期刊
DIAGNOSTICS
卷 11, 期 2, 页码 -出版社
MDPI
DOI: 10.3390/diagnostics11020208
关键词
finite element analysis; multidetector computed tomography; osteoporosis; spine; incidental vertebral fracture
资金
- German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) [432290010]
- SGP Healthcare Fund [PIE-SGP-HC-2019-01]
By combining FE analysis with BMD measurements from routine thoracic/abdominal MDCT, the prediction of incidental fractures at vertebral-specific level can be improved. This study found that certain normalized FE and BMD parameters showed higher discriminative power in identifying incidental fractures compared to standard mean BMD measurements.
To investigate whether finite element (FE) analysis of the spine in routine thoracic/abdominal multi-detector computed tomography (MDCT) can predict incidental osteoporotic fractures at vertebral-specific level; Baseline routine thoracic/abdominal MDCT scans of 16 subjects (8(m), mean age: 66.1 +/- 8.2 years and 8(f), mean age: 64.3 +/- 9.5 years) who sustained incidental osteoporotic vertebral fractures as confirmed in follow-up MDCTs were included in the current study. Thoracic and lumbar vertebrae (T5-L5) were automatically segmented, and bone mineral density (BMD), finite element (FE)-based failure-load, and failure-displacement were determined. These values of individual vertebrae were normalized globally (g), by dividing the absolute value with the average of L1-3 and locally by dividing the absolute value with the average of T5-12 and L1-5 for thoracic and lumbar vertebrae, respectively. Mean-BMD of L1-3 was determined as reference. Receiver operating characteristics (ROC) and area under the curve (AUC) were calculated for different normalized FE (K-load, K-displacement,K-(load)g, and K-(displacement)g) and BMD (K-BMD, and K-(BMD)g) ratio parameter combinations for identifying incidental fractures. K-load, K-(load)g, K-BMD, and K-(BMD)g showed significantly higher discriminative power compared to standard mean BMD of L1-3 (BMDStandard) (AUC = 0.67 for K-load; 0.64 for K-(load)g; 0.64 for K-BMD; 0.61 for K-(BMD)g vs. 0.54 for BMDStandard). The combination of K-load, K-displacement, and K-BMD increased the AUC further up to 0.77 (p < 0.001). The combination of FE with BMD measurements derived from routine thoracic/abdominal MDCT allowed an improved prediction of incidental fractures at vertebral-specific level.
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