Clinical Assessment of Hip Fracture Biomechanics using MRI

使用 MRI 进行髋部骨折生物力学的临床评估

• 批准号: 9750622
• 负责人: Chamith Sudesh Rajapakse
• 金额: $ 35.39万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9750622
• 关键词: Accounting; Address; Admission activity; Agreement; Assessment tool; Biomechanics; Bone Density; Bone Marrow; Bone Tissue; Cadaver; Caring; Clinical; Clinical assessments; Computer software; Computers; Coupled; Diagnosis; Direct Costs; Dual-Energy X-Ray Absorptiometry; Elements; Event; Failure; Femoral Neck Fractures; Femur; Finite Element Analysis; Fracture; Geometry; Gold; Hip Fractures; Hip region structure; Image; Individual; Injury; Ionizing radiation; Longitudinal Studies; Magnetic Resonance Imaging; Marrow; Measurement; Mechanics; Methods; Modeling; Monitor; Nature; Noise; Nursing Homes; Osteoporosis; Patients; Performance; Pharmaceutical Preparations; Physicians; Postmenopause; Probability; Protocols documentation; Radiation Dose Unit; Reproducibility; Research; Research Personnel; Resolution; Risk; Risk Assessment; Risk Factors; Roentgen Rays; Scanning; Side; Signal Transduction; Structure; Techniques; Testing; Time; United States; Validation; Variant; Walking; Woman; Work; X-Ray Computed Tomography; attenuation; base; bone; bone strength; clinical risk; clinical translation; cost; disability; falls; fracture risk; fragility fracture; high resolution imaging; image guided; improved; in vivo; mortality; novel; public health relevance; tool; two-dimensional

 DESCRIPTION (provided by applicant): Hip fracture is a devastating event. Within a year of the injury, 20-30% of patients die and 50% lose the ability to walk; in the United States these fractures account for 70% ($12 billion) of the direct annual costs of fracture care. Ironically, more than half of the women who sustain a hip fracture would not have qualified for osteoporosis treatment by the current criteria, which are based on bone mineral density (BMD) measurements by dual energy X-ray absorptiometry (DXA). Thus, a better approach is needed to determine if an individual is at risk for hip fracture from a fall. Biomechanically, a hip will fracture if the impact force resulting from a fall is greater than the bone strength. Therefore, th ability to determine hip strength is critical for fracture risk assessment. The current best non-invasive tool for direct hip strength assessment is based on quantitative computed tomography (QCT) guided finite element models. However, due to ionizing-radiation dose restrictions, the spatial resolution of clinical QCT (0.6-1 mm) is not sufficient to resolve bone microstructure at the hip. Leveraging our recent work, we propose to develop a novel method for assessing hip strength in vivo using magnetic resonance imaging (MRI) coupled with biomechanics. First, we propose to optimize our current MRI protocol for microstructural hip imaging to achieve 0.23-0.5 mm spatial resolution, and to reduce the finite element computation time to less than 30 minutes for predicting hip strength simulating a fall onto the hip on a desktop computer. Second, we propose to validate the accuracy of our MRI-derived hip strength technique by comparing the values obtained by this technique to the values obtained from the gold standard technique of mechanical testing of cadaveric femurs obtained from 30 donors. Third, we propose to apply the method optimized and validated above to determine if patients with hip fracture (N=40) have low bone strength for a fall onto the hip compared to matched healthy controls (N=40). We also propose to determine the test-retest reproducibility of MRI-derived strength by repeating the scanning and analysis in 10 healthy subjects. If further validated in longitudinal studies, the groundwork proposed under this project has the potential to introduce a paradigm shift for assessing hip fracture risk and monitoring the efficacy of osteoporosis treatment.

 描述（适用提供）：髋部骨折是一个破坏性的事件。在受伤的一年内，有20％至30％的患者死亡，50％失去了行走的能力。在美国，这些骨折占断裂护理年度直接年费用的70％（120亿美元）。具有讽刺意味的是，超过一半的维持髋部骨折的妇女不会通过当前标准获得骨质疏松治疗的资格，该标准基于双重能量X射线绝对测定法（DXA）基于骨矿物质密度（BMD）测量。这是需要更好的方法来确定一个人是否有跌倒的髋部骨折风险。在生物力学上，如果跌落产生的撞击力大于骨强度，则髋部会断裂。因此，确定髋关节增强的能力对于断裂风险评估至关重要。当前用于直接髋关节增强评估的最佳非侵入性工具基于定量计算机断层扫描（QCT）引导有限元模型。但是，由于电离辐射剂量限制，临床QCT（0.6-1 mm）的空间分辨率不足以解决臀部的骨微结构。利用我们最近的工作，我们建议使用一种与生物力学相结合的磁共振成像（MRI）来评估体内髋部强度的新方法。首先，我们建议优化当前的微结构髋关节成像的MRI协议，以实现0.23-0.5 mm的空间分辨率，并将有限元计算时间缩短到少于30分钟，以预测髋关节强度模拟在台式计算机上掉落到臀部上的臀部。其次，我们建议通过比较该技术获得的值与从30个供体获得的尸体股骨的金标准技术获得的值来验证MRI衍生的髋关节强度技术的准确性。第三，我们建议采用上述优化和验证的方法，以确定与匹配的健康对照组相比，跌落到臀部的髋部骨折患者（n = 40）是否具有较低的骨骼强度（n = 40）。我们还建议通过重复10名健康受试者的扫描和分析来确定MRI衍生强度的重现测试重现性。如果在纵向研究中进一步验证，则该项目下提出的基础工作有可能引入范式转移，以评估髋部骨折风险并监测骨质疏松治疗的效率。

项目成果

A deep learning system for automated, multi-modality 2D segmentation of vertebral bodies and intervertebral discs.

• DOI: 10.1016/j.bone.2021.115972
• 发表时间: 2021-08
• 期刊: Bone
• 影响因子: 4.1
• 作者: Suri A;Jones BC;Ng G;Anabaraonye N;Beyrer P;Domi A;Choi G;Tang S;Terry A;Leichner T;Fathali I;Bastin N;Chesnais H;Rajapakse CS
• 通讯作者: Rajapakse CS

Assessment of femoral neck bone metabolism using 18F-sodium fluoride PET/CT imaging.

使用 18F-氟化钠 PET/CT 成像评估股骨颈骨代谢。

• DOI: 10.1016/j.bone.2020.115351
• 发表时间: 2020
• 期刊: Bone
• 影响因子: 4.1
• 作者: Rhodes,Sylvia;Batzdorf,Alexandra;Sorci,Olivia;Peng,Matthew;Jankelovits,Amanda;Hornyak,Julia;An,Jongyun;Noël,PeterB;Høilund-Carlsen,PoulF;Alavi,Abass;Rajapakse,ChamithS
• 通讯作者: Rajapakse,ChamithS