How is finite element estimated strength associated with BMD from clinical CT?

Project Description

How is finite element estimated strength associated with BMD from clinical CT?

The diagnosis of osteoporosis from clinical CT via opportunistic screening is not typically used clinically, in part because associations with fracture outcomes have not been established. The best way to address this issue is to build a prospective cohort of people who have had a CT scan so that we can generate reference BMD and then associate that with fracture outcomes in the longitudinal study. That may be possible to build from retrospective data (aka. pseudo- prospective), but will be difficult. In the interim we can use finite element estimated strength as a reference.

The estimation of strength can be performed at L1 (and rest of spine) and proximate femur on a large cohort. Then in the same cohort we could explore which meausurement of BMD is most closely linked. BMD might be measured on a number of ways: (1) the trabecular region only in an ellipsoid (traditional method), (2) the entire trabecular region 3mm from the cortical margin, (3) the entire vertebral body, or (4) the body and processes. While this cannot still be associated with a fracture outcome (i.e., build a CT-based T-score), it will inform us of which measure of BMD is most associated with bone strength.

Reference data that uses quantitative approaches (particularly without the fat-error) will be important to develop. This research would inform what aspect of BMD is most appropriate to use as the reference.

Scope

• PhD project

Data Source

• RETRO2

Resources

• Python scripts
• Ogo GitHub repository