Holger Frank Boehm MD, Presenter: Nothing to Disclose

Juergen Lutz MD, Abstract Co-Author: Nothing to Disclose

Markus Koerner MD, Abstract Co-Author: Nothing to Disclose

Wolf Mutschler, Abstract Co-Author: Nothing to Disclose

Klaus Jürgen Pfeifer PhD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

To introduce a quantitative algorithm for differentiation between post-menopausal women with and without fracture of the hip using texture parameters based on the Radon-Transform (RT) applied to standard radiographs of the proximal femur and to compare the results with the discriminative potential of bone mineral density (BMD).

The study comprises 50 post-menopausal women (78.6 ± 11.5yrs) including 25 patients who have sustained a hip-fracture due to a fall from standing height and 25 age-matched controls. We obtain femoral BMD by dual energy x-ray absorptiometry (DXA) using a clinical DXA-scanner as well as standard radiographs of the pelvis. In the radiographs we analyse the trabecular patterns of the hip in a region-of-interest of 57x29mm using the RT. In the case of the patients with unilateral hip fracture the unaffected femur is considered. From the histogram-representation of the RT we extract several characteristic parameters. By ROC- and discriminant-analysis we assess the statistical power of both methods.

Area-under-the-curve (AUC) for correct differentiation between fracture and non-fracture cases by femoral BMD is 0.78, AUC for the RT-based parameters ranges from 0.73 to 0.8. By combination of densitometric and textural information in a multivariate model the fracture status of 84% of subjects is predicted correctly, identification of fracture cases rises to a total of 88%.  

Quantitative texture features characterizing mechanical properties of trabecular bone can be extracted objectively from standard radiographs of the proximal femur using the Radon Transform. Performance of the newly proposed methodology appears to be comparable to DXA which at present is the gold-standard for the assessment of fracture risk in osteoporosis.

The proposed algorithm can be used as an enhancement to standard radiography and - as an alternative to DXA - may provide a way to predict an individual´s risk for hip fracture.  

Boehm, H, Lutz, J, Koerner, M, Mutschler, W, Pfeifer, K, Reiser, M, Application of the Radon Transform to Pelvic X-ray Images for Differentiation between Post-Menopausal Women with Hip Fracture and Age-matched Controls.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6009450.html