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Klintström E, Klintström B, Smedby Ö, Moreno R. Automated region growing-based segmentation for trabecular bone structure in fresh-frozen human wrist specimens. BMC Med Imaging 2024; 24:101. [PMID: 38693510 PMCID: PMC11061919 DOI: 10.1186/s12880-024-01281-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/23/2024] [Indexed: 05/03/2024] Open
Abstract
Bone strength depends on both mineral content and bone structure. Measurements of bone microstructure on specimens can be performed by micro-CT. In vivo measurements are reliably performed by high-resolution peripheral computed tomography (HR-pQCT) using dedicated software. In previous studies from our research group, trabecular bone properties on CT data of defatted specimens from many different CT devices have been analyzed using an Automated Region Growing (ARG) algorithm-based code, showing strong correlations to micro-CT.The aim of the study was to validate the possibility of segmenting and measuring trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens. Data from micro-CT was used as reference. The hypothesis was that the ARG-based in-house built software could be used for such measurements.HR-pQCT image data at two resolutions (61 and 82 µm isotropic voxels) from 23 fresh-frozen human forearms were analyzed. Correlations to micro-CT were strong, varying from 0.72 to 0.99 for all parameters except trabecular termini and nodes. The bone volume fraction had correlations varying from 0.95 to 0.98 but was overestimated compared to micro-CT, especially at the lower resolution. Trabecular separation and spacing were the most stable parameters with correlations at 0.80-0.97 and mean values in the same range as micro-CT.Results from this in vitro study show that an ARG-based software could be used for segmenting and measuring 3D trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens using micro-CT data as reference. Over-and underestimation of several of the bone structure parameters must however be taken into account.
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Affiliation(s)
- Eva Klintström
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, SE-58185, Sweden.
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE-58185, Sweden.
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, SE-14157, Sweden
| | - Örjan Smedby
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, SE-14157, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, SE-14157, Sweden
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Zhou Y, Klintström E, Klintström B, Ferguson SJ, Helgason B, Persson C. A convolutional neural network-based method for the generation of super-resolution 3D models from clinical CT images. Comput Methods Programs Biomed 2024; 245:108009. [PMID: 38219339 DOI: 10.1016/j.cmpb.2024.108009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/01/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND OBJECTIVE The accurate evaluation of bone mechanical properties is essential for predicting fracture risk based on clinical computed tomography (CT) images. However, blurring and noise in clinical CT images can compromise the accuracy of these predictions, leading to incorrect diagnoses. Although previous studies have explored enhancing trabecular bone CT images to super-resolution (SR), none of these studies have examined the possibility of using clinical CT images from different instruments, typically of lower resolution, as a basis for analysis. Additionally, previous studies rely on 2D SR images, which may not be sufficient for accurate mechanical property evaluation, due to the complex nature of the 3D trabecular bone structures. The objective of this study was to address these limitations. METHODS A workflow was developed that utilizes convolutional neural networks to generate SR 3D models across different clinical CT instruments. The morphological and finite-element-derived mechanical properties of these SR models were compared with ground truth models obtained from micro-CT scans. RESULTS A significant improvement in analysis accuracy was demonstrated, where the new SR models increased the accuracy by up to 700 % compared with the low-resolution data, i.e. clinical CT images. Additionally, we found that the mixture of different CT image datasets may improve the SR model performance. CONCLUSIONS SR images, generated by convolutional neural networks, outperformed clinical CT images in the determination of morphological and mechanical properties. The developed workflow could be implemented for fracture risk prediction, potentially leading to improved diagnoses and subsequent clinical decision making.
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Affiliation(s)
- Yijun Zhou
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Ångströmlaboratoriet, Uppsala University, Lägerhyddsvägen 1, Uppsala 75237, Sweden
| | - Eva Klintström
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Sweden; Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Sweden
| | | | | | - Cecilia Persson
- Division of Biomedical Engineering, Department of Materials Science and Engineering, Ångströmlaboratoriet, Uppsala University, Lägerhyddsvägen 1, Uppsala 75237, Sweden.
