Holger Frank Boehm MD, Presenter: Nothing to Disclose

Bernhard Baumert, Abstract Co-Author: Nothing to Disclose

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

Janusch Blautzik MD, Abstract Co-Author: Nothing to Disclose

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

To use the Radon-Transform (RT) for differentiation between patients with and without fracture of the hip by analysis of three regions-of-interest (ROI) of standard femoral radiographs and to compare results with bone mineral densitometry by DXA.  

The study comprises 50 post-menopausal women aged 75±8.7 years, 25 of whom have confirmed hip-fractures, and 25 age-matched controls. None of the patients have a history of metabolic or metastatic bone disease. The diagnostic work-up includes conventional imaging and hip-DXA. By RT, we analyse trabecular patterns in standard radiographs of the hip in three circular ROIs (femoral head, neck, and inter-trochanteric area). We obtain 4 characteristic parameters based on the RT (maxH, skewH, kurtH, and madH) that are evaluated by ROC- and discriminant analysis with respect to correct prediction of the fracture status.    

AUC for correct identification of fractures for RT-based parameters [by BMD] ranges from 0.662 to 0.826 [is 0.798]. Best overall classification results with respect to the fracture status are achieved in the inter-trochanteric area. Statistical combination of all three ROIs allows to identify up to 80% of fractures and to correctly classify up to 78% of all patients.

RT is capable of identifying patients with hip fracture at a rate comparable to that of bone densitometry. Performance depends on the choice of the anatomical location. In the future, RT-based texture evaluation of x-ray images may help to supplement screening for patients at imminent risk of hip fracture if or where DXA is not available.  

Skeletal radiographs contain textural information that is currently not fully exploited. We propose an algorithm using ROI-oriented Radon-Transform for quantitative image-analysis of hip-x-rays.

Boehm, H, Baumert, B, Lutz, J, Blautzik, J, Reiser, M, Identification of Postmenopausal Patients with Hip Fracture by Application of the Radon Transform to Clinical Radiographs of the Proximal Femur Using Three Regions of Interest  .  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001777.html