Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature

Abstract Background Finite element modeling of human bone provides a powerful tool to evaluate a wide variety of outcomes in a highly repeatable and parametric manner. These models are most often derived from computed tomography data, with mechanical properties related to bone mineral density (BMD)...

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Main Authors: Nikolas K. Knowles, Jacob M. Reeves, Louis M. Ferreira
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1186/s40634-016-0072-2
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author Nikolas K. Knowles
Jacob M. Reeves
Louis M. Ferreira
author_facet Nikolas K. Knowles
Jacob M. Reeves
Louis M. Ferreira
author_sort Nikolas K. Knowles
collection DOAJ
description Abstract Background Finite element modeling of human bone provides a powerful tool to evaluate a wide variety of outcomes in a highly repeatable and parametric manner. These models are most often derived from computed tomography data, with mechanical properties related to bone mineral density (BMD) from the x‐ray energy attenuation provided from this data. To increase accuracy, many researchers report the use of quantitative computed tomography (QCT), in which a calibration phantom is used during image acquisition to improve the estimation of BMD. Since model accuracy is dependent on the methods used in the calculation of BMD and density‐mechanical property relationships, it is important to use relationships developed for the same anatomical location and using the same scanner settings, as these may impact model accuracy. The purpose of this literature review is to report the relationships used in the conversion of QCT equivalent density measures to ash, apparent, and/or tissue densities in recent finite element (FE) studies used in common density‐modulus relationships. For studies reporting experimental validation, the validation metrics and results are presented. Results Of the studies reviewed, 29% reported the use of a dipotassium phosphate (K2HPO4) phantom, 47% a hydroxyapatite (HA) phantom, 13% did not report phantom type, 7% reported use of both K2HPO4 and HA phantoms, and 4% alternate phantom types. Scanner type and/or settings were omitted or partially reported in 31% of studies. The majority of studies used densitometric and/or density‐modulus relationships derived from different anatomical locations scanned in different scanners with different scanner settings. The methods used to derive various densitometric relationships are reported and recommendations are provided toward the standardization of reporting metrics. Conclusions This review assessed the current state of QCT‐based FE modeling with use of clinical scanners. It was found that previously developed densitometric relationships vary by anatomical location, scanner type and settings. Reporting of all parameters used when referring to previously developed relationships, or in the development of new relationships, may increase the accuracy and repeatability of future FE models.
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spelling doaj.art-6d350f0d48cf4bd9a8d875481c50ee082024-02-07T15:05:53ZengWileyJournal of Experimental Orthopaedics2197-11532016-01-0131n/an/a10.1186/s40634-016-0072-2Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literatureNikolas K. Knowles0Jacob M. Reeves1Louis M. Ferreira2Graduate Program in Biomedical EngineeringThe University of Western Ontario1151 Richmond StLondonONCanadaRoth|McFarlane Hand and Upper Limb CentreSurgical Mechatronics LaboratorySt. Josephs Health Care268 Grosvenor StLondonONCanadaGraduate Program in Biomedical EngineeringThe University of Western Ontario1151 Richmond StLondonONCanadaAbstract Background Finite element modeling of human bone provides a powerful tool to evaluate a wide variety of outcomes in a highly repeatable and parametric manner. These models are most often derived from computed tomography data, with mechanical properties related to bone mineral density (BMD) from the x‐ray energy attenuation provided from this data. To increase accuracy, many researchers report the use of quantitative computed tomography (QCT), in which a calibration phantom is used during image acquisition to improve the estimation of BMD. Since model accuracy is dependent on the methods used in the calculation of BMD and density‐mechanical property relationships, it is important to use relationships developed for the same anatomical location and using the same scanner settings, as these may impact model accuracy. The purpose of this literature review is to report the relationships used in the conversion of QCT equivalent density measures to ash, apparent, and/or tissue densities in recent finite element (FE) studies used in common density‐modulus relationships. For studies reporting experimental validation, the validation metrics and results are presented. Results Of the studies reviewed, 29% reported the use of a dipotassium phosphate (K2HPO4) phantom, 47% a hydroxyapatite (HA) phantom, 13% did not report phantom type, 7% reported use of both K2HPO4 and HA phantoms, and 4% alternate phantom types. Scanner type and/or settings were omitted or partially reported in 31% of studies. The majority of studies used densitometric and/or density‐modulus relationships derived from different anatomical locations scanned in different scanners with different scanner settings. The methods used to derive various densitometric relationships are reported and recommendations are provided toward the standardization of reporting metrics. Conclusions This review assessed the current state of QCT‐based FE modeling with use of clinical scanners. It was found that previously developed densitometric relationships vary by anatomical location, scanner type and settings. Reporting of all parameters used when referring to previously developed relationships, or in the development of new relationships, may increase the accuracy and repeatability of future FE models.https://doi.org/10.1186/s40634-016-0072-2QCTBone densityFinite element analysisMechanical properties
spellingShingle Nikolas K. Knowles
Jacob M. Reeves
Louis M. Ferreira
Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
Journal of Experimental Orthopaedics
QCT
Bone density
Finite element analysis
Mechanical properties
title Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
title_full Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
title_fullStr Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
title_full_unstemmed Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
title_short Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature
title_sort quantitative computed tomography qct derived bone mineral density bmd in finite element studies a review of the literature
topic QCT
Bone density
Finite element analysis
Mechanical properties
url https://doi.org/10.1186/s40634-016-0072-2
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