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Klintström E, Klintström B, Spångeus A, Sandborg M, Woisetschläger M. Trabecular bone microstructure analysis on data from a novel twin robotic X-ray device. Acta Radiol 2022; 64:1566-1572. [PMID: 36373570 PMCID: PMC10088033 DOI: 10.1177/02841851221134973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Bone strength is related to both mineral density (BMD) and the bone microstructure. However, only the assessment of BMD is available in clinical routine care today. Purpose To analyze and study the correlation of trabecular bone microstructure from the imaging data of a prototype Multitom Rax system, using micro-computed tomography (CT) data as the reference method (Skyscan 1176). Material and Methods Imaging data from 14 bone samples from the human radius were analyzed regarding six bone structure parameters, i.e. trabecular nodes, separation, spacing, and thickness as well as bone volume (BV/TV) and structural model index (SMI). Results All six structure parameters showed strong correlations to micro-CT with Spearman correlation coefficients in the range of 0.83–0.93. BV/TV and SMI had a correlation >0.90. Two of the parameters, namely, separation and number, had mean values in the same range as micro-CT. The other four were either over- or underestimated. Conclusion The strong correlation between micro-CT and the clinical imaging system, indicates the possibility for analyzing bone microstructure with potential to add value in fracture assessment using the studied device in a clinical workflow.
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Affiliation(s)
- Eva Klintström
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Anna Spångeus
- Department of Acute Internal Medicine and Geriatrics/Department of Endocrinology, Linköping University Hospital, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Michael Sandborg
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Medical Radiation Physics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mischa Woisetschläger
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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Klintström B, Henriksson L, Moreno R, Malusek A, Smedby Ö, Woisetschläger M, Klintström E. Photon-counting detector CT and energy-integrating detector CT for trabecular bone microstructure analysis of cubic specimens from human radius. Eur Radiol Exp 2022; 6:31. [PMID: 35882679 PMCID: PMC9325937 DOI: 10.1186/s41747-022-00286-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background As bone microstructure is known to impact bone strength, the aim of this in vitro study was to evaluate if the emerging photon-counting detector computed tomography (PCD-CT) technique may be used for measurements of trabecular bone structures like thickness, separation, nodes, spacing and bone volume fraction. Methods Fourteen cubic sections of human radius were scanned with two multislice CT devices, one PCD-CT and one energy-integrating detector CT (EID-CT), using micro-CT as a reference standard. The protocols for PCD-CT and EID-CT were those recommended for inner- and middle-ear structures, although at higher mAs values: PCD-CT at 450 mAs and EID-CT at 600 (dose equivalent to PCD-CT) and 1000 mAs. Average measurements of the five bone parameters as well as dispersion measurements of thickness, separation and spacing were calculated using a three-dimensional automated region growing (ARG) algorithm. Spearman correlations with micro-CT were computed. Results Correlations with micro-CT, for PCD-CT and EID-CT, ranged from 0.64 to 0.98 for all parameters except for dispersion of thickness, which did not show a significant correlation (p = 0.078 to 0.892). PCD-CT had seven of the eight parameters with correlations ρ > 0.7 and three ρ > 0.9. The dose-equivalent EID-CT instead had four parameters with correlations ρ > 0.7 and only one ρ > 0.9. Conclusions In this in vitro study of radius specimens, strong correlations were found between trabecular bone structure parameters computed from PCD-CT data when compared to micro-CT. This suggests that PCD-CT might be useful for analysing bone microstructure in the peripheral human skeleton.
