This study aimed to develop and validate a fully automated system that quantifies proximal femoral bone mineral density (BMD) from CT images. The study analyzed 978 pairs of hip CT and dual-energy X-ray absorptiometry (DXA) measurements of the proximal femur (DXA-BMD) collected from three institutions. From the CT images, the femur and a calibration phantom were automatically segmented using previously trained deep-learning models. The Hounsfield units of each voxel were converted into density (mg/cm3). Then, a deep-learning model trained by manual landmark selection of 315 cases was developed to select the landmarks at the proximal femur to rotate the CT volume to the neutral position. Finally, the CT volume of the femur was projected onto the coronal plane, and the areal BMD of the proximal femur (CT-aBMD) was quantified. CT-aBMD correlated to DXA-BMD, and a receiver operating characteristic (ROC) analysis quantified the accuracy in diagnosing osteoporosis.Aims
Methods
Type 2 diabetes mellitus (T2DM) impairs bone strength and is a significant risk factor for hip fracture, yet currently there is no reliable tool to assess this risk. Most risk stratification methods rely on bone mineral density, which is not impaired by diabetes, rendering current tests ineffective. CT-based finite element analysis (CTFEA) calculates the mechanical response of bone to load and uses the yield strain, which is reduced in T2DM patients, to measure bone strength. The purpose of this feasibility study was to examine whether CTFEA could be used to assess the hip fracture risk for T2DM patients. A retrospective cohort study was undertaken using autonomous CTFEA performed on existing abdominal or pelvic CT data comparing two groups of T2DM patients: a study group of 27 patients who had sustained a hip fracture within the year following the CT scan and a control group of 24 patients who did not have a hip fracture within one year. The main outcome of the CTFEA is a novel measure of hip bone strength termed the Hip Strength Score (HSS).Aims
Methods
We investigated the development of CT-based bony
radiological parameters associated with femoroacetabular impingement
(FAI) in a paediatric and adolescent population with no known orthopaedic
hip complaints. We retrospectively reformatted and reoriented
225 abdominal CTs into standardised CT pelvic images with neutral
pelvic tilt and inclination (244 female and 206 male hips) in patients
ranging from two to 19 years of age (mean 10.4 years). The Tönnis
angle, acetabular depth ratio, lateral centre–edge angle, acetabular
version and α-angle were assessed. Acetabular measurements demonstrated increased acetabular coverage
with age and/or progressive ossification of the acetabulum. The α-angle
decreased with age and/or progressive cortical bone development
and resultant narrowing of the femoral neck. Cam and pincer morphology
occurred as early as ten and 12 years of age, respectively, and
their prevalence in the adolescent patient population is similar
to that reported in the adult literature. Future aetiological studies
of FAI will need to focus on the early adolescent population. Cite this article:
