Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jun;16(3):216-223.
doi: 10.1007/s11914-018-0438-8.

Are CT-Based Finite Element Model Predictions of Femoral Bone Strength Clinically Useful?

Marco Viceconti  1   2   3 , Muhammad Qasim  4   5 , Pinaki Bhattacharya  4   5 , Xinshan Li  4   5
Affiliations
Review

Are CT-Based Finite Element Model Predictions of Femoral Bone Strength Clinically Useful?

Marco Viceconti et al. Curr Osteoporos Rep. 2018 Jun.

Erratum in

Abstract

Purpose of review: This study reviews the available literature to compare the accuracy of areal bone mineral density derived from dual X-ray absorptiometry (DXA-aBMD) and of subject-specific finite element models derived from quantitative computed tomography (QCT-SSFE) in predicting bone strength measured experimentally on cadaver bones, as well as their clinical accuracy both in terms of discrimination and prediction. Based on this information, some basic cost-effectiveness calculations are performed to explore the use of QCT-SSFE instead of DXA-aBMD in (a) clinical studies with femoral strength as endpoint, (b) predictor of the risk of hip fracture in low bone mass patients.

Recent findings: Recent improvements involving the use of smooth-boundary meshes, better anatomical referencing for proximal-only scans, multiple side-fall directions, and refined boundary conditions increase the predictive accuracy of QCT-SSFE. If these improvements are adopted, QCT-SSFE is always preferable over DXA-aBMD in clinical studies with femoral strength as the endpoint, while it is not yet cost-effective as a hip fracture risk predictor, although pathways that combine both QCT-SSFE and DXA-aBMD are promising.

Keywords: Computed tomography; Cost-benefit; Hip fracture; Subject-specific finite element models.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

Marco Viceconti, Muhammad Qasim, Pinaki Bhattacharya, and Xinshan Li declare that they do not have any financial or personal relationships with other people or organisations that could have inappropriately influenced this study. The University of Sheffield will soon start to offer the CT2S analysis as a paid service to other Universities and hospitals.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kanis JA, Harvey NC, Johansson H, Oden A, McCloskey EV, Leslie WD. Overview of fracture prediction tools. J Clin Densitom. 2017;20:444–450. doi: 10.1016/j.jocd.2017.06.013. - DOI - PMC - PubMed
    1. Wainwright SA, Marshall LM, Ensrud KE, Cauley JA, Black DM, Hillier TA, Hochberg MC, Vogt MT, Orwoll ES. Study of osteoporotic fractures research G. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787–2793. doi: 10.1210/jc.2004-1568. - DOI - PubMed
    1. Basu PK, Beall AG, Simmons DJ, Vannier M. 3-D femoral stress analysis using CT scans and p-version FEM. Biomater Med Devices Artif Organs. 1985;13:163–186. doi: 10.3109/10731198509118849. - DOI - PubMed
    1. Pottecher P, Engelke K, Duchemin L, Museyko O, Moser T, Mitton D, Vicaut E, Adams J, Skalli W, Laredo JD, Bousson V. Prediction of hip failure load: in vitro study of 80 femurs using three imaging methods and finite element models-the European fracture study (EFFECT) Radiology. 2016;280:837–847. doi: 10.1148/radiol.2016142796. - DOI - PubMed
    1. Zysset P, Qin L, Lang T, Khosla S, Leslie WD, Shepherd JA, Schousboe JT, Engelke K. Clinical use of quantitative computed tomography-based finite element analysis of the hip and spine in the management of osteoporosis in adults: the 2015 ISCD official positions-part II. J Clin Densitom. 2015;18:359–392. doi: 10.1016/j.jocd.2015.06.011. - DOI - PubMed

Publication types

MeSH terms