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Affiliation(s)
- Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, SE-14157, Huddinge, Sweden.
| | - Lilian Henriksson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, SE-58185, Linköping, Sweden.,Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, SE-58185, Linköping, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, SE-14157, Huddinge, Sweden
| | - Alexandr Malusek
- Center for Medical Image Science and Visualization (CMIV), Linköping University, SE-58185, Linköping, Sweden.,Radiation Physics, Department of Health, Medicine and Caring Sciences, Linköping University, SE-58183, Linköping, Sweden
| | - Örjan Smedby
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Hälsovägen 11C, SE-14157, Huddinge, Sweden
| | - Mischa Woisetschläger
- Center for Medical Image Science and Visualization (CMIV), Linköping University, SE-58185, Linköping, Sweden.,Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, SE-58185, Linköping, Sweden
| | - Eva Klintström
- Center for Medical Image Science and Visualization (CMIV), Linköping University, SE-58185, Linköping, Sweden.,Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, SE-58185, Linköping, Sweden
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Abtahi J, Klintström B, Klintström E. Ibandronate Reduces the Surface Bone Resorption of Mandibular Bone Grafts: A Randomized Trial With Internal Controls. JBMR Plus 2021; 5:e10468. [PMID: 33778329 PMCID: PMC7990152 DOI: 10.1002/jbm4.10468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 11/19/2022] Open
Abstract
Autologous bone grafts are considered the gold standard for reconstruction of the edentulous alveolar ridges. However, this procedure is associated with unpredictable bone loss caused by physiological bone resorption. Bisphosphonates are antiresorptive drugs that act specifically on osteoclasts, thereby maintaining bone density, volume, and strength. It was hypothesized that the resorption of bone grafts treated with an ibandronate solution would be less advanced than bone grafts treated with saline. Ten patients who underwent bilateral sagittal split osteotomy were included in a randomized double‐blind trial with internal controls. Each patient received a bone graft treated with a solution of ibandronate on one side and a graft treated with saline (controls) contralaterally. Radiographs for the measurement of bone volume were obtained at 2 weeks and at 6 months after surgery. The primary endpoint was the difference in the change of bone volume between the control and the ibandronate bone grafts 6 months after surgery. All of the bone grafts healed without complications. One patient was excluded because of reoperation. In eight of the nine patients, the ibandronate bone grafts showed an increase in bone volume compared with baseline, with an average gain of 126 mm3 (40% more than baseline) with a range of +27 to +218 mm3. Only one ibandronate‐treated graft had a decrease in bone volume (8%). In the controls, an average bone volume loss of −146 mm3 (58% of baseline) with a range of −29 to −301 mm3 was seen. In the maxillofacial field, the reconstructions of atrophic alveolar ridges, especially in the esthetical zones, are challenging. These results show that bone grafts locally treated with ibandronate solution increases the remaining bone volume. This might lead to new possibilities for the maxillofacial surgeons in the preservation of bone graft volumes and for dental implant installations. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jahan Abtahi
- Department of Oral & Maxillofacial Surgery and Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden.,Center for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems KTH Royal Institute of Technology Stockholm Sweden
| | - Eva Klintström
- Center for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden.,Department of Radiology and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
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Guha I, Klintström B, Klintström E, Zhang X, Smedby Ö, Moreno R, Saha PK. A comparative study of trabecular bone micro-structural measurements using different CT modalities. Phys Med Biol 2020; 65:10.1088/1361-6560/abc367. [PMID: 33086213 PMCID: PMC8058110 DOI: 10.1088/1361-6560/abc367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/21/2020] [Indexed: 01/23/2023]
Abstract
Osteoporosis, characterized by reduced bone mineral density and micro-architectural degeneration, significantly enhances fracture-risk. There are several viable methods for trabecular bone micro-imaging, which widely vary in terms of technology, reconstruction principle, spatial resolution, and acquisition time. We have performed an excised cadaveric bone specimen study to evaluate different computed tomography (CT)-imaging modalities for trabecular bone micro-structural analysis. Excised cadaveric bone specimens from the distal radius were scanned using micro-CT and fourin vivoCT imaging modalities: high-resolution peripheral quantitative computed tomography (HR-pQCT), dental cone beam CT (CBCT), whole-body multi-row detector CT (MDCT), and extremity CBCT. A new algorithm was developed to optimize soft thresholding parameters for individualin vivoCT modalities for computing quantitative bone volume fraction maps. Finally, agreement of trabecular bone micro-structural measures, derived from differentin vivoCT imaging, with reference measures from micro-CT imaging was examined. Observed values of most trabecular measures, including trabecular bone volume, network area, transverse and plate-rod micro-structure, thickness, and spacing, forin vivoCT modalities were higher than their micro-CT-based reference values. In general, HR-pQCT-based trabecular bone measures were closer to their reference values as compared to otherin vivoCT modalities. Despite large differences in observed values of measures among modalities, high linear correlation (rε [0.94 0.99]) was found between micro-CT andin vivoCT-derived measures of trabecular bone volume, transverse and plate micro-structural volume, and network area. All HR-pQCT-derived trabecular measures, except the erosion index, showed high correlation (rε [0.91 0.99]). The plate-width measure showed a higher correlation (rε [0.72 0.91]) amongin vivoand micro-CT modalities than its counterpart binary plate-rod characterization-based measure erosion index (rε [0.65 0.81]). Although a strong correlation was observed between micro-structural measures fromin vivoand micro-CT imaging, large shifts in their values forin vivomodalities warrant proper scanner calibration prior to adopting in multi-site and longitudinal studies.
