Authors: K K Nishiyama M Ito A Harada S K Boyd
Publish Date: 2013/08/16
Volume: 25, Issue: 2, Pages: 619-626
Abstract
We used quantitative computed tomography and finite element analysis to classify women with and without hip fracture Highly accurate classifications were achieved indicating the potential for these methods to be used for subjectspecific assessment of fracture riskAreal bone mineral density aBMD is the current clinical diagnostic standard for assessing fracture risk however many fractures occur in people not defined as osteoporotic by aBMD Finite element FE analysis based on quantitative computed tomography QCT images takes into account both bone material and structural properties to provide subjectspecific estimates of bone strength Thus our objective was to determine if FE estimates of bone strength could classify women with and without hip fractureTwenty women with femoral neck fracture and 15 women with trochanteric fractures along with 35 agematched controls were scanned with QCT at the hip Since it is unknown how a specific subject will fall FE analysis was used to estimate bone stiffness and bone failure load under loading configurations with femoral neck internal rotation angles ranging from −30° to 45° with 15° intervals Support vector machine SVM models and a tenfold crossvalidation scheme were used to classify the subjects with and without fractureHigh accuracy was achieved when using only FE analysis for classifying the women with and without fracture both when the fracture types were pooled 829 and when analyzed separately by femoral neck fracture 875 and trochanteric fracture 800 The accuracy was further increased when FE analysis was combined with volumetric BMD pooled fractures accuracy 914 We wish to thank all of the participants in this study as well as all of the technicians who performed the scans We would also like to thank Meaghan Nolan for the preparation of the figure We would like to acknowledge the Canadian Institutes of Health Research CIHR the Natural Sciences and Engineering Research Council of Canada NSERC and the Vanier Canada Graduate Scholarships
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