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. 2013 Jul 20:2:331.
doi: 10.1186/2193-1801-2-331. eCollection 2013.

Hip structural analysis: a comparison of DXA with CT in postmenopausal Japanese women

Kazuhiro Ohnaru  1 , Teruki Sone, Kensuke Tanaka, Kazumi Akagi, Yong-In Ju, Hak-Jin Choi, Tatsushi Tomomitsu, Masao Fukunaga
Affiliations

Hip structural analysis: a comparison of DXA with CT in postmenopausal Japanese women

Kazuhiro Ohnaru et al. Springerplus. .

Abstract

Geometry of the proximal femur is one determinant of fracture risk, and can be analyzed by a simple method using dual-energy X-ray absorptiometry (DXA). The aim of the present study was to investigate the accuracy of hip structural analysis (HSA) using clinical data in postmenopausal Japanese women. A total of 184 postmenopausal women aged 51-88 years (mean, 70.5 ± 8.7 years) who underwent artificial joint replacement surgery for osteoarthrosis of the hip or knee joint were included. Computed tomography (CT) data from preoperative assessment were utilized for analysis of proximal femoral geometry (CT-HSA) using QCTPro Software (Mindways Software Inc., Austin, TX) and compared with HSA results based on DXA (DXA-HSA). The results of femoral geometry were further compared with a CT-based finite-element method (CT/FEM). There was moderate to high correlation between DXA-HSA and CT-HSA (r=0.60-0.90, p<0.001), except for the buckling ratio in the intertrochanteric region. Moreover, the correlation of HSA with CT/FEM was similar between DXA-HSA and CT-HSA. The present results suggest that the geometry of proximal femoral cross sections can be reasonably well characterized using DXA.

Keywords: Bone strength; CT-based finite-element method; Hip structural analysis; QCT.

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Figures

Figure 1
Figure 1
Schematic representation of sectors in the narrow neck and intertrochanteric regions for the calculation of average cortical thickness (CTh). Average in cortical thickness in eight or 16 sectors are used for the estimate of CTh in each region.
Figure 2
Figure 2
Schematic representation of 16 sectors in the intertrochanteric region. Average of buckling ratio (BR) in all sectors is used for the estimate of BR in the intertrochanteric region.
Figure 3
Figure 3
Scatter plots showing the relationship between DXA-HSA and CT-HSA in the narrow neck region. CSA: bone cross-sectional area, SM: section modulus, CTh: average cortical thickness, BR: buckling ratio, NN: narrow neck region.
Figure 4
Figure 4
Scatter plots showing the relationship between DXA-HSA and CT-HSA in the intertrochanteric region. CSA: bone cross-sectional area, SM: section modulus, CTh: average cortical thickness, BR: buckling ratio, IT intertrochanteric region.
See this image and copyright information in PMC

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