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Affiliation(s)
- Indranil Guha
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Eva Klintström
- Department of Medical and Health Sciences and Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Xiaoliu Zhang
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
| | - Örjan Smedby
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Punam K Saha
- Department of Electrical and Computer Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States of America
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States of America
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Klintström E, Klintström B, Pahr D, Brismar TB, Smedby Ö, Moreno R. Direct estimation of human trabecular bone stiffness using cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:72-82. [PMID: 29735401 DOI: 10.1016/j.oooo.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 03/04/2018] [Accepted: 03/16/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the possibility of estimating the biomechanical properties of trabecular bone through finite element simulations by using dental cone beam computed tomography data. STUDY DESIGN Fourteen human radius specimens were scanned in 3 cone beam computed tomography devices: 3-D Accuitomo 80 (J. Morita MFG., Kyoto, Japan), NewTom 5 G (QR Verona, Verona, Italy), and Verity (Planmed, Helsinki, Finland). The imaging data were segmented by using 2 different methods. Stiffness (Young modulus), shear moduli, and the size and shape of the stiffness tensor were studied. Corresponding evaluations by using micro-CT were regarded as the reference standard. RESULTS The 3-D Accuitomo 80 (J. Morita MFG., Kyoto, Japan) showed good performance in estimating stiffness and shear moduli but was sensitive to the choice of segmentation method. NewTom 5 G (QR Verona, Verona, Italy) and Verity (Planmed, Helsinki, Finland) yielded good correlations, but they were not as strong as Accuitomo 80 (J. Morita MFG., Kyoto, Japan). The cone beam computed tomography devices overestimated both stiffness and shear compared with the micro-CT estimations. CONCLUSIONS Finite element-based calculations of biomechanics from cone beam computed tomography data are feasible, with strong correlations for the Accuitomo 80 scanner (J. Morita MFG., Kyoto, Japan) combined with an appropriate segmentation method. Such measurements might be useful for predicting implant survival by in vivo estimations of bone properties.
