Preventing Osteoporotic Hip Fractures by Accurately Predicting Future Fractures

通过准确预测未来骨折来预防骨质疏松性髋部骨折

• 批准号: 7053955
• 负责人: CLAUDE D ARNAUD
• 金额: $ 10.9万
• 依托单位: IMAGING THERAPEUTICS, INC.
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-10 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7053955
• 关键词: accidental falls; bioimaging /biomedical imaging; biomechanics; bone; bone density; bone imaging /visualization /scanning; bone preservation; computer simulation; disease /disorder proneness /risk; hip; hip fractures; human tissue; image processing; morphometry; osteoporosis; pelvis; photon absorptiometry; postmortem; radiography; technology /technique development

DESCRIPTION (provided by applicant): Hip fracture is the most serious consequence of osteoporosis (OP). In 2002, the cost of treating hip fractures consumed 63% of the national direct expenditure for OP, or more than $10 billion. By 2050, due to a rapidly aging population, the annual cost of treating hip fractures is projected to increase 6 fold to more than $60 billion. The ability to accurately estimate an individual's risk of osteoporotic hip fracture is key in preventing the expected increase of hip fractures because it would identify those individuals needing the most potent available fracture reduction therapy. Bone Mineral Density (BMD) measurement is currently used for diagnosis of osteoporosis. However, it has only limited utility in predicting hip fracture. This is because Individual fracture risk is also strongly influenced by local bone architecture and structure, bone turnover, cortical thickness, and, fall biomechanics. We recently developed non- invasive automated imaging technology using ordinary radiographs that can measure cortical and trabecular parameters that are comparable to those measured by 3D uCT. Those 2D measurements correlated with biomechanical failure loads applied to cadaver proximal femoral bone cores as well to whole cadaver proximal femora. Furthermore, 2D mapping of structural parameters and watershed boundary detection in those same proximal femora appear to predict the location of osteoporotic fracture lines with a high degree of accuracy. Thus targeted measurement of trabecular parameters at a predicted fracture site could yield more precise and accurate estimates of failure load than those that are not at a predicted fracture site. Phase 1 of the preset Fast Track is designed to show that these observations are more than theoretical and that they can be used to develop a reference scale of cadaver fracture load values in Phase 2, along with a biomechanical component to predict individualized fracture risk. Finally that technology will be used attempt to predict hip fracture from pelvic radiographs obtained in the University of California, San Francisco prospective Study of Osteoporotic Fractures (SOF). Thus the present Fast Track Phase 1 and Phase 2 applications propose to develop powerful new technology that would identify individuals with OP at high risk for hip fracture so that they can be definitively treated. It is expected that this action could markedly reduce the morbidity, mortality and cost of this pervasive disease.

描述（由申请人提供）：髋部骨折是骨质疏松症（OP）最严重的后果。 2002年，治疗髋部骨折的费用占全国OP直接支出的63%，即超过100亿美元。到 2050 年，由于人口迅速老龄化，每年治疗髋部骨折的费用预计将增加 6 倍，达到超过 600 亿美元。准确估计个体骨质疏松性髋部骨折风险的能力是防止髋部骨折预期增加的关键，因为它将识别出那些需要最有效的骨折复位治疗的个体。骨矿物质密度（BMD）测量目前用于诊断骨质疏松症。然而，它在预测髋部骨折方面的作用有限。这是因为个体骨折风险还受到局部骨结构和结构、骨转换、皮质厚度和跌倒生物力学的强烈影响。我们最近开发了使用普通放射线照片的无创自动成像技术，可以测量与 3D uCT 测量的数据相当的皮质和小梁参数。这些二维测量结果与应用于尸体近端股骨核心以及整个尸体近端股骨的生物力学失效载荷相关。此外，这些相同的近端股骨中的结构参数的二维映射和分水岭边界检测似乎可以高精度地预测骨质疏松骨折线的位置。因此，与不在预测骨折部位的小梁参数相比，对预测骨折部位的小梁参数进行有针对性的测量可以产生更精确和准确的失效载荷估计。预设快速通道的第一阶段旨在表明这些观察结果不仅仅是理论上的，它们可用于开发第二阶段尸体骨折负荷值的参考量表，以及预测个体骨折风险的生物力学成分。最后，该技术将用于尝试根据加州大学旧金山骨质疏松性骨折前瞻性研究 (SOF) 获得的骨盆 X 光照片来预测髋部骨折。因此，目前的快速通道第一阶段和第二阶段申请建议开发强大的新技术，以识别髋部骨折高风险的 OP 患者，以便他们能够得到明确的治疗。预计这一行动将显着降低这种普遍性疾病的发病率、死亡率和成本。