CUED Publications database

Cortical thickness estimation of the proximal femur from multi-view Dual-Energy X-ray Absorptiometry (DXA)

Tsaousis, N and Gee, AH and Treece, GM and Poole, KES (2013) Cortical thickness estimation of the proximal femur from multi-view Dual-Energy X-ray Absorptiometry (DXA). Proceedings of SPIE - The International Society for Optical Engineering, 8670. ISSN 0277-786X

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Abstract

Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 ± 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 ± 0:79 mm. © 2013 SPIE.

Item Type: Article
Uncontrolled Keywords: Cortical thickness CT DXA Hip fracture
Subjects: UNSPECIFIED
Divisions: Div F > Machine Intelligence
Depositing User: Cron Job
Date Deposited: 07 Mar 2014 11:46
Last Modified: 08 Dec 2014 02:18
DOI: 10.1117/12.2006389