Reliability of an image analysis system for quantifying the radiographic trabecular pattern

Relevance of 2D radiographic texture analysis for the assessment of 3D bone micro-architecture

Although the diagnosis of osteoporosis is mainly based on dual x-ray absorptiometry, it has been shown that trabecular bone micro-architecture is also an important factor in regard to fracture risk. In vivo, techniques based on high-resolution x-ray radiography associated to texture analysis have been proposed to investigate bone micro-architecture, but their relevance for giving pertinent 3D information is unclear. Thirty-three calcaneus and femoral neck bone samples including the cortical shells (diameter: 14 mm, height: 30-40 mm) were imaged using 3D-synchrotron x-ray micro-CT at the ESRF. The 3D reconstructed images with a cubic voxel size of 15 microm were further used for two purposes: (1) quantification of three-dimensional trabecular bone micro-architecture, (2) simulation of realistic x-ray radiographs under different acquisition conditions. The simulated x-ray radiographs were then analyzed using a large variety of texture analysis methods (co-occurrence, spectral density, fractal, morphology, etc.). The range of micro-architecture parameters was in agreement with previous studies and rather large, suggesting that the population was representative. More than 350 texture parameters were tested. A small number of them were selected based on their correlation to micro-architectural morphometric parameters. Using this subset of texture parameters, multiple regression allowed one to predict up to 93% of the variance of micro-architecture parameters using three texture features. 2D texture features predicting 3D micro-architecture parameters other than BV/TV were identified. The methodology proposed for evaluating the relationships between 3D micro-architecture and 2D texture parameters may also be used for optimizing the conditions for radiographic imaging. Further work will include the application of the method to physical radiographs. In the future, this approach could be used in combination with DXA to refine osteoporosis diagnosis.

A sensitive method for measuring spatial orientation in bone structures

OBJECTIVES

This article introduces the newly developed line frequency deviation (LFD) method for measuring the orientation of the trabecular structure and shows that it is more sensitive than the mean intercept length (MIL) method that is commonly used.

METHODS

The LFD method, which has been developed to measure the orientation of bone on two-dimensional X-ray images, was expanded to handle three-dimensional shapes. For the purpose of comparison, both the LFD and the MIL methods were applied to micro CT scans of 24 trabecular bone samples as well as to 24 simple synthetic samples. LFD and MIL values were calculated in various directions and collected in polar plots. Next, the anisotropy was quantified by calculating the coefficient of variation as well as by fitting ellipsoids through the plots.

RESULTS

The MIL method yielded smooth rather spherical ellipsoidal polar plots with almost no sensitivity for changes in structure. The LFD method yielded more slender polar plots and more sensitivity for geometrical changes. The LFD method yielded significantly more anistropy and larger variation in anisotropy.

CONCLUSIONS

The LFD method is a more sensitive descriptor of spatial orientation of bone structures than the MIL method.

Medieval trabecular bone architecture: the influence of age, sex, and lifestyle

Osteoporosis has become a growing health concern in developed countries and an extensive area of research in skeletal biology. Despite numerous paleopathological studies of bone mass, few studies have measured bone quality in past populations. In order to examine age- and sex-related changes in one aspect of bone quality in the past, a study was made of trabecular bone architecture in a British medieval skeletal sample. X-ray images of 5-mm-thick coronal lumbar vertebral bone sections were taken from a total of 54 adult individuals divided into three age categories (18-29, 30-49, and 50+ years), and examined using image analysis to evaluate parameters related to trabecular bone structure and connectivity. Significant age-related changes in trabecular bone structure (trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and anisotropic ratio (Tb.An)) were observed to occur primarily by middle age with significant differences between the youngest and two older age groups. Neither sex showed continuing change in trabecular structure between the middle and old age groups. Age-related changes in bone connectivity (number of nodes (N.Nd) and node-to-node strut length (Nd.Nd)) similarly indicated a change in bone connectivity only between the youngest and two older age groups. However, females showed no statistical differences among the age groups in bone connectivity. These patterns of trabecular bone loss and fragility contrast with those generally found in modern populations that typically report continuing loss of bone structure and connectivity between middle and old age, and suggest greater loss in females. The patterns of bone loss in the archaeological samples must be interpreted cautiously. We speculate that while nutritional factors may have initiated some bone loss in both sexes, physical activity could have conserved bone architecture in old age in both sexes, and reproductive factors such as high parity and extended periods of lactation could have played a key role in female bone maintenance in this historic population. The study of qualitative elements (such as trabecular architecture) is vital if we are to understand bone maintenance and fragility in the past.

Computerized radiographic texture measures for characterizing bone strength: a simulated clinical setup using femoral neck specimens

We are investigating computerized methods to ultimately characterize bone trabecular pattern from clinical skeletal radiographs. In this paper, we present a "phantom" for potential use in the development and evaluation of computerized methods for characterizing radiographic trabecular patterns and ultimately bone strength. Femoral neck specimens were excised during total hip arthroplasties from subjects exhibiting a range of diseases. To mimic the femoral neck in vivo, a "simulated clinical" setup was implemented in which specimens were exposed under conditions that yielded radiographs similar in appearance to standard pelvis radiographs. Fourier-based and fractal-based texture measures were used in the computer analysis; including RMS variation, first moment of the power spectrum, angular-dependent forms of these measures, and fractal dimension. The texture measures obtained from the "simulated clinical" specimen films correlated modestly with those from direct exposure "verification" films of the specimens (r= 0.59-0.69; p<0.0001). From our study, we conclude that the femoral neck specimen "phantoms" may be useful in the development and evaluation of computerized methods for analyzing bone trabecular patterns from skeletal radiographs. The use of a phantom that simulates the clinical radiographic examination allows for repeat exposures without the concern of excessive radiation exposure to a patient.

Comparison of two methods for measuring orientation

At the Department of Dental Radiology of ACTA, the line fraction deviation (LFD) method was developed to measure orientation on radiographic trabecular patterns. This article explains the measurement of the LFD index of orientation in a downscaled model. When investigations began to produce noteworthy results, the need for deeper understanding of the method and the resulting diagrams increased. Because it had previously been applied on rather complex patterns originating from bone it seemed worthwhile to study simpler images as well, which might yield a more intuitive understanding of the diagrams. Moreover, it seemed useful to compare the new LFD method with the well-accepted mean intercept length (MIL) method. Fifty images originating from cancellous bone structures and 25 drawings were analyzed. The results show that the MIL method tends to produce ellipses (not only on images originating from bone), and also that the LFD method is more sensitive to anisotropy.