Jan Stefan Bauer MD, Presenter: Nothing to Disclose

Roberto Adrian Monetti PhD, Abstract Co-Author: Nothing to Disclose

Dirk Mueller MD, Abstract Co-Author: Nothing to Disclose

Ernst Josef Rummeny MD, Abstract Co-Author: Nothing to Disclose

Felix Eckstein MD, Abstract Co-Author: Co-owner, Chondrometrics GmbH Co-founder, Chondrometrics GmbH CEO, Chondrometrics GmbH Consultant, Pfizer Inc Consultant, Merck KGaA

Thomas M. Link MD, Abstract Co-Author: Research grant, Merck & Co, Inc

Eva-Maria Lochmueller MD, Abstract Co-Author: Nothing to Disclose

Christoph W. Raeth PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

The goal of this in-vitro study was to investigate, whether the quantification of trabecular directionalities, measured with an automated analysis of Multidetector Computed Tomography (MDCT) scans of the proximal femur, were able to improve the prediction of biomechanical bone strength compared to bone mineral density (BMD) as a standard parameter.

130 left femur specimens were harvested from formalin-fixed human cadavers (mean-age 80±10 years). BMD was determined using Dual X-ray Absorptiometry (DXA). High resolution images were acquired using a 16-Row MDCT. Directionalities (D) and standard morphometric (SM) structure-parameters were calculated in these regions. A 3-point bending test, simulating a fall on the greater trochanter, was used to determine bone strength (MCS) of the proximal femur.

DXA and structure parameters both showed significant correlations (p<0.01) with MCS. The highest correlations were found for a measure of the directionality relative to the loading direction (r up to 0.77). Although correlations were higher compared to BMD (r=0.71) and structure parameters (up to r=0.73), differences were not significant (p>0.05).

The feasibility of the determination of local directionalities using MDCT images of the proximal femur was demonstrated, achieving high correlations with bone strength. A trend to higher correlations was found compared to DXA BMD, yet differences were not significant.

Analyzing the local distribution of directionalities within the proximal femur is useful for determining bone strength and may help to better determine proximal femur fracture risk.

Bauer, J, Monetti, R, Mueller, D, Rummeny, E, Eckstein, F, Link, T, Lochmueller, E, Raeth, C, et al, , The Main Directionality of the Trabecular Network for the Prediction of the Femoral Bone Strength: A Comparison with BMC.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017717.html