Generation of an atlas of the proximal femur and its application to trabecular bone analysis

Carballido‐Gamio, Julio; Folkesson, Jenny; Karampinos, Dimitrios C.; Baum, Thomas; Link, Thomas M.; Majumdar, Sharmila; Krug, Roland

doi:10.1002/mrm.22885

Cited by 15 publications

(9 citation statements)

References 46 publications

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“…In addition, novel coil correction methods (24) and image analysis approaches (25)(26)(27)(28) complement the in-vivo assessment of structural bone integrity in the proximal femur. Lastly, the development of advanced image registration techniques allow the comparison of structural bone parameters across a set of MR images at corresponding anatomic locations, e.g., the femoral head, greater trochanter, femoral neck, as well as the total femur (29,30).…”

Section: Introductionmentioning

confidence: 99%

Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density

Kazakia

Carballido‐Gamio

Lai

et al. 2018

Quant. Imaging Med. Surg.

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Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis.Methods: Eight HIV-infected men and 11 healthy age-matched controls were recruited and informed consent was obtained before each scan. High-resolution MRI of the proximal femur was performed using fully balanced steady state free precession (bSSFP) on a 3T system. Three volumes of interest at corresponding anatomic locations across all subjects were defined based on registrations of a common template. Four MR-based trabecular microstructural parameters were analyzed at each region: fuzzy bone volume fraction (f-BVF), trabecular number (Tb.N), thickness (Tb.Th), and spacing (Tb.Sp). In addition, the distal radius and distal tibia were imaged with HR-pQCT. Four HR-pQCT-based microstructural parameters were analyzed: trabecular bone volume fraction (BV/TV), Tb.N, Tb.Th, and Tb.Sp. Total hip and spine aBMD were determined from DXA.Results: Microstructural bone parameters derived from MRI at the proximal femur and from HR-pQCT at the distal tibia showed significantly lower bone quality in HIV-infected patients compared to healthy controls. In contrast, DXA aBMD data showed no significant differences between HIV-infected patients and healthy controls. Conclusions:Our results suggest that high-resolution imaging is a powerful tool to assess trabecular bone microstructure and can be used to assess bone health in HIV-infected men who show no differences to healthy males by DXA aBMD. Advances in MRI technology have made microstructural imaging at the proximal femur possible. Further studies in larger patient cohorts are clearly warranted.Keywords: Human immunodeficiency virus (HIV); trabecular bone microstructure; high-resolution magnetic resonance imaging (MRI); high resolution peripheral quantitative computed tomography (HR-pQCT); dual X-ray absorptiometry (DXA); areal bone mineral density (aBMD)

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Section: Introductionmentioning

confidence: 99%

Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density

Kazakia

Carballido‐Gamio

Lai

et al. 2018

Quant. Imaging Med. Surg.

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“…Computational anatomy techniques—borrowed from the neuroimaging community—enable local multiparametric assessments of the spatial distribution of volumetric bone mineral density (vBMD) and structural features of the proximal femur from quantitative computed tomography (QCT) images at the population level. Techniques such as voxel‐based morphometry (VBM) for the spatial assessment of vBMD and surface‐based statistical parametric mapping (SPM) for the spatial assessment of cortical bone properties, including cortical bone thickness (Ct.Th) and cortical vBMD (Ct.vBMD), have been validated and successfully applied in previous studies . These advanced image analysis techniques generate cohort‐based spatial parametric atlases by registering individual subject images to a common coordinate system, thus enabling point‐by‐point statistical tests at corresponding anatomic locations.…”

Section: Introductionmentioning

confidence: 99%

“…Techniques such as voxel-based morphometry (VBM) for the spatial assessment of vBMD and surface-based statistical parametric mapping (SPM) for the spatial assessment of cortical bone properties, including cortical bone thickness (Ct.Th) and cortical vBMD (Ct.vBMD), have been validated and successfully applied in previous studies. (8)(9)(10)(11)(12)(13)(14) These advanced image analysis techniques generate cohort-based spatial parametric atlases by registering individual subject images to a common coordinate system, thus enabling point-by-point statistical tests at corresponding anatomic locations. These statistical atlases provide an opportunity to visualize a physical parameter of interest, such as vBMD or Ct.Th, in relation to a variable of interest.…”

Section: Introductionmentioning

confidence: 99%

Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures

Carballido‐Gamio

Wang

et al. 2017

Journal of Bone and Mineral Research

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There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean±SD age: 70.6±12.7 years) and 21 with trochanteric fractures (75.6±9.3 years), and 50 control subjects (63.7±7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture, that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared to controls. Using surface-based SPM, we found that compared to controls both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for trochanteric fractures in Chinese women.

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“…This is probably due to small differences in patient positioning. In the future, atlas-based segmentation/registration could improve the reproducibility further [15]; this strategy has been successfully used in the neuroimaging community over the last 15 years.…”

Section: Discussionmentioning

confidence: 99%

Measurement reproducibility of magnetic resonance imaging-based finite element analysis of proximal femur microarchitecture for in vivo assessment of bone strength

Chang

Hotca-Cho

Rusinek

et al. 2014

Magn Reson Mater Phy

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Introduction Osteoporosis is a disease of weak bone. Our goal was to determine the measurement reproducibility of magnetic resonance assessment of proximal femur strength. Methods This study had institutional review board approval, and written informed consent was obtained from all subjects. We obtained images of proximal femur microarchitecture by scanning 12 subjects three times within 1 week at 3T using a high-resolution 3-D FLASH sequence. We applied finite element analysis to compute proximal femur stiffness and femoral neck elastic modulus. Results Within-day and between-day root-mean-square coefficients of variation and intraclass correlation coefficients ranged from 3.5 to 6.6 % and 0.96 to 0.98, respectively. Conclusion The measurement reproducibility of magnetic resonance assessment of proximal femur strength is suitable for clinical studies of disease progression or treatment response related to osteoporosis bone-strengthening interventions.

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Generation of an atlas of the proximal femur and its application to trabecular bone analysis

Cited by 15 publications

References 46 publications

Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density

Trabecular bone microstructure is impaired in the proximal femur of human immunodeficiency virus-infected men with normal bone mineral density

Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures

Measurement reproducibility of magnetic resonance imaging-based finite element analysis of proximal femur microarchitecture for in vivo assessment of bone strength

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