Generation of 3D shape, density, cortical thickness and finite element mesh of proximal femur from a DXA image

Väänänen, Sami P.; Grassi, Lorenzo; Flivik, Gunnar; Jurvelin, Jukka S.; Isaksson, Hanna

doi:10.1016/j.media.2015.06.001

Cited by 80 publications

(48 citation statements)

References 54 publications

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“…2015) and is only briefly summarized here. A training set of 34 proximal femur anatomies was retrieved (Finnish population, 13 right and 21 left, 30 men and 4 women, age years old, age range 18–82).…”

Section: Methodsmentioning

confidence: 99%

“…2011; Väänänen et al. 2015). Two-dimensional FE models based on DXA may accurately predict femoral strength (Yang et al.…”

Section: Introductionmentioning

confidence: 99%

“…The accuracy in the reconstruction of both shape and BMD has reached remarkable levels [average shape reconstruction error 1.4 mm, mean absolute difference of the reconstructed volumetric BMD (Väänänen et al. 2015)].…”

Section: Introductionmentioning

confidence: 99%

“…However, element distortion can be mitigated by using a mesh relaxation algorithm and by implementing a modified cost function for bone reconstruction (Väänänen et al. 2015). …”

Section: Introductionmentioning

confidence: 99%

“…2015), as well as a subject-specific FE modelling procedure from CT scans to predict strain and strength of human proximal femora (Grassi et al. 2016).…”

Section: Introductionmentioning

confidence: 99%

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Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments

Grassi

Väänänen

Ristinmaa

et al. 2016

Biomech Model Mechanobiol

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Computed tomography (CT)-based finite element (FE) models may improve the current osteoporosis diagnostics and prediction of fracture risk by providing an estimate for femoral strength. However, the need for a CT scan, as opposed to the conventional use of dual-energy X-ray absorptiometry (DXA) for osteoporosis diagnostics, is considered a major obstacle. The 3D shape and bone mineral density (BMD) distribution of a femur can be reconstructed using a statistical shape and appearance model (SSAM) and the DXA image of the femur. Then, the reconstructed shape and BMD could be used to build FE models to predict bone strength. Since high accuracy is needed in all steps of the analysis, this study aimed at evaluating the ability of a 3D FE model built from one 2D DXA image to predict the strains and fracture load of human femora. Three cadaver femora were retrieved, for which experimental measurements from ex vivo mechanical tests were available. FE models were built using the SSAM-based reconstructions: using only the SSAM-reconstructed shape, only the SSAM-reconstructed BMD distribution, and the full SSAM-based reconstruction (including both shape and BMD distribution). When compared with experimental data, the SSAM-based models predicted accurately principal strains (coefficient of determination >0.83, normalized root-mean-square error <16%) and femoral strength (standard error of the estimate 1215 N). These results were only slightly inferior to those obtained with CT-based FE models, but with the considerable advantage of the models being built from DXA images. In summary, the results support the feasibility of SSAM-based models as a practical tool to introduce FE-based bone strength estimation in the current fracture risk diagnostics.

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Section: Methodsmentioning

confidence: 99%

“…2011; Väänänen et al. 2015). Two-dimensional FE models based on DXA may accurately predict femoral strength (Yang et al.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, element distortion can be mitigated by using a mesh relaxation algorithm and by implementing a modified cost function for bone reconstruction (Väänänen et al. 2015). …”

Section: Introductionmentioning

confidence: 99%

“…2015), as well as a subject-specific FE modelling procedure from CT scans to predict strain and strength of human proximal femora (Grassi et al. 2016).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments

Grassi

Väänänen

Ristinmaa

et al. 2016

Biomech Model Mechanobiol

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3D Finite Element Models Reconstructed From 2D Dual‐Energy X‐Ray Absorptiometry (DXA) Images Improve Hip Fracture Prediction Compared to Areal BMD in Osteoporotic Fractures in Men (MrOS) Sweden Cohort

Grassi

Väänänen

Jehpsson

et al. 2023

J of Bone & Mineral Res

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Bone strength is an important contributor to fracture risk. Areal bone mineral density (aBMD) derived from dual‐energy X‐ray absorptiometry (DXA) is used as a surrogate for bone strength in fracture risk prediction tools. 3D finite element (FE) models predict bone strength better than aBMD, but their clinical use is limited by the need for 3D computed tomography and lack of automation. We have earlier developed a method to reconstruct the 3D hip anatomy from a 2D DXA image, followed by subject‐specific FE‐based prediction of proximal femoral strength. In the current study, we aim to evaluate the method's ability to predict incident hip fractures in a population‐based cohort (Osteoporotic Fractures in Men [MrOS] Sweden). We defined two subcohorts: (i) hip fracture cases and controls cohort: 120 men with a hip fracture (<10 years from baseline) and two controls to each hip fracture case, matched by age, height, and body mass index; and (ii) fallers cohort: 86 men who had fallen the year before their hip DXA scan was acquired, 15 of which sustained a hip fracture during the following 10 years. For each participant, we reconstructed the 3D hip anatomy and predicted proximal femoral strength in 10 sideways fall configurations using FE analysis. The FE‐predicted proximal femoral strength was a better predictor of incident hip fractures than aBMD for both hip fracture cases and controls (difference in area under the receiver operating characteristics curve, ΔAUROC = 0.06) and fallers (ΔAUROC = 0.22) cohorts. This is the first time that FE models outperformed aBMD in predicting incident hip fractures in a population‐based prospectively followed cohort based on 3D FE models obtained from a 2D DXA scan. Our approach has potential to notably improve the accuracy of fracture risk predictions in a clinically feasible manner (only one single DXA image is needed) and without additional costs compared to the current clinical approach. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

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The accuracy of statistical shape models in predicting bone shape: A systematic review

Patil

Kulkarni

Xie

et al. 2023

Robotics Computer Surgery

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Background This systematic review aims to ascertain how accurately 3D models can be predicted from two‐dimensional (2D) imaging utilising statistical shape modelling. Methods A systematic search of published literature was conducted in September 2022. All papers which assessed the accuracy of 3D models predicted from 2D imaging utilising statistical shape models and which validated the models against the ground truth were eligible. Results 2127 papers were screened and a total of 34 studies were included for final data extraction. The best overall achievable accuracy was 0.45 mm (root mean square error) and 0.16 mm (average error). Conclusion Statistical shape modelling can predict detailed 3D anatomical models from minimal 2D imaging. Future studies should report the intended application domain of the model, the level of accuracy required, the underlying demographics of subjects, and the method in which accuracy was calculated, with root mean square error recommended if appropriate.

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Generation of 3D shape, density, cortical thickness and finite element mesh of proximal femur from a DXA image

Cited by 80 publications

References 54 publications

Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments

Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments

3D Finite Element Models Reconstructed From 2D Dual‐Energy X‐Ray Absorptiometry (DXA) Images Improve Hip Fracture Prediction Compared to Areal BMD in Osteoporotic Fractures in Men (MrOS) Sweden Cohort

The accuracy of statistical shape models in predicting bone shape: A systematic review

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