Online citations, reference lists, and bibliographies.

Quantitative Computed Tomography (QCT) Derived Bone Mineral Density (BMD) In Finite Element Studies: A Review Of The Literature

N. Knowles, J. Reeves, L. Ferreira
Published 2016 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
BackgroundFinite element modeling of human bone provides a powerful tool to evaluate a wide variety of outcomes in a highly repeatable and parametric manner. These models are most often derived from computed tomography data, with mechanical properties related to bone mineral density (BMD) from the x-ray energy attenuation provided from this data. To increase accuracy, many researchers report the use of quantitative computed tomography (QCT), in which a calibration phantom is used during image acquisition to improve the estimation of BMD. Since model accuracy is dependent on the methods used in the calculation of BMD and density-mechanical property relationships, it is important to use relationships developed for the same anatomical location and using the same scanner settings, as these may impact model accuracy. The purpose of this literature review is to report the relationships used in the conversion of QCT equivalent density measures to ash, apparent, and/or tissue densities in recent finite element (FE) studies used in common density-modulus relationships. For studies reporting experimental validation, the validation metrics and results are presented.ResultsOf the studies reviewed, 29% reported the use of a dipotassium phosphate (K2HPO4) phantom, 47% a hydroxyapatite (HA) phantom, 13% did not report phantom type, 7% reported use of both K2HPO4 and HA phantoms, and 4% alternate phantom types. Scanner type and/or settings were omitted or partially reported in 31% of studies. The majority of studies used densitometric and/or density-modulus relationships derived from different anatomical locations scanned in different scanners with different scanner settings. The methods used to derive various densitometric relationships are reported and recommendations are provided toward the standardization of reporting metrics.ConclusionsThis review assessed the current state of QCT-based FE modeling with use of clinical scanners. It was found that previously developed densitometric relationships vary by anatomical location, scanner type and settings. Reporting of all parameters used when referring to previously developed relationships, or in the development of new relationships, may increase the accuracy and repeatability of future FE models.
This paper references
Prediction of local proximal tibial subchondral bone structural stiffness using subject-specific finite element modeling: Effect of selected density-modulus relationship.
S. Nazemi (2015)
Torsional stiffness and strength of the proximal tibia are better predicted by finite element models than DXA or QCT.
W. B. Edwards (2013)
Accuracy of specimen-specific nonlinear finite element analysis for evaluation of radial diaphysis strength in cadaver material
Yusuke Matsuura (2015)
On the dependence of the elasticity
J Rice (1988)
scapula using computed tomography data. Trends Biomater Artif Organs
IT Haider (2013)
JBJS Trustees' Commitment to the Profession
Michael A. Simon (2008)
Predicting Proximal Femoral Strength Using Structural Engineering Models
J. Keyak (2005)
Structural patterns of the proximal femur in relation to age and hip fracture risk in women.
J. Carballido-Gamio (2013)
Relationships between femoral strength
H Gong (2012)
Schuller-Götzburg P (2014) Need for CT
K Entacher (2014)
Validated finite element models of the proximal femur using two-dimensional projected geometry and bone density
J. O. D. Buijs (2011)
Need for CT-based bone density modelling in finite element analysis of a shoulder arthroplasty revealed through a novel method for result analysis
Werner Pomwenger (2014)
Automatic multi-parametric quantification of the proximal femur with quantitative computed tomography.
J. Carballido-Gamio (2015)
Femoral strength in osteoporotic women treated with teriparatide or alendronate.
T. M. Keaveny (2012)
Effect of finite element model loading condition on fracture risk assessment in men and women: the AGES-Reykjavik study.
J. Keyak (2013)
Numerical analysis of an osseointegrated prosthesis fixation with reduced bone failure risk and periprosthetic bone loss.
P. Tomaszewski (2012)
The influence of bone density and anisotropy in finite element models of distal radius fracture osteosynthesis: Evaluations and comparison to experiments.
A. Synek (2015)
Cortical bone finite element models in the estimation of experimentally measured failure loads in the proximal femur.
Janne E. M. Koivumäki (2012)
The effect of in situ/in vitro three-dimensional quantitative computed tomography image voxel size on the finite element model of human vertebral cancellous bone
Yongtao Lu (2014)
Vertebral fracture risk and alendronate effects on osteoporosis assessed by a computed tomography-based nonlinear finite element method
K. Imai (2011)
The influence of bone
A Synek (2015)
The finite cell method for bone simulations: verification and validation
M. Ruess (2012)
Femoral and Vertebral Strength Improvements in Postmenopausal Women With Osteoporosis Treated With Denosumab
T. M. Keaveny (2014)
Quantitative computed tomography: comparative study using different scanners with two calibration phantoms.
S. Suzuki (1991)
Augmented wedgeshaped glenoid component for the correction of glenoid retroversion: a finite element analysis
Jc Hermida
Mechanical testing of cancellous bone from the femoral head: experimental errors due to off-axis measurements.
C. Ohman (2007)
Validated finite element models of the proximal femur using two-dimensional projected geometry and bone density
Op Den BuijsJorn (2011)
Patient-specific finite element
S jbiomech.2008.11.028 Poelert (2013)
An improved method for the automatic mapping of computed tomography numbers onto finite element models.
F. Taddei (2004)
Physical properties of trabecular bone
J. Galante (2005)
Subchondral cysts create increased intra-osseous stress in early knee OA: A finite element analysis using simulated lesions.
D. McErlain (2011)
Mechanical evaluation by patient-specific finite element analyses demonstrates therapeutic effects for osteoporotic vertebrae.
Daisuke Tawara (2010)
Proximal femur bone strength estimated by a computationally fast finite element analysis in a sideways fall configuration.
K. Nishiyama (2013)
Bone Miner Res 29:158–165
J denosumab (2013)
Experimental versus Computational Analysis of Micromotions at the Implant—Bone Interface
M. Tarala (2011)
An accurate estimation of bone density improves the accuracy of subject-specific finite element models.
E. Schileo (2008)
Analysis of strength and failure pattern of human proximal femur using quantitative computed tomography (QCT)-based finite element method.
Majid Mirzaei (2014)
Accuracy of methods for calculating volumetric wear from coordinate measuring machine data of retrieved metal-on-metal hip joint implants
Z. Lu (2014)
An investigation to determine if a single validated density-elasticity relationship can be used for subject specific finite element analyses of human long bones.
S. Eberle (2013)
Advanced CