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Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 3/2018

Open Access 01-06-2018 | Biomechanics (G Niebur and J Wallace, Section Editors)

Are CT-Based Finite Element Model Predictions of Femoral Bone Strengthening Clinically Useful?

Authors: Marco Viceconti, Muhammad Qasim, Pinaki Bhattacharya, Xinshan Li

Published in: Current Osteoporosis Reports | Issue 3/2018

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Abstract

Purpose of Review

This study reviews the available literature to compare the accuracy of areal bone mineral density derived from dual X-ray absorptiometry (DXA-aBMD) and of subject-specific finite element models derived from quantitative computed tomography (QCT-SSFE) in predicting bone strength measured experimentally on cadaver bones, as well as their clinical accuracy both in terms of discrimination and prediction. Based on this information, some basic cost-effectiveness calculations are performed to explore the use of QCT-SSFE instead of DXA-aBMD in (a) clinical studies with femoral strength as endpoint, (b) predictor of the risk of hip fracture in low bone mass patients.

Recent Findings

Recent improvements involving the use of smooth-boundary meshes, better anatomical referencing for proximal-only scans, multiple side-fall directions, and refined boundary conditions increase the predictive accuracy of QCT-SSFE.

Summary

If these improvements are adopted, QCT-SSFE is always preferable over DXA-aBMD in clinical studies with femoral strength as the endpoint, while it is not yet cost-effective as a hip fracture risk predictor, although pathways that combine both QCT-SSFE and DXA-aBMD are promising.
Footnotes
1
Hereinafter, we will use the % symbol to indicate the percent ratio between the value of interest and some average value that can be used to normalise it. Vice versa, we will use percentage point (annotated with the symbol pp) to indicate difference in percentage between two normalised values.
 
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Metadata
Title
Are CT-Based Finite Element Model Predictions of Femoral Bone Strengthening Clinically Useful?
Authors
Marco Viceconti
Muhammad Qasim
Pinaki Bhattacharya
Xinshan Li
Publication date
01-06-2018
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 3/2018
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-018-0438-8

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