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Automated 3D trabecular bone structure analysis of the proximal femur--prediction of biomechanical strength by CT and DXA
Osteoporosis International, 10/30/09

Baum T et al. – A combination of bone mass (DXA) and structure parameters of the trabecular bone (linear and nonlinear, global and local) most accurately predicted absolute and relative femoral bone strength.

Methods

187 proximal femur specimens were harvested from formalin-fixed human cadavers
BMC and BMD determined by DXA
Structure parameters of trabecular bone (i.e., morphometry, fuzzy logic, Minkowski functionals, and the scaling index method [SIM]) computed from CT images
Absolute femoral bone strength assessed with biomechanical side-impact test measuring failure load (FL)
Adjusted FL parameters for appraisal of relative bone strength calculated by dividing FL by influencing variables such as body height, weight, or femoral head diameter

Results

Best single parameter predicting FL and adjusted FL parameters apparent trabecular separation (morphometry) or DXA-derived BMC or BMD with correlations up to r?=?0.802
In combination with DXA, structure parameters (most notably the SIM and morphometry) added in linear regression models significant information in predicting FL and all adjusted FL parameters and allowed for significant better prediction than DXA alone

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