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Proceedings Paper

Hip fracture risk estimation based on bone mineral density of a biomechanically guided region of interest: a preliminary study
Author(s): Wenjun Li; John Kornak; Caixia Li; Alain Koyama; Isra Saeed; Ying Lu; Thomas Lang
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Paper Abstract

We aim to define a biomechanically-guided region of interest inside the proximal femur for improving fracture risk prediction based on bone density measurements. The central hypothesis is that by identifying and focusing on the proximal femoral tissues strongly associated with hip fracture risk, we can provide a better densitometric evaluation of fracture risk compared to current evaluations based on anatomically defined regions of interest using DXA or CT. To achieve this, we have constructed a hip statistical atlas of quantitative computed tomography (QCT) images by applying rigid and non-rigid inter-subject image registration to transform hip QCT scans of 15 fractured patients and 15 controls into a common reference space, and performed voxel-by-voxel t-tests between the two groups to identify bone tissues that showed the strongest relevance to hip fracture. Based on identification of this fracture-relevant tissue volume, we have generated a biomechanically-guided region of interest (B-ROI). We have applied BMD measured from this new region of interest to discriminate the fractured patients and controls, and compared it to BMD measured in the total proximal femur. For the femur ROI approach, the BMD values of the fractured patients and the controls had an overlap of 60 mg/cm3, and only 1 out of 15 fractured patients had BMD below the overlap region; for the B-ROI approach, a much narrower BMD overlap region of 28 mg/cm3 was observed, and 11 out of 15 fractured patients had BMDs below the overlap region.

Paper Details

Date Published: 3 April 2008
PDF: 8 pages
Proc. SPIE 6916, Medical Imaging 2008: Physiology, Function, and Structure from Medical Images, 691616 (3 April 2008); doi: 10.1117/12.769588
Show Author Affiliations
Wenjun Li, University of California, San Francisco (United States)
John Kornak, University of California, San Francisco (United States)
Caixia Li, University of California, San Francisco (United States)
Alain Koyama, University of California, San Francisco (United States)
Isra Saeed, University of California, San Francisco (United States)
Ying Lu, University of California, San Francisco (United States)
Thomas Lang, University of California, San Francisco (United States)


Published in SPIE Proceedings Vol. 6916:
Medical Imaging 2008: Physiology, Function, and Structure from Medical Images
Xiaoping P. Hu; Anne V. Clough, Editor(s)

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