Combination of texture analysis and bone mineral density improves the prediction of fracture load in human femurs

Corroller, Thomas Le; Halgrin, Julien; Pithioux, Martine; Guenoun, Daphné; Chabrand, Patrick; Champsaur, Pierre

doi:10.1007/s00198-011-1703-1

Cited by 45 publications

(28 citation statements)

References 36 publications

(62 reference statements)

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“…21 The combination of texture parameters and BMD has been shown to improve the assessment of fracture risk compared to using texture parameters or BMD alone. 21,22 Combining morphological structure parameters and BMD demonstrates the highest correlations with bone strength. 23,24 Another study reported that individual cortical thickness and BMD showed better performance.…”

Section: A N U S C R I P Tmentioning

confidence: 95%

Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women

Kavitha

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Section: A N U S C R I P Tmentioning

confidence: 95%

Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women

Kavitha

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…Therefore, bone quality measures, including architecture, turnover, damage accumulation and mineralization, have been proposed as additional features in predicting bone fractures (NIH, 2000). New techniques, such as fractal texture analysis (Majumdar et al, 1993; Benhamou et al, 1994; Buckland-Wright et al, 1994; Majumdar et al, 2000; Pothuaud et al, 2000; Chappard et al, 2001; Messent et al, 2005; Apostol et al, 2006; Lespessailles et al, 2008; Le Corroller et al, 2012), topological analysis (Boehm et al, 2007; Boehm et al, 2008), hip structure analysis (Beck, 2003; Beck, 2007), finite element analysis (Langton et al, 2009), and trabecular bone score based on the experimental variogram (Pothuaud et al, 2008; Pothuaud et al, 2009; Hans et al, 2011; Winzenrieth et al, 2013), have been introduced to enhance the prediction of bone fractures from DXA images by providing additional information of bone quality.…”

Section: Introductionmentioning

confidence: 99%

“…Fractal analysis of texture in two-dimensional images is a useful imaging technique that has been successfully applied to high-resolution radiography images to extract the hidden geometric and microstructure parameters of trabecular bone in both clinical studies and in vitro studies (Majumdar et al, 1993; Benhamou et al, 1994; Buckland-Wright et al, 1994; Majumdar et al, 2000; Pothuaud et al, 2000; Chappard et al, 2001; Messent et al, 2005; Apostol et al, 2006; Lespessailles et al, 2008; Le Corroller et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Random field assessment of inhomogeneous bone mineral density from DXA scans can enhance the differentiation between postmenopausal women with and without hip fractures

Dong

Pinninti

Lowe

et al. 2015

Journal of Biomechanics

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Bone mineral density (BMD) measurements from Dual-energy X-ray Absorptiometry (DXA) alone cannot account for all factors associated with the risk of hip fractures. For example, the inhomogeneity of bone mineral density in the hip region also contributes to bone strength. In the stochastic assessment of bone inhomogeneity, the BMD map in the hip region is considered as a random field and stochastic predictors can be calculated by fitting a theoretical model onto the experimental variogram of the BMD map. The objective of this study was to compare the ability of bone mineral density and stochastic assessment of inhomogeneous distribution of bone mineral density in predicting hip fractures for postmenopausal women. DXA scans in the hip region were obtained from postmenopausal women with hip fractures (N=47, Age: 71.3±11.4 years) and without hip fractures (N=45, Age: 66.7±11.4 years). Comparison of BMD measurements and stochastic predictors in assessing bone fragility was based on the area under the receiver operating characteristic curves (AUC) from logistic regression analyses. Although stochastic predictors offered higher accuracy (AUC=0.675) in predicting the risk of hip fractures than BMD measurements (AUC=0.625), such difference was not statistically significant (p=0.548). Nevertheless, the combination of stochastic predictors and BMD measurements had significantly (p=0.039) higher prediction accuracy (AUC=0.748) than BMD measurements alone. This study demonstrates that stochastic assessment of bone mineral distribution from DXA scans can serve as a valuable tool in enhancing the prediction of hip fractures for postmenopausal women in addition to BMD measurements.

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“…For example, DXA does not assess bone microarchitecture, which is included in the definition of osteoporosis and is an important contributor to bone strength and quality [2, 7, 8]. Indeed, the addition of structural measures to BMD improves the prediction of bone strength in ex vivo studies [9–11]. Second, DXA has poor sensitivity for the detection of patients with bone fragility.…”

Section: Introductionmentioning

confidence: 99%

7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density

et al. 2014

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Osteoporosis is a disease of poor bone quality. Bone mineral density (BMD) has limited ability to discriminate between subjects without and with poor bone quality, and assessment of bone microarchitecture may have added value in this regard. Our goals were to use 7 T MRI to: (1) quantify and compare distal femur bone microarchitecture in women without and with poor bone quality (defined clinically by presence of fragility fractures); and (2) determine whether microarchitectural parameters could be used to discriminate between these two groups. This study had institutional review board approval, and we obtained written informed consent from all subjects. We used a 28-channel knee coil to image the distal femur of 31 subjects with fragility fractures and 25 controls without fracture on a 7 T MRI scanner using a 3-D fast low angle shot sequence (0.234 mm × 0.234 mm × 1 mm, parallel imaging factor = 2, acquisition time = 7 min 9 s). We applied digital topological analysis to quantify parameters of bone microarchitecture. All subjects also underwent standard clinical BMD assessment in the hip and spine. Compared to controls, fracture cases demonstrated lower bone volume fraction and markers of trabecular number, plate-like structure, and plate-to-rod ratio, and higher markers of trabecular isolation, rod disruption, and network resorption (p < 0.05 for all). There were no differences in hip or spine BMD T-scores between groups (p > 0.05). In receiver-operating-characteristics analyses, microarchitectural parameters could discriminate cases and controls (AUC = 0.66–0.73, p < 0.05). Hip and spine BMD T-scores could not discriminate cases and controls (AUC = 0.58–0.64, p ≥ 0.08). We conclude that 7 T MRI can detect bone microarchitectural deterioration in women with fragility fractures who do not differ by BMD. Microarchitectural parameters might some day be used as an additional tool to detect patients with poor bone quality who cannot be detected by dual-energy X-ray absorptiometry (DXA).

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Combination of texture analysis and bone mineral density improves the prediction of fracture load in human femurs

Abstract: In these excised femurs, the combination of bone texture parameters with BMD demonstrated a better performance in the failure load prediction than that of BMD alone.

Cited by 45 publications

References 36 publications

Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women

Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women

Random field assessment of inhomogeneous bone mineral density from DXA scans can enhance the differentiation between postmenopausal women with and without hip fractures

7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density

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