Predicting Vertebral Bone Strength Using Finite Element Analysis for Opportunistic Osteoporosis Screening in Routine Multidetector Computed Tomography Scans—A Feasibility Study

Abstract

PurposeTo investigate the feasibility of using routine clinical multidetector computed tomography (MDCT) scans for conducting finite element (FE) analysis to predict vertebral bone strength for opportunistic osteoporosis screening.MethodsRoutine abdominal MDCT with and without intravenous contrast medium (IVCM) of seven subjects (five male; two female; mean age: 71.86 ± 7.40 years) without any bone disease were used. FE analysis was performed on individual vertebrae (T11, T12, L1, and L2) including the posterior elements to investigate the effect of IVCM and slice thickness (1 and 3 mm) on vertebral bone strength. Another subset of data from subjects with vs. without osteoporotic vertebral fractures (n = 9 age and gender-matched pairs) was analyzed for investigating the ability of FE-analysis to differentiate the two cohorts. Bland-Altman plots, box plots, and coefficient of correlation (R2) were calculated to determine the variations in FE-predicted failure loads for different conditions.ResultsThe FE-predicted failure loads obtained from routine MDCT scans were strongly correlated with those from without IVCM (R2 = 0.91 for 1mm; R2 = 0.92 for 3mm slice thickness, respectively) and different slice thicknesses (R2 = 0.93 for 1mm vs. 3mm with IVCM). Furthermore, a good correlation was observed for 3mm slice thickness with IVCM vs. 1mm without IVCM (R2 = 0.87). Significant difference between FE-predicted failure loads of healthy and fractured patients was observed (4,705 ± 1,238 vs. 4,010 ± 1,297 N; p=0.026).ConclusionRoutine clinical MDCT scans could be reliably used for assessment of fracture risk based on FE analysis and may be beneficial for patients who are at increased risk for osteoporotic fractures.

Biomechanical evaluation of different hallux valgus treatment with plate fixations using single first metatarsal bone model and musculoskeletal lower extremity model

“…The effective loading and boundary conditions are normally applied to simulate the effects of the adjacent bones and muscles. This kind of simplified method had been used to evaluate the biomechanics of human bones such as femur (Dhanopia & Bhargava, 2017), tibia (Abdul Wahab et al, 2020), humerus (Jabran et al, 2019), rib (Yates et al, 2021), and vertebra (Rayudu et al, 2021). Those finite element models could significantly reduce the modelling steps and computational time as compared to a musculoskeletal system model.…”

Imaging techniques to study diabetic bone disease

“…The relatively high radiation levels preclude the use of QCT for pediatric research. Although QCT has become the standard 3D approach to assess vBMD at the proximal femur and lumbar spine, substantial efforts are underway to validate opportunistic screening based on clinical CT scans -that is, without a calibration phantom -for assessments of vBMD [16] and estimates of bone strength using FEA [16][17][18]. Cross-sections of coronal and sagittal reformations of QCT scans of the proximal femora and lumbar spine are shown in Fig.…”

Finite Element Method for the Evaluation of the Human Spine: A Literature Overview

“…Vertebral body, intervertebral disc, surrounding ligaments and muscles may be simulated by FEM models and may also be used to describe spine-related biomechanical particularities, as well as to analyze the stress allocation of the vertebral sections. As far as osteoporosis is concerned, there are numerous studies that have used FEM models to assess fracture risk, treatment comparison and biomechanics in the osteoporotic bones [54][55][56][57][58][59][60][61][62][63][64]. In particular, it is reported that nonlinear CT/FEA had better distinctive ability for vertebral fractures than lumbar spine BMD by DXA and QCT [55,59].…”