Bone Radiomics Score Derived From DXA Hip Images Enhances Hip Fracture Prediction in Older Women

• Published in: Journal of bone and mineral research 2021-09, Vol.36 (9), p.1708-1716
• Main Authors: Hong, Namki, Park, Heajeong, Kim, Chang Oh, Kim, Hyeon Chang, Choi, Jin‐Young, Kim, Hwiyoung, Rhee, Yumie
• Format: Article
• Language: English
• Subjects: Age; Body mass index; Bone mineral density; Dual energy X-ray absorptiometry; DXA; FRACTURE RISK ASSESSMENT; Fractures; Hip; OSTEOPOROSIS; Predictions; Radiomics; Risk assessment
• ISSN: 0884-0431; 1523-4681
• DOI: 10.1002/jbmr.4342

ABSTRACT Dual‐energy X‐ray absorptiometry (DXA)‐based bone mineral density testing is standard to diagnose osteoporosis to detect individuals at high risk of fracture. A radiomics approach to extract quantifiable texture features from DXA hip images may improve hip fracture prediction without additional costs. Here, we investigated whether bone radiomics scores from DXA hip images could improve hip fracture prediction in a community‐based cohort of older women. The derivation set (143 women who sustained hip fracture [mean age 73 years, time to fracture median 2.1 years] versus 290 age‐matched women [mean age 73 years] who did not sustain hip fracture during follow‐up [median 5.5 years]) were split into the train set (75%) and the test set (25% hold‐out set). Among various models using 14 selected features out of 300 texture features mined from DXA hip images in the train set, random forest model was selected as the best model to build a bone radiomics score (range 0 to 100) based on the performance in the test set. In a community‐based cohort (2029 women, mean age 71 years) as the clinical validation set, the bone radiomics score was calculated using a model fitted in the train set. A total of 34 participants (1.7%) sustained hip fracture during median follow‐up of 5.4 years (mean bone radiomics score 40 ± 16 versus 28 ± 12 in non‐fractured, p