Fracture Prediction by Computed Tomography and Finite Element Analysis: Current and Future Perspectives

Abstract

Purpose of review: This review critiques the ability of CT-based methods to predict incident hip and vertebral fractures.

Recent findings: CT-based techniques with concurrent calibration all show strong associations with incident hip and vertebral fracture, predicting hip and vertebral fractures as well as, and sometimes better than, dual-energy X-ray absorptiometry areal biomass density (DXA aBMD). There is growing evidence for use of routine CT scans for bone health assessment. CT-based techniques provide a robust approach for osteoporosis diagnosis and fracture prediction. It remains to be seen if further technical advances will improve fracture prediction compared to DXA aBMD. Future work should include more standardization in CT analyses, establishment of treatment intervention thresholds, and more studies to determine whether routine CT scans can be efficiently used to expand the number of individuals who undergo evaluation for fracture risk.

Keywords: Computational anatomy; Finite element analysis (FEA); Hip fracture; Opportunistic CT; Quantitative computed tomography (QCT); Vertebral fracture.