Multi-detector computed tomography (MDCT) imaging: association of bone texture parameters with finite element analysis (FEA)-based failure load of single vertebrae and functional spinal units

Quantitative Imaging in Medicine and Surgery

article

Nico Sollmann¹  Nithin Manohar Rayudu⁴  John Jie Sheng Lim⁴  Michael Dieckmeyer¹  Egon Burian¹  Maximilian T. Löffler¹  Jan S. Kirschke¹  Thomas Baum¹  Karupppasamy Subburaj⁴ 

[1] Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich;TUM-Neuroimaging Center, Technical University of Munich;Department of Diagnostic and Interventional Radiology, University Hospital Ulm;Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD)

关键词: Failure load;    finite element analysis (FEA);    functional spinal unit (FSU);    texture analysis (TA);    vertebral fracture;   

DOI  :  10.21037/qims-20-1156

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Osteoporosis is a systemic skeletal disease that is characterized by low bone mass and microarchitectural deterioration, predisposing affected individuals to fragility fractures. Yet, standard measurement of areal bone mineral density (BMD) in dual-energy X-ray absorptiometry (DXA) as the current reference standard has limitations for correctly detecting osteoporosis and fracture risk, with opportunistic osteoporosis screening using computed tomography (CT) showing increasing importance. This study’s objective is to compare finite element analysis (FEA)-based vertebral failure load with parameters of texture analysis (TA) derived from multi-detector CT (MDCT). Methods: MDCT data of seven subjects (mean age: 71.9±7.4 years) were included for FEA and TA. Manual segmentation was performed for the vertebral bodies T11, T12, L1, and L2 and the intervertebral discs (IVDs) T11/12, T12/L1, L1/2, and L2/3. Correlation analyses between FEA-derived failure loads and parameters of TA for the single vertebrae and two functional spinal units (FSUs) were calculated, defining FSU-1 as T11-IVD-T12-IVD-L1 and FSU-2 as T12-IVD-L1-IVD-L2. Furthermore, multivariate regressions were performed to identify the texture parameters that predicted the failure load best. Results: For single vertebrae, the strongest correlations were observed for skewnessglobal, kurtosisglobal, and gray level variance (rho =−0.7668 to −0.7362; P<0.001), while for FSUs, SumAverage, long-run emphasis, long-run low gray-level emphasis, homogeneity, and energy showed the strongest correlations (rho =−0.8187 to 0.8407; P<0.05) to failure loads. SumAverage best predicted the failure load for single vertebrae (R 2 adj =0.523, P<0.001). For the two FSUs, kurtosisglobal (FSU-1: R 2 adj =0.611, P=0.001) and skewnessglobal (FSU-2: R 2 adj =0.579, P=0.002) were the best predictors. Conclusions: TA using MDCT data of the spine was significantly associated with FEA-derived failure loads of both, single vertebrae and FSUs. Texture parameters predicted failure loads of FSUs as a more realistic in-vivo scenario equally well as compared to single vertebrae analyses. TA may reflect a less complex and time-consuming approach to accurately and non-invasively evaluate vertebral bone strength.

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