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Are CT-based finite element model predictions of femoral bone strength clinically useful?

Are CT-based finite element model predictions of femoral bone strength clinically useful?
Are CT-based finite element model predictions of femoral bone strength clinically useful?

PURPOSE OF REVIEW: This study reviews the available literature to compare the accuracy of areal bone mineral density derived from dual X-ray absorptiometry (DXA-aBMD) and of subject-specific finite element models derived from quantitative computed tomography (QCT-SSFE) in predicting bone strength measured experimentally on cadaver bones, as well as their clinical accuracy both in terms of discrimination and prediction. Based on this information, some basic cost-effectiveness calculations are performed to explore the use of QCT-SSFE instead of DXA-aBMD in (a) clinical studies with femoral strength as endpoint, (b) predictor of the risk of hip fracture in low bone mass patients.

RECENT FINDINGS: Recent improvements involving the use of smooth-boundary meshes, better anatomical referencing for proximal-only scans, multiple side-fall directions, and refined boundary conditions increase the predictive accuracy of QCT-SSFE. If these improvements are adopted, QCT-SSFE is always preferable over DXA-aBMD in clinical studies with femoral strength as the endpoint, while it is not yet cost-effective as a hip fracture risk predictor, although pathways that combine both QCT-SSFE and DXA-aBMD are promising.

Absorptiometry, Photon/economics, Bone Density, Cost-Benefit Analysis, Femur/diagnostic imaging, Finite Element Analysis, Hip Fractures/epidemiology, Humans, Osteoporosis/diagnostic imaging, Osteoporotic Fractures/epidemiology, Tomography, X-Ray Computed/economics
216-223
Viceconti, Marco
330883be-abb2-4fd9-9f97-eb4f086be088
Qasim, Muhammad
2952cbef-3a52-4fe2-a1a2-c58876c22f91
Bhattacharya, Pinaki
0baad915-e88e-4879-9082-86554e28e408
Li, Xinshan
ea976853-d14c-41a4-ba12-5b700f5858e5
Viceconti, Marco
330883be-abb2-4fd9-9f97-eb4f086be088
Qasim, Muhammad
2952cbef-3a52-4fe2-a1a2-c58876c22f91
Bhattacharya, Pinaki
0baad915-e88e-4879-9082-86554e28e408
Li, Xinshan
ea976853-d14c-41a4-ba12-5b700f5858e5

Viceconti, Marco, Qasim, Muhammad, Bhattacharya, Pinaki and Li, Xinshan (2018) Are CT-based finite element model predictions of femoral bone strength clinically useful? Current Osteoporosis Reports, 16 (3), 216-223. (doi:10.1007/s11914-018-0438-8).

Record type: Review

Abstract

PURPOSE OF REVIEW: This study reviews the available literature to compare the accuracy of areal bone mineral density derived from dual X-ray absorptiometry (DXA-aBMD) and of subject-specific finite element models derived from quantitative computed tomography (QCT-SSFE) in predicting bone strength measured experimentally on cadaver bones, as well as their clinical accuracy both in terms of discrimination and prediction. Based on this information, some basic cost-effectiveness calculations are performed to explore the use of QCT-SSFE instead of DXA-aBMD in (a) clinical studies with femoral strength as endpoint, (b) predictor of the risk of hip fracture in low bone mass patients.

RECENT FINDINGS: Recent improvements involving the use of smooth-boundary meshes, better anatomical referencing for proximal-only scans, multiple side-fall directions, and refined boundary conditions increase the predictive accuracy of QCT-SSFE. If these improvements are adopted, QCT-SSFE is always preferable over DXA-aBMD in clinical studies with femoral strength as the endpoint, while it is not yet cost-effective as a hip fracture risk predictor, although pathways that combine both QCT-SSFE and DXA-aBMD are promising.

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More information

e-pub ahead of print date: 14 April 2018
Published date: 1 June 2018
Keywords: Absorptiometry, Photon/economics, Bone Density, Cost-Benefit Analysis, Femur/diagnostic imaging, Finite Element Analysis, Hip Fractures/epidemiology, Humans, Osteoporosis/diagnostic imaging, Osteoporotic Fractures/epidemiology, Tomography, X-Ray Computed/economics

Identifiers

Local EPrints ID: 447695
URI: http://eprints.soton.ac.uk/id/eprint/447695
PURE UUID: e55fa72f-d8d1-4d87-93a7-f8ecb405bd17

Catalogue record

Date deposited: 18 Mar 2021 17:46
Last modified: 25 Nov 2021 21:39

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Contributors

Author: Marco Viceconti
Author: Muhammad Qasim
Author: Pinaki Bhattacharya
Author: Xinshan Li

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