An anatomic coordinate system of the femoral neck for highly reproducible BMD measurements using 3D QCT

Kang, Yan; Engelke, Klaus; Fuchs, Christina; Kalender, Willi A.

doi:10.1016/j.compmedimag.2005.05.002

Cited by 47 publications

(34 citation statements)

References 13 publications

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“…Our findings are similar to those in the study by Kang et al(2005), who reported intra-and interobserver precision errors for BMD in trabecular, cortical, and integral bones at the neck as 1.20% and 1.56%, 0.81% and 0.78%, and 0.57% and 0.80%, respectively. In another in vivo study, Li et al(2006) used registration techniques, and reported precision errors of 4.53% for neck VOI and 0.60% for trochanter VOI.…”

Section: Discussionsupporting

confidence: 81%

“…These included measurements of trabecular bone (TRAB), cortical bone (CORT) and integral bone (INTGL) using a previously-published method (Kang et al, 2005) incorporating an anatomic coordinate system (semi-automatic volumetric segmentation) (Fig.1). Using the same software for hip geometric measurements, neck axis length (NAL), All data expressed as mean±SD measured between the lateral edge of the greater trochanter and the medial edge of the femoral head, and the minimum cross-section area (mCSA), the regions across the narrowest plane of the femoral neck, were calculated automatically.…”

Section: Bmd and Geometric Measurements Of The Proximal Femurmentioning

confidence: 99%

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Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

Jia

Hans

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To demonstrate the validity and reliability of volumetric quantitative computed tomography (vQCT) with multi-slice computed tomography (MSCT) and dual energy X-ray absorptiometry (DXA) for hip bone mineral density (BMD) measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods: Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes <−2SD, with and without radiographically confirmed vertebral fracture (n=11 and 33, respectively). Group 3 comprised normal controls with BMD changes ≥−1SD (n=46). Post-MSCT (GE, LightSpeed16) scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters: volumetric BMD values of trabecular bone (TRAB), cortical bone (CORT), and integral bone (INTGL) of the left femoral neck, femoral neck axis length (NAL), and minimum cross-section area (mCSA). DXA BMD measurements of the lumbar spine (AP-SPINE) and the left femoral neck (NECK) also were performed for each subject. Results: The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women (P<0.05, respectively). Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture(s) [(109.8±9.61) and (243.3±33.0) mg/cm 3 , respectively] than in those without [(148.9±7.47) and (285.4±17.8) mg/cm 3 , respectively] (P<0.05, respectively), but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion: the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from those without. vQCT might be useful to evaluate the effect of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck.

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Section: Discussionsupporting

confidence: 81%

Section: Bmd and Geometric Measurements Of The Proximal Femurmentioning

confidence: 99%

Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

Jia

Hans

et al. 2009

J. Zhejiang Univ. Sci. B

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“…Another advantage is the automatic determination of a neck coordinate system (NCS), relative to which the volumes of interest (VOIs) analyzed are located. (14,(35)(36)(37) The analysis is semiautomatic, with only occasional corrections by the operator being necessary. (37) In this study, Version 4.0 was used; the processing time for each femur was 15 to 20 minutes (Pentium 4, 1 GB).…”

Section: Image Analysismentioning

confidence: 99%

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

Bousson

Adams

Engelke³

et al. 2010

Journal of Bone and Mineral Research

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In assessing osteoporotic fractures of the proximal femur, the main objective of this in vivo case-control study was to evaluate the performance of quantitative computed tomography (QCT) and a dedicated 3D image analysis tool [Medical Image Analysis Framework-Femur option (MIAF-Femur)] in differentiating hip fracture and non-hip fracture subjects. One-hundred and seven women were recruited in the study, 47 women (mean age 81.6 years) with low-energy hip fractures and 60 female non-hip fracture control subjects (mean age 73.4 years). Bone mineral density (BMD) and geometric variables of cortical and trabecular bone in the femoral head and neck, trochanteric, and intertrochanteric regions and proximal shaft were assessed using QCT and MIAF-Femur. Areal BMD (aBMD) was assessed using dual-energy X-ray absorptiometry (DXA) in 96 (37 hip fracture and 59 non-hip fracture subjects) of the 107 patients. Logistic regressions were computed to extract the best discriminates of hip fracture, and area under the receiver characteristic operating curve (AUC) was calculated. Three logistic models that discriminated the occurrence of hip fracture with QCT variables were obtained (AUC ¼ 0.84). All three models combined one densitometric variable-a trabecular BMD (measured in the femoral head or in the trochanteric region)-and one geometric variable-a cortical thickness value (measured in the femoral neck or proximal shaft). The best discriminant using DXA variables was obtained with total femur aBMD (AUC ¼ 0.80, p ¼ .003). Results highlight a synergistic contribution of trabecular and cortical components in hip fracture risk and the utility of assessing QCT BMD of the femoral head for improved understanding and possible insights into prevention of hip fractures. ß

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“…Periosteal and endosteal bone surfaces of the QCT images were segmented using the Medical Image Analysis Framework (MIAF) software package developed at the University of Erlangen. (18) Four subjects did not have the proximal femur scanned appropriately, 1 scan file was corrupted during data transfer, and in 2 cases the femurs were not segmented successfully, yielding 41 subjects with complete data for this analysis.…”

Section: Data Acquisitionmentioning

confidence: 99%

Volumetric DXA (VXA): A new method to extract 3D information from multiple in vivo DXA images

Taylor

Ahmad

2010

Journal of Bone and Mineral Research

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Three-dimensional geometric and structural measurements of the proximal femur are of considerable interest in understanding the strength of the femur and its susceptibility to fracture. Quantitative computed tomography (QCT) with a small voxel size ( 1 mm per side) is the current ''gold standard'' to examine the macrostructure of the femur, but it has a high effective radiation dose (approximately 2 to 5 mSv) and cost. Volumetric dual-energy X-ray absorptiometry (VXA) uses a commercially available DXA system (Hologic Discovery A) to reconstruct the proximal femur from four DXA scans delivering an effective radiation dose of 0.04 mSv. VXA was compared with QCT (voxel size of 0.29 Â 0.29 Â 1 mm) in 41 elderly women (age 82 AE 2.4 years) at slices located at the femoral neck and trochanteric regions of interest. For parameters of shape, the femoral neck axis length (FNAL) and the cross-sectional slice area (SA), accuracy and strong linear correlations (r ¼ 0.84 to 0.98) were demonstrated. Similar correlations (r ¼ 0.81 to 0.97) were observed for the density parameters, the cross-sectional bone area (CSA) and volumetric bone mineral density (vBMD). VXA also demonstrated strong correlations (r ¼ 0.76 to 0.99) for the engineering parameters of the minimum, maximum, and polar cross-sectional moments of inertia (CSMIs) and the section modulus (Z). We conclude that VXA is capable of generating a variety of 3D geometric and structural measurements that are highly correlated with QCT in elderly subjects in vivo. Moreover, the VXA measurements can be made with a commercially available DXA device at a very low radiation dose. ß

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An anatomic coordinate system of the femoral neck for highly reproducible BMD measurements using 3D QCT

Cited by 47 publications

References 13 publications

Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

Volumetric DXA (VXA): A new method to extract 3D information from multiple in vivo DXA images

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