Radiographic texture analysis of densitometer-generated calcaneus images differentiates postmenopausal women with and without fractures

• Published in: Osteoporosis international 2006-10, Vol.17 (10), p.1472-1482
• Main Authors: VOKES, T. J, GIGER, M. L, CHINANDER, M. R, KARRISON, T. G, FAVUS, M. J, DIXON, L. B
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Bone Density; Bones; Calcaneus - diagnostic imaging; Calcaneus - physiopathology; Cross-Sectional Studies; Diseases of the osteoarticular system; Female; Femur Neck - physiopathology; Fractals; Fractures; Fractures, Bone - diagnostic imaging; Fractures, Bone - etiology; Fractures, Bone - physiopathology; Hip Joint - physiopathology; Humans; Image Processing, Computer-Assisted - methods; Injuries of the limb. Injuries of the spine; Lumbar Vertebrae - physiopathology; Medical sciences; Menopause; Middle Aged; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - diagnostic imaging; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Radiography; Radiology; Traumas. Diseases due to physical agents; Women
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-006-0089-y

Bone fragility is determined by bone mass, measured as bone mineral density (BMD), and by trabecular structure, which cannot be easily measured using currently available noninvasive methods. In previous studies, radiographic texture analysis (RTA) performed on the radiographic images of the spine, proximal femur, and os calcis differentiated subjects with and without osteoporotic fractures. The present cross-sectional study was undertaken to determine whether such differentiation could also be made using high-resolution os calcis images obtained on a peripheral densitometer. In 170 postmenopausal women (42 with and 128 without prevalent vertebral fractures) who had no secondary causes of osteoporosis and were not receiving treatment for osteoporosis, BMD of the lumbar spine, proximal femur, and os calcis was measured using dual energy x-ray absorptiometry. Vertebral fractures were diagnosed on densitometric spine images. RTA, including Fourier-based and fractal analyses, was performed on densitometric images of os calcis. BMD at all three sites and all texture features was significantly different in subjects with and without fractures, with the most significant differences observed for the femoral neck and total hip measurements and for the RTA feature Minkowski fractal (p