Validation of 3d finite element models from simulated Dxa images for Biofidelic simulations of sideways fall impact to the hip
(2020) In Bone 142.- Abstract
Computed tomography (CT)-derived finite element (FE) models have been proposed as a tool to improve the current clinical assessment of osteoporosis and personalized hip fracture risk by providing an accurate estimate of femoral strength. However, this solution has two main drawbacks, namely: (i) 3D CT images are needed, whereas 2D dual-energy x-ray absorptiometry (DXA) images are more generally available, and (ii) quasi-static femoral strength is predicted as a surrogate for fracture risk, instead of predicting whether a fall would result in a fracture or not. The aim of this study was to combine a biofidelic fall simulation technique, based on 3D computed tomography (CT) data with an algorithm that reconstructs 3D femoral shape and BMD... (More)
Computed tomography (CT)-derived finite element (FE) models have been proposed as a tool to improve the current clinical assessment of osteoporosis and personalized hip fracture risk by providing an accurate estimate of femoral strength. However, this solution has two main drawbacks, namely: (i) 3D CT images are needed, whereas 2D dual-energy x-ray absorptiometry (DXA) images are more generally available, and (ii) quasi-static femoral strength is predicted as a surrogate for fracture risk, instead of predicting whether a fall would result in a fracture or not. The aim of this study was to combine a biofidelic fall simulation technique, based on 3D computed tomography (CT) data with an algorithm that reconstructs 3D femoral shape and BMD distribution from a 2D DXA image. This approach was evaluated on 11 pelvis-femur constructs for which CT scans, ex vivo sideways fall impact experiments and CT-derived biofidelic FE models were available. Simulated DXA images were used to reconstruct the 3D shape and bone mineral density (BMD) distribution of the left femurs by registering a projection of a statistical shape and appearance model with a genetic optimization algorithm. The 2D-to-3D reconstructed femurs were meshed, and the resulting FE models inserted into a biofidelic FE modeling pipeline for simulating a sideways fall. The median 2D-to-3D reconstruction error was 1.02 mm for the shape and 0.06 g/cm3 for BMD for the 11 specimens. FE models derived from simulated DXAs predicted the outcome of the falls in terms of fracture versus non-fracture with the same accuracy as the CT-derived FE models. This study represents a milestone towards improved assessment of hip fracture risk based on widely available clinical DXA images.
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- author
- Grassi, Lorenzo LU ; Fleps, Ingmar ; Sahlstedt, Hannicka LU ; Väänänen, Sami P ; Ferguson, Stephen J ; Isaksson, Hanna LU and Helgason, Benedikt
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Fracture risk assessment, Biomechanics, Statistical shape model, Validation, Statistical appearance models, Orthopedics
- in
- Bone
- volume
- 142
- article number
- 115678
- publisher
- Elsevier
- external identifiers
-
- scopus:85094611942
- pmid:33022451
- ISSN
- 1873-2763
- DOI
- 10.1016/j.bone.2020.115678
- language
- English
- LU publication?
- yes
- id
- 7d694d6b-712f-47b0-828a-7c62ba7f7f83
- date added to LUP
- 2020-10-15 08:09:33
- date last changed
- 2024-09-19 06:38:22
@article{7d694d6b-712f-47b0-828a-7c62ba7f7f83, abstract = {{<p>Computed tomography (CT)-derived finite element (FE) models have been proposed as a tool to improve the current clinical assessment of osteoporosis and personalized hip fracture risk by providing an accurate estimate of femoral strength. However, this solution has two main drawbacks, namely: (i) 3D CT images are needed, whereas 2D dual-energy x-ray absorptiometry (DXA) images are more generally available, and (ii) quasi-static femoral strength is predicted as a surrogate for fracture risk, instead of predicting whether a fall would result in a fracture or not. The aim of this study was to combine a biofidelic fall simulation technique, based on 3D computed tomography (CT) data with an algorithm that reconstructs 3D femoral shape and BMD distribution from a 2D DXA image. This approach was evaluated on 11 pelvis-femur constructs for which CT scans, ex vivo sideways fall impact experiments and CT-derived biofidelic FE models were available. Simulated DXA images were used to reconstruct the 3D shape and bone mineral density (BMD) distribution of the left femurs by registering a projection of a statistical shape and appearance model with a genetic optimization algorithm. The 2D-to-3D reconstructed femurs were meshed, and the resulting FE models inserted into a biofidelic FE modeling pipeline for simulating a sideways fall. The median 2D-to-3D reconstruction error was 1.02 mm for the shape and 0.06 g/cm3 for BMD for the 11 specimens. FE models derived from simulated DXAs predicted the outcome of the falls in terms of fracture versus non-fracture with the same accuracy as the CT-derived FE models. This study represents a milestone towards improved assessment of hip fracture risk based on widely available clinical DXA images.</p>}}, author = {{Grassi, Lorenzo and Fleps, Ingmar and Sahlstedt, Hannicka and Väänänen, Sami P and Ferguson, Stephen J and Isaksson, Hanna and Helgason, Benedikt}}, issn = {{1873-2763}}, keywords = {{Fracture risk assessment; Biomechanics; Statistical shape model; Validation; Statistical appearance models; Orthopedics}}, language = {{eng}}, publisher = {{Elsevier}}, series = {{Bone}}, title = {{Validation of 3d finite element models from simulated Dxa images for Biofidelic simulations of sideways fall impact to the hip}}, url = {{http://dx.doi.org/10.1016/j.bone.2020.115678}}, doi = {{10.1016/j.bone.2020.115678}}, volume = {{142}}, year = {{2020}}, }