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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.

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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.

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