ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Advanced 2D image processing technique to predict hip fracture risk in an older population based on single DXA scans.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 14 citations in OpenAlex.
- Development of an automated landmarking tool for the femur in dual-energy X-ray absorptiometry scans using contour-based image analysis.JBMR plus · 2026Article
- The Use of Statistical Shape and Appearance Modelling for Predicting Osteoporotic Fracture Risk.Current osteoporosis reports · 2026Review
- A Neural Network Model for Intelligent Classification of Distal Radius Fractures Using Statistical Shape Model Extraction Features.Orthopaedic surgery · 2025Article
- Computer-aided diagnosis for China-Japan Friendship Hospital classification of necrotic femurs using statistical shape and appearance model based on CT scans.Medical & biological engineering & computing · 2025Article
- The effect of file type and DXA protocol on an image processing fracture risk prediction tool.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2025Article
- Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the multi-ethnic study of atherosclerosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- The effect of femur positioning on dual-energy X-ray absorptiometry (DXA) measures and statistical shape and appearance modeling (SSAM) fracture risk assessments.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2024Article
- Quantitating Age-Related BMD Textural Variation from DXA Region-Free-Analysis: A Study of Hip Fracture Prediction in Three Cohorts.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Statistical Shape and Appearance Models: Development Towards Improved Osteoporosis Care.Current osteoporosis reports · 2021Review
- 3D Analysis of the Proximal Femur Compared to 2D Analysis for Hip Fracture Risk Prediction in a Clinical Population.Annals of biomedical engineering · 2021Article
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Abstract
A new technique to enhance hip fracture risk prediction in older adults was presented and assessed. The new method dramatically improved prediction at high specificity levels using only a standard clinical diagnostic scan. This has the potential to be implemented in clinical practice to enhance patient fragility diagnosis.
introductionDiagnosis of osteoporosis is based on the measurement of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) scans. However, studies have shown this to be insufficient to accurately predict hip fractures. Therefore, complementary methods are needed to enhance hip fracture risk prediction to identify vulnerable patients.
methodsHip DXA scans were obtained for 192 subjects from the Canadian Multicenter Osteoporosis Study (CaMos), 50 of whom had experienced a hip fracture within 5 years of the scan. 2D statistical shape and appearance modeling was performed to account for the effect of the femur's geometry and BMD distribution on hip fracture risk. Statistical shape modeling (SSM), and statistical appearance modeling (SAM) were also used separately to predict the fracture risk based solely on the femur's geometry and BMD distribution, respectively. Combined with BMD, age, and body mass index (BMI), logistic regression was performed to estimate the fracture risk over the 5-year period.
resultsUsing the new technique, hip fractures were correctly predicted in 78% of cases compared with 36% when using the T-score. The accuracy of the prediction was not greatly reduced when using SSM and SAM (78% and 74% correct, respectively). Various geometric and BMD distribution traits were identified in the fractured and non-fractured groups.
conclusion2D SSAM can dramatically improve hip fracture prediction at high specificity levels and estimate the year of the impending fracture using standard clinical images. This has the potential to be implemented in clinical practice to estimate hip fracture risk.
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