Radiographic texture analysis of densitometric calcaneal images: Relationship to clinical characteristics and to bone fragility

Abstract

Osteoporotic fractures are related not only to bone mineral density (BMD) but also to bone structure or microarchitecture, which is not assessed routinely with currently available methods. We have developed radiographic texture analysis (RTA) for calcaneal images from a peripheral densitometer as an easy, noninvasive method for assessing bone structure. We conducted a cross-sectional study of the relationship between RTA and prevalent vertebral fractures (n = 148) among 900 subjects (ages 19 to 99 years, 94 males) referred for bone densitometry as part of their routine medical care. RTA features were derived from Fourier-based image analysis of the radiographic texture pattern (including root mean square, first moment, and power spectral analyses). RTA features were associated with age, weight, gender, and race, as well as glucocorticoid use. When controlling for clinical risk factors and BMD (or a summary measure calculated using FRAX algorithms), RTA features were significantly different for subjects with and without prevalent vertebral fractures [adjusted odds ratio (OR) = 1.5 per 1 standard deviation (SD) decrease in RTA feature beta, 95% confidence interval (CI) 1.2–1.8, p = .001]. Gender and use of pharmacologic therapy for osteoporosis did not significantly affect this association, suggesting that RTA can be applied to a wide range of densitometry patients. We conclude that RTA obtained using a portable instrument has a potential as a noninvasive method to enhance identification of patients at increased risk of osteoporotic fractures. Copyright © 2010 American Society for Bone and Mineral Research

Bone texture analysis of human femurs using a new device (BMA™) improves failure load prediction

“…This is comparable to what was previously found in the calcaneus [27,31]. It also confirms recently published results, using radiographs of 14 femurs measured in vitro: texture parameters were highly correlated with failure load (r 2 up to 0.61, p<0.01) and were partially independent of BMD, suggesting that texture information contained in trabecular bone structure may determine local bone non-quantitative parameters [32].…”

“…These parameters, measured at the spine [23], the femur [24], or the calcaneus [12,25,26], discriminated patients with and without fractures. Texture analysis of the calcaneus measured by a peripheral densitometer could differentiate between patients with and without vertebral fracture even after controlling for clinical risk factors and BMD [27]. At least two hypotheses can be drawn to explain the improvement of the failure load prediction.…”

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

“…In particular, the fractal parameter Hmean demonstrates significant correlations with Young's modulus and bone failure load [31]. Besides, the potential interest of texture analysis has been highlighted in clinical studies, suggesting that DXA and BMA assess different bone parameters [21,33]. In addition, when compared to histomorphometric indices measured on calcaneus biopsies, Hmean is correlated with trabecular separation and reflects more BMA than bone mass [16].…”

Méthodes d’évaluation de la microarchitecture de l’os trabéculaire humain

“…Appliqué au calcanéum, un appareil dédié a montré sa capacité à identifier les patientes ayant des antécédents de fractures, et la reproductibilité des mesures [7]. L'image de DXA a été proposée comme support à l'analyse de texture, reflet de la microarchitecture au niveau du calcanéum [8] et du rachis, ce dernier qui est un site habituel de fractures et de mesure de la densité minérale osseuse [9,10]. Le principal avantage des méthodes 3D utilisées sur des sujets in vivo est de pouvoir faire une analyse séparée de l'os trabéculaire et de l'os cortical.…”