Purpose: The purpose of the study was to evaluate the usefulness of power law spectral analysis on mammographic parenchymal patterns in breast cancer risk assessment. Materials and Methods: Mammograms from 172 subjects (30 women with the BRCA1/BRCA2 gene mutation and 142 low-risk women) were retrospectively collected and digitized. Because age is a very important risk factor, 60 low-risk women were randomly selected from the 142 low-risk subjects and were age matched to the 30 gene mutation carriers. Regions of interest were manually selected from the central breast region behind the nipple of these digitized mammograms and subsequently used in power spectral analysis. The power law spectrum of the form P f ð Þ ¼ B f β was evaluated for the mammographic patterns. The performance of exponent β as a decision variable for differentiating between gene mutation carriers and low-risk women was assessed using receiver operating characteristic analysis for both the entire database and the age-matched subset. Results:Power spectral analysis of mammograms demonstrated a statistically significant difference between the 30 BRCA1/BRCA2 gene mutation carriers and the 142 low risk women with an average β values of 2.92 (±0.28) and 2.47(±0.20), respectively. An A z value of 0.90 was achieved in distinguishing between gene mutation carriers and low-risk women in the entire database, with an A z value of 0.89 being achieved on the age-matched subset. Conclusions: The BRCA1/BRCA2 gene mutation carriers and low-risk women have different mammographic parenchymal patterns. It is expected that women identified as high risk by computerized feature analyses might potentially be more aggressively screened for breast cancer.

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Both bone mineral density (BMD) and trabecular structure are important determinates of bone mechanical properties. However, neither BMD or trabecular structural features can completely explain the variations in bone mechanical properties. In this study, we combine BMD and bone structural features to characterize bone mechanical behavior. Radiographs were obtained from 34 femoral neck specimens excised during total hip arthroplasties. Each neck radiograph was digitized and a region of interest (ROI) was selected from the medial side of the femoral neck. Textural features, the global Minkoswski dimension and trabecular orientation, were extracted from each ROI image using Minkowski dimension analysis. The BMD of each specimen was measured using dual-energy x-ray absorptiometry (DXA) and subsequently normalized by bone size as measured from a standard pelvis radiograph. Mechanical testing was performed on the trabecular bone cubes machined from each femoral neck to yield bone mechanical properties. Multiple regression was performed to select the best features to predict bone mechanical properties. The results suggest that, using multiple predictors including normalized BMD structural features, and patient age, the coefficients of determination (R2) improved over the use of BMD alone. For bone strength, the R2 was improved from 0.24 using conventional BMD to 0.48 using a four-predictor model. Similar results were obtained in the prediction of Young's modulus, i.e., the R2 was improved from 0.25 to 0.55 in going from the model using conventional BMD to a four-predictor model. This study demonstrates the contributions of normalized BMD, structural features, and age to bone mechanical properties, and suggests a potential method for the noninvasive evaluation of bone mechanical properties.

This study suggests that RTA of densitometer-generated calcaneus images provides an estimate of bone fragility independent of and complementary to BMD measurement and age.

We are investigating computerized methods to ultimately characterize bone trabecular pattern from clinical skeletal radiographs. In this paper, we present a "phantom" for potential use in the development and evaluation of computerized methods for characterizing radiographic trabecular patterns and ultimately bone strength. Femoral neck specimens were excised during total hip arthroplasties from subjects exhibiting a range of diseases. To mimic the femoral neck in vivo, a "simulated clinical" setup was implemented in which specimens were exposed under conditions that yielded radiographs similar in appearance to standard pelvis radiographs. Fourier-based and fractal-based texture measures were used in the computer analysis; including RMS variation, first moment of the power spectrum, angular-dependent forms of these measures, and fractal dimension. The texture measures obtained from the "simulated clinical" specimen films correlated modestly with those from direct exposure "verification" films of the specimens (r= 0.59-0.69; p<0.0001). From our study, we conclude that the femoral neck specimen "phantoms" may be useful in the development and evaluation of computerized methods for analyzing bone trabecular patterns from skeletal radiographs. The use of a phantom that simulates the clinical radiographic examination allows for repeat exposures without the concern of excessive radiation exposure to a patient.