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High-Resolution Three-Dimensional-pQCT Images Can Be An Adequate Basis For In-Vivo μFE Analysis Of Bone

W. Pistoia, B. van Rietbergen, A. Laib, P. Ru¨egsegger

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Micro-finite element (μFE) models based on high-resolution images have enabled the calculation of elastic properties of trabecular bone in vitro. Recently, techniques have been developed to image trabecular bone structure in vivo, albeit at a lesser resolution. The present work studies the usefulness of such in-vivo images for μFE analyses, by comparing their μFE results to those of models based on high-resolution micro-CT (μCT) images. Fifteen specimens obtained from human femoral heads were imaged first with a 3D-pQCT scanner at 165 μm resolution and a second time with a μCT scanner at 56 μm resolution. A third set of images with a resolution of 165 μm was created by downscaling the μCT measurements. The μFE models were created directly from these images. Orthotropic elastic properties and the average tissue von Mises stress of the specimens were calculated from six FE-analyses per specimen. The results of the 165 μm models were compared to those of the 56 μm model, which was taken as the reference model. The results calculated from the pQCT-based models, correlated excellent with those calculated from the reference model for both moduli R2>0.95 and for the average tissue von Mises stress R2>0.83. Results calculated from the downscaled micro-CT models correlated even better with those of the reference models (R2>0.99 for the moduli and R2>0.96 for the average von Mises stress). In the case of the 3D-pQCT based models, however, the slopes of the regression lines were less than one and had to be corrected. The prediction of the Poisson’s ratios was less accurate (R2>0.45 and R2>0.67) for the models based on 3D-pQCT and downscaled μCT images respectively). The fact that the results from the downscaled and original μCT images were nearly identical indicates that the need for a correction in the case of the 3D-pQCT measurements was not due to the voxel size of the images but due to a higher noise level and a lower contrast in these images, in combination with the application of a filtering procedure at 165 micron images. In summary: the results of μFE models based on in-vivo images of the 3D-pQCT can closely resemble those obtained from μFE models based on higher resolution μCT system.