process priors. The method is based on the idea of spectral tempering, i.e. the spectrum of the Gaussian process is modified depending on a user defined tempering function. The result is a non-stationary Gaussian process, which induces different amount of smoothness in different areas. In contrast to most other schemes for spatially-varying registration, our approach does not require any change in the registration algorithm itself, but only affects the prior model. Thus we can obtain spatially-varying versions of any registration method whose deformation prior can be formulated in terms of a Gaussian process. This includes for example most spline-based models, but also statistical shape or deformation models. We present results for the problem of atlas based skull-registration of cone beam CT images. These datasets are difficult to register as they contain a large amount of noise around the teeth. We show that with our method we can become robust against noise, but still obtain accurate correspondence where the data is clean.
Collapse
|