TY - JOUR
T1 - Image-based micro-finite-element modeling for improved distal radius strength diagnosis: moving from bench to bedside
AU - Pistoia, W.
AU - Rietbergen, van, B.
AU - Lochmüller, E.M.
AU - Lill, C.A.
AU - Eckstein, F.
AU - Rüegsegger, P.
PY - 2004
Y1 - 2004
N2 - Although osteoporosis is characterized by quantitative (mass) and qualitative (structural) changes, standard clinical techniques (dual-energy X-ray absorptiometry, DXA) only measure the former. Three-dimensional micro-finite-element (micro-FE) models based on high-resolution images can account for structural aspects as well, and it has recently been shown that an improved prediction of distal radius strength is possible with micro-FE analysis. A clinical application of this technique, however, is limited by its high imaging and computational demands. The objective of this study is to investigate if an improved prediction of bone strength can be obtained as well when only a small part of the radius is used for micro-FE modeling. Images of a 1-cm region of the metaphysis of the distal radius of 54 cadaver arms (mean age: 82 +/- 9 SD) made with a three-dimensional peripheral quantitative computed tomography (pQCT) device at 165- micro m resolution formed the basis for micro-FE models that were used to predict the bone failure load. Following imaging, specimens were experimentally compressed to failure to produce a Colles'-type fracture. Failure loads predicted from micro-FE analyses agreed well with those measured experimentally (R2 = 0.66, p <0.001). Lower correlations were observed with bone mass (R2 = 0.48, p <0.001) and microstructural parameters (R2 = 0.47, p <0.001). Hence, even when only a small region is modeled, micro-FE analysis provides an improved prediction of radius strength.
AB - Although osteoporosis is characterized by quantitative (mass) and qualitative (structural) changes, standard clinical techniques (dual-energy X-ray absorptiometry, DXA) only measure the former. Three-dimensional micro-finite-element (micro-FE) models based on high-resolution images can account for structural aspects as well, and it has recently been shown that an improved prediction of distal radius strength is possible with micro-FE analysis. A clinical application of this technique, however, is limited by its high imaging and computational demands. The objective of this study is to investigate if an improved prediction of bone strength can be obtained as well when only a small part of the radius is used for micro-FE modeling. Images of a 1-cm region of the metaphysis of the distal radius of 54 cadaver arms (mean age: 82 +/- 9 SD) made with a three-dimensional peripheral quantitative computed tomography (pQCT) device at 165- micro m resolution formed the basis for micro-FE models that were used to predict the bone failure load. Following imaging, specimens were experimentally compressed to failure to produce a Colles'-type fracture. Failure loads predicted from micro-FE analyses agreed well with those measured experimentally (R2 = 0.66, p <0.001). Lower correlations were observed with bone mass (R2 = 0.48, p <0.001) and microstructural parameters (R2 = 0.47, p <0.001). Hence, even when only a small region is modeled, micro-FE analysis provides an improved prediction of radius strength.
U2 - 10.1385/JCD:7:2:153
DO - 10.1385/JCD:7:2:153
M3 - Article
VL - 7
SP - 153
EP - 160
JO - Journal of Clinical Densitometry
JF - Journal of Clinical Densitometry
SN - 1094-6950
IS - 2
ER -