Computed tomography assessment of pelvic bone density: Associations with age and pelvic fracture in motor vehicle crashes

• Published in: Accident analysis and prevention 2023-12, Vol.193, p.107291-107291, Article 107291
• Main Authors: Weaver, Ashley A., Ronning, Isaac N., Armstrong, William, Miller, Anna N., Kiani, Bahram, Shayn Martin, R., Beavers, Kristen M., Stitzel, Joel D.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - statistics & numerical data; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Bone Density; Bone Mineral Density; Female; Fracture; Fractures, Bone - diagnostic imaging; Fractures, Bone - epidemiology; Humans; Imaging; Male; Middle Aged; Opportunistic; Pelvic Bones - diagnostic imaging; Pelvic Bones - injuries; Pelvis; Phantoms, Imaging; Radiology; Tomography, X-Ray Computed - statistics & numerical data; Young Adult
• ISSN: 0001-4575; 1879-2057; 1879-2057
• DOI: 10.1016/j.aap.2023.107291

•Trauma computed tomography (CT) scans can be used to derive bone density.•Phantom-less CT measurement of pelvic bone mineral density (BMD) was validated.•Pelvic BMD was measured from CT scans of 252 motor vehicle crash (MVC) occupants.•BMD at the anterior superior iliac spine and the iliac crest declined with age.•Regressions suggest pelvic BMD is a contributing factor for pelvic fracture in MVCs. Motor vehicle crash (MVC) occupants routinely get a computed tomography (CT) scan to screen for internal injury, and this CT can be leveraged to opportunistically derive bone mineral density (BMD). This study aimed to develop and validate a method to measure pelvic BMD in CT scans without a phantom, and examine associations of pelvic BMD with age and pelvic fracture incidence in seriously injured MVC occupants from the Crash Injury Research and Engineering Network (CIREN) study. A phantom-less muscle-fat calibration technique to measure pelvic BMD was validated using 45 quantitative CT scans with a bone calibration phantom. The technique was then used to measure pelvic BMD from CT scans of 252 CIREN occupants (ages 16+) in frontal MVCs who had sustained either abdominal or pelvic injury. Pelvic BMD was analyzed in relation to age and pelvic fracture incidence. In the validation set, phantom-based calibration vs. phantom-less muscle-fat calibration yielded similar BMD values at the anterior superior iliac spine (ASIS; R2 = 0.95, p