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Affiliation(s)
- Eva Klintström
- Department of Medical and Health Sciences and Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - Benjamin Klintström
- School of Technology and Health, KTH Royal Institute of Technology, Hälsovägen, Stockholm, Sweden
| | - Dieter Pahr
- Institute of Lightweight Design and Structural Biomechanics, Technical University Vienna, Vienna, Austria
| | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology at Karolinska Institute and Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Örjan Smedby
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
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Klintström E, Klintström B, Moreno R, Brismar TB, Pahr DH, Smedby Ö. Predicting Trabecular Bone Stiffness from Clinical Cone-Beam CT and HR-pQCT Data; an In Vitro Study Using Finite Element Analysis. PLoS One 2016; 11:e0161101. [PMID: 27513664 PMCID: PMC4981445 DOI: 10.1371/journal.pone.0161101] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 07/29/2016] [Indexed: 11/18/2022] Open
Abstract
Stiffness and shear moduli of human trabecular bone may be analyzed in vivo by finite element (FE) analysis from image data obtained by clinical imaging equipment such as high resolution peripheral quantitative computed tomography (HR-pQCT). In clinical practice today, this is done in the peripheral skeleton like the wrist and heel. In this cadaveric bone study, fourteen bone specimens from the wrist were imaged by two dental cone beam computed tomography (CBCT) devices and one HR-pQCT device as well as by dual energy X-ray absorptiometry (DXA). Histomorphometric measurements from micro-CT data were used as gold standard. The image processing was done with an in-house developed code based on the automated region growing (ARG) algorithm. Evaluation of how well stiffness (Young’s modulus E3) and minimum shear modulus from the 12, 13, or 23 could be predicted from the CBCT and HR-pQCT imaging data was studied and compared to FE analysis from the micro-CT imaging data. Strong correlations were found between the clinical machines and micro-CT regarding trabecular bone structure parameters, such as bone volume over total volume, trabecular thickness, trabecular number and trabecular nodes (varying from 0.79 to 0.96). The two CBCT devices as well as the HR-pQCT showed the ability to predict stiffness and shear, with adjusted R2-values between 0.78 and 0.92, based on data derived through our in-house developed code based on the ARG algorithm. These findings indicate that clinically used CBCT may be a feasible method for clinical studies of bone structure and mechanical properties in future osteoporosis research.
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Affiliation(s)
- Eva Klintström
- Department of Medical and Health Science, Division of Radiology, Linköping University, Linköping, Sweden
- Center for medical Image Science and Visualization, Linköping University, Linköping, Sweden
- * E-mail:
| | - Benjamin Klintström
- Center for medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Rodrigo Moreno
- KTH Royal Institute of Technology, School of Technology and Health, Huddinge, Stockholm, Sweden
| | - Torkel B. Brismar
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Dieter H. Pahr
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Örjan Smedby
- Department of Medical and Health Science, Division of Radiology, Linköping University, Linköping, Sweden
- KTH Royal Institute of Technology, School of Technology and Health, Huddinge, Stockholm, Sweden
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Klintström E, Smedby O, Klintström B, Brismar TB, Moreno R. Trabecular bone histomorphometric measurements and contrast-to-noise ratio in CBCT. Dentomaxillofac Radiol 2014; 43:20140196. [PMID: 25168811 DOI: 10.1259/dmfr.20140196] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate how imaging parameters at clinical dental CBCT affect the accuracy in quantifying trabecular bone structures, contrast-to-noise ratio (CNR) and radiation dose. METHODS 15 radius samples were examined using CBCT (Accuitomo FPD; J. Morita Mfg., Kyoto, Japan). Nine imaging protocols were used, differing in current, voltage, rotation degree, voxel size, imaging area and rotation time. Radiation doses were measured using a kerma area product-meter. After segmentation, six bone structure parameters and CNRs were quantified. Micro-CT (μCT) images with an isotropic resolution of 20 μm were used as a gold standard. RESULTS Structure parameters obtained by CBCT were strongly correlated to those by μCT, with correlation coefficients >0.90 for all studied parameters. Bone volume and trabecular thickness were not affected by changes in imaging parameters. Increased tube current from 5 to 8 mA, decreased isotropic voxel size from 125 to 80 μm and decreased rotation angle from 360° to 180° affected correlations for trabecular termini negatively. Decreasing rotation degree also weakened correlations for trabecular separation and trabecular number at 80 μm voxel size. Changes in the rotation degree and tube current affected CNR significantly. The radiation dose varied between 269 and 1153 mGy cm(2). CONCLUSIONS Trabecular bone structure can be accurately quantified by clinical dental CBCT in vitro, and the obtained structure parameters are strongly related to those obtained by μCT. A fair CNR and strong correlations can be obtained with a low radiation dose, indicating the possibility for monitoring trabecular bone structure also in vivo.
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Affiliation(s)
- E Klintström
- 1 Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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