Evidence map›Paper›PMID 40891498›Full record

ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2026

Use of DXA-derived 3D-modeling, as implemented by 3D-Shaper, for the assessment of fracture risk in a population-based setting.

Kirsty Huininga, Fjorda Koromani, M Carola Zillikens, Evert F S van Velsen, Fernando Rivadeneira

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Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

Kirsty HuiningaInternal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, 3015GD, The Netherlands.ORCID 0009-0007-5094-608X
Fjorda KoromaniInternal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, 3015GD, The Netherlands.ORCID 0000-0002-6942-5889
M Carola ZillikensInternal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, 3015GD, The Netherlands.ORCID 0000-0001-9186-3423
Evert F S van VelsenInternal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, 3015GD, The Netherlands.ORCID 0000-0002-6938-065X
Fernando RivadeneiraInternal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, 3015GD, The Netherlands.

Funding

Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw)European Commission (DG XII)European Research Council 101021500Ministry for Health, Welfare and SportsMinistry of Education, Culture and ScienceMunicipality of RotterdamResearch Institute for Diseases in the Elderly (RIDE)
6 · The paper itself

Abstract

Three-dimensional modeling of hip DXA scans has been proposed to partition BMD into cortical surface (csBMD) and trabecular "volumetric" (tvBMD). We assessed in a population-based cohort, whether such partitioning contributes to fracture risk assessment compared to aBMD alone. Participants (N = 4908) from the Rotterdam Study comprised 56% women, with a mean age of 67.4 (SD = 10.1) years. Hip DXA scans were analyzed with enCore (GE Lunar) and 3D-Shaper software. Pearson partial correlation was calculated between aBMD, csBMD, and tvBMD at the total hip, femoral neck, and trochanter. Incident fractures were collected from GP or hospital records. During a mean follow-up of 6.8 (SD = 2.5) years, 171 sustained a hip fracture, and 1019 any-type fractures. Fracture risk estimates were determined as hazard ratios (HR) per SD decrease in BMD, from Cox-regression adjusted for multiple confounders. High correlation (r = >.81; p < .001) was observed between aBMD and the modeled 3D parameters, and between csBMD and tvBMD (r = 0.85; p < .001 at the total hip). Lower aBMD was associated with higher incidence of any-type (HR = 1.60, 95% CI: 1.43-1.78) and hip (HR = 2.46, 95% CI: 1.90-3.17) fracture; lower csBMD with increased risk of any-type (HR = 1.44, 95% CI: 1.30-1.60) and hip (csBMD HR = 1.76, 95% CI: 1.39-2.23) fracture; and tvBMD with increased risk of any-type (HR = 1.62, 95% CI: 1.45-1.80) and hip fracture (HR = 2.44, 95% CI: 1.88-3.15). Inclusion of aBMD in models with tvBMD or csBMD resulted in high multicollinearity and unreliable coefficient parameters (VIF > 5). The effect of csBMD was largely attenuated after inclusion of tvBMD in the same model for both any-type (csBMD HR = 0.96, 95% CI: 0.81-1.13; tvBMD HR = 1.67, 95% CI: 1.41-1.98) and hip (csBMD HR = 0.83, 95% CI: 0.58-1.21; tvBMD HR = 2.82, 95% CI: 1.94-4.10) fractures. Similar results were observed at the neck and intertrochanteric regions. DXA-derived 3D modeled parameters are highly correlated to aBMD and do not provide additional value for the estimation of fracture risk beyond aBMD alone.

Indexed as

Absorptiometry, PhotonFractures, BoneHip FracturesImaging, Three-DimensionalAgedBone DensityFemaleHumansMaleMiddle AgedRisk AssessmentRisk Factors3D-ShaperBone fragilityBone Mineral Density (BMD)DXAFracture riskOsteoporosis

Identifiers

PMID40891498
PMCPMC12865847

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.