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Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models

Osteoporotic fracture incidence represents a major social and economic concern in the modern society, where the progressive graying of the population involves an highly increased fracture occurrence. Although the gold standard to diagnose osteoporosis is represented by the T-score measurement, estim...

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Autores principales: Terzini, Mara, Aldieri, Alessandra, Rinaudo, Luca, Osella, Giangiacomo, Audenino, Alberto L., Bignardi, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746936/
https://www.ncbi.nlm.nih.gov/pubmed/31552243
http://dx.doi.org/10.3389/fbioe.2019.00220
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author Terzini, Mara
Aldieri, Alessandra
Rinaudo, Luca
Osella, Giangiacomo
Audenino, Alberto L.
Bignardi, Cristina
author_facet Terzini, Mara
Aldieri, Alessandra
Rinaudo, Luca
Osella, Giangiacomo
Audenino, Alberto L.
Bignardi, Cristina
author_sort Terzini, Mara
collection PubMed
description Osteoporotic fracture incidence represents a major social and economic concern in the modern society, where the progressive graying of the population involves an highly increased fracture occurrence. Although the gold standard to diagnose osteoporosis is represented by the T-score measurement, estimated from the Bone Mineral Density (BMD) using Dual-energy X-ray Absorptiometry (DXA), the identification of the subjects at high risk of fracture still remains an issue. From this perspective, the purpose of this work is to investigate the role that DXA-based two-dimensional patient-specific finite element (FE) models of the proximal femur, in combination with T-score, could play in enhancing the risk of fracture estimation. With this aim, 2D FE models were built from DXA images of the 28 post-menopausal female subjects involved. A sideways fall condition was reproduced and a Risk of Fracture ([Formula: see text]) was computed on the basis of principal strains criteria. The identified [Formula: see text] was then compared to that derived from the CT-based models developed in a previous study. The 2D and 3D [Formula: see text] turned out to be significantly correlated (Spearman's ρ = 0.66, p < 0.001), highlighting the same patients as those at higher risk. Moreover, the 2D [Formula: see text] resulted significantly correlated with the T-score (Spearman's ρ = −0.69, p < 0.001), and managed to better differentiate osteopenic patients, drawing the attention to some of them. The Hip Structural Analysis (HSA) variables explaining the majority of the variance of the 2D and 3D fracture risk were the same as well, i.e., neck-shaft angle and narrow neck buckling ratio. In conclusion, DXA-based FE models, developable from currently available clinical data, appear promising in supporting and integrating the present diagnostic procedure.
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spelling pubmed-67469362019-09-24 Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models Terzini, Mara Aldieri, Alessandra Rinaudo, Luca Osella, Giangiacomo Audenino, Alberto L. Bignardi, Cristina Front Bioeng Biotechnol Bioengineering and Biotechnology Osteoporotic fracture incidence represents a major social and economic concern in the modern society, where the progressive graying of the population involves an highly increased fracture occurrence. Although the gold standard to diagnose osteoporosis is represented by the T-score measurement, estimated from the Bone Mineral Density (BMD) using Dual-energy X-ray Absorptiometry (DXA), the identification of the subjects at high risk of fracture still remains an issue. From this perspective, the purpose of this work is to investigate the role that DXA-based two-dimensional patient-specific finite element (FE) models of the proximal femur, in combination with T-score, could play in enhancing the risk of fracture estimation. With this aim, 2D FE models were built from DXA images of the 28 post-menopausal female subjects involved. A sideways fall condition was reproduced and a Risk of Fracture ([Formula: see text]) was computed on the basis of principal strains criteria. The identified [Formula: see text] was then compared to that derived from the CT-based models developed in a previous study. The 2D and 3D [Formula: see text] turned out to be significantly correlated (Spearman's ρ = 0.66, p < 0.001), highlighting the same patients as those at higher risk. Moreover, the 2D [Formula: see text] resulted significantly correlated with the T-score (Spearman's ρ = −0.69, p < 0.001), and managed to better differentiate osteopenic patients, drawing the attention to some of them. The Hip Structural Analysis (HSA) variables explaining the majority of the variance of the 2D and 3D fracture risk were the same as well, i.e., neck-shaft angle and narrow neck buckling ratio. In conclusion, DXA-based FE models, developable from currently available clinical data, appear promising in supporting and integrating the present diagnostic procedure. Frontiers Media S.A. 2019-09-10 /pmc/articles/PMC6746936/ /pubmed/31552243 http://dx.doi.org/10.3389/fbioe.2019.00220 Text en Copyright © 2019 Terzini, Aldieri, Rinaudo, Osella, Audenino and Bignardi. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Terzini, Mara
Aldieri, Alessandra
Rinaudo, Luca
Osella, Giangiacomo
Audenino, Alberto L.
Bignardi, Cristina
Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title_full Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title_fullStr Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title_full_unstemmed Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title_short Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models
title_sort improving the hip fracture risk prediction through 2d finite element models from dxa images: validation against 3d models
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746936/
https://www.ncbi.nlm.nih.gov/pubmed/31552243
http://dx.doi.org/10.3389/fbioe.2019.00220
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