Klintström Benjamin, Spångeus Anna, Malusek Alexandr, Synek Alexander, Woisetschläger Mischa, Pahr Dieter, Klintström Eva
Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Sweden.
Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Sci Rep. 2024 Dec 16;14(1):30466. doi: 10.1038/s41598-024-75222-6.
Fracture liaison services are essential to mitigate underdiagnosis and undertreatment of osteoporosis-related fractures. However, it often suffers from limited access to dual-energy X-ray absorptiometry (DXA) or high-resolution peripheral quantitative CT equipment. This in vivo study of 21 patients aims to evaluate the feasibility of dental cone beam CT (dCBCT) to analyse bone properties of human wrists, comparing with DXA and finite element (FE) analysis. dCBCT grey-scale values were transformed to HU using a phantom containing materials with known HU values. Strong correlations were found between bone mineral content (BMC) from dCBCT and DXA (r = 0.78 to 0.84, p < 0.001), as well as between BMC from dCBCT FE-predicted stiffness (r = 0.91) and maximum force (r = 0.93), p < 0.001. BMC values from dCBCT were higher than DXA measurements (2.34 g vs. 1.5 g, p < 0.001). Cortical thickness strongly correlated to bone mineral density (BMD) from dCBCT (r = 0.83, p < 0.001). No statistically significant correlations were found between trabecular bone microstructure and FE predictions. The results indicate the feasibility to analyse osteoporosis related bone properties of human wrists from corrected dCBCT data. The dCBCT values of BMD and BMC were strongly correlated with DXA.
骨折联络服务对于减少骨质疏松相关骨折的诊断不足和治疗不足至关重要。然而，该服务常常面临双能X线吸收法（DXA）或高分辨率外周定量CT设备获取受限的问题。这项针对21名患者的体内研究旨在评估牙科锥形束CT（dCBCT）分析人体手腕骨特性的可行性，并与DXA和有限元（FE）分析进行比较。使用含有已知HU值材料的体模将dCBCT灰度值转换为HU。发现dCBCT测得的骨矿物质含量（BMC）与DXA测得的BMC之间存在强相关性（r = 0.78至0.84，p < 0.001），dCBCT测得的BMC与FE预测的刚度（r = 0.91）和最大力（r = 0.93）之间也存在强相关性，p < 0.001。dCBCT测得的BMC值高于DXA测量值（2.34 g对1.5 g，p < 0.001）。皮质厚度与dCBCT测得的骨矿物质密度（BMD）密切相关（r = 0.83，p < 0.001）。未发现小梁骨微结构与FE预测之间存在统计学上的显著相关性。结果表明，从校正后的dCBCT数据分析人体手腕骨质疏松相关骨特性具有可行性。dCBCT测得的BMD和BMC值与DXA密切相关。
