3-D Visualization and Prediction of Spine Fractures

脊柱骨折的 3D 可视化和预测

• 批准号: 8066431
• 负责人: Elise F Morgan
• 金额: $ 30.56万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-07 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8066431
• 关键词: 3-Dimensional; Accounting; Age; Anisotropy; Anterior; Area; Behavior; Bone Density; Bone Tissue; Clinical; Clinical assessments; Coupled; Data; Diagnosis; Elderly; Elements; Failure; Finite Element Analysis; Fracture; Future; Generic Drugs; Goals; Gold; Health; Heterogeneity; High Prevalence; Human; Image; Imagery; Imaging Device; Individual; Measurement; Measures; Mechanics; Methods; Modeling; Pain; Patients; Pattern; Performance; Population; Prevention; Property; Quality of life; Regression Analysis; Resolution; Risk; Risk Estimate; Scanning; Series; Specimen; Speed; Spinal Fractures; System; Techniques; Testing; Textiles; Vertebral column; Woman; Work; X-Ray Computed Tomography; base; bone; bone strength; clinically relevant; computer studies; density; detector; digital imaging; improved; in vivo; innovation; mechanical behavior; men; mortality; osteoporosis with pathological fracture; research clinical testing; research study; spine bone structure; substantia spongiosa; theories; tool

DESCRIPTION (provided by applicant): Vertebral fractures are the most common type of osteoporotic fracture, afflicting approximately one in three women and one in six men over the age of 50. Despite their high prevalence, sensitive and specific estimates of vertebral fracture risk have remained elusive. This is due in large part to the limited accuracy and precision of current methods of estimating vertebral strength. Average measures of bone mineral density (BMD) explain only 50-70% of the variance in vertebral strength, a result that is not surprising given the heterogeneous distribution of bone tissue throughout the vertebra. A growing and compelling amount of evidence points to importance of this heterogeneity in governing the mechanical behavior of the vertebra. Recent advances in quantitative computed tomography (QCT) allow non-invasive measurement of the distribution of bone density and even trabecular anisotropy in whole bones. We propose that these additional measurements can be used to establish a new standard for clinical evaluation of vertebral fracture risk. Our overall hypothesis is that CT- based methods that account for the heterogeneous distribution of density and trabecular anisotropy throughout the vertebra provide more accurate predictions of vertebral strength than do methods based solely on average BMD. Four specific aims are proposed. Aim #1 will test whether CT-based measures of the intra-vertebral heterogeneity in density are independent predictors of vertebral strength. Aims #2-#4 are closely coupled experimental and computational studies that will test the importance of incorporating specimen-specific, anisotropic material properties in QCT-based finite element (FE) models of the vertebra. These studies will investigate the effect of this material property assignment on the accuracy of the FE predictions of vertebral strength and failure behavior. Aim #2 will use micro-finite element analysis to quantify the anisotropic elastic properties throughout the centrum. Aim #3 will carry out the QCT-based FE analyses using the material properties obtained in Aim #2 and also using properties determined purely from estimates based on BMD or on BMD and trabecular anisotropy. The accuracy of the FE predictions of vertebral mechanical behavior will be evaluated through experiments performed in Aim #4. These experiments will use 3-D failure visualization techniques that we have developed over the past several years. These techniques afford us the unique ability to assess the fidelity with which the FE models predict bone strength as well as the true deformation and failure behavior of the vertebra. Such assessment is critical for gauging the performance of these models, for identifying means of improving their predictions, and for enabling their widespread implementation in the clinical arena. Taken together, the proposed studies constitute a set of concrete and consequential steps towards our long-term goal of developing techniques for highly accurate, patient-specific predictions of vertebral strength from clinically feasible measurements. As such, this work has strong potential for leading the way to better diagnosis, treatment, and prevention of spine fractures. PUBLIC HEALTH RELEVANCE. One in three women and one in six men over age 50 will suffer a spine fracture in their remaining lifetime. This project focuses on developing methods for obtaining more accurate predictions of bone strength in the spine.

描述（由申请人提供）：椎骨骨折是最常见的骨质疏松性骨折类型，大约三分之一的女性和50岁以上的六分之一的男性遭受了较高的患病率，椎骨骨折风险的敏感和特定估计值仍然难以捉摸。这在很大程度上归因于当前估计椎骨强度的准确性和精度有限。骨矿物质密度（BMD）的平均度量仅解释了椎骨强度方差的50-70％，这一结果不足为奇，鉴于整个椎骨骨组织的异质分布。越来越多的证据表明，这种异质性在管理椎骨的机械行为中的重要性。定量计算机断层扫描（QCT）的最新进展允许无创测量整个骨骼中骨密度甚至小梁各向异性的分布。我们建议这些额外的测量可用于建立椎骨骨折风险临床评估的新标准。我们的总体假设是，在整个椎骨中说明密度和小梁各向异性的异质分布的基于CT的方法比仅基于平均BMD的方法提供了更准确的椎骨强度预测。提出了四个具体目标。 AIM＃1将测试基于CT的脊椎内异质性的度量是否是椎骨强度的独立预测指标。目标＃2-＃4是紧密耦合的实验和计算研究，将测试将标本特异性的各向异性材料特性纳入椎骨的有限元（FE）模型。这些研究将研究该材料特性分配对椎骨强度和失败行为的Fe预测准确性的影响。 AIM＃2将使用微型元素分析来量化整个中心的各向异性弹性特性。 AIM＃3将使用AIM＃2中获得的材料属性进行基于QCT的FE分析，并使用纯粹根据BMD或BMD和小梁各向异性确定的属性。将通过在AIM＃4中进行的实验来评估椎体机械行为的Fe预测的准确性。这些实验将使用过去几年中我们开发的3-D故障可视化技术。这些技术为我们提供了评估Fe模型预测骨骼强度以及椎骨的真实变形和失败行为的独特能力。这种评估对于衡量这些模型的性能，确定改善其预测的手段以及在临床领域的广泛实施至关重要。综上所述，拟议的研究构成了一组具体的和相应的步骤，朝着我们的长期目标开发技术，从而从临床上可行的测量中对椎骨强度进行高度准确，特定于患者的预测。因此，这项工作具有领先于更好地诊断，治疗和预防脊柱骨折的强大潜力。公共卫生相关性。三分之一的女性和50岁以上的六分之一的男性在剩余的一生中会遭受脊柱骨折。该项目着重于开发用于获得脊柱中骨强度的更准确预测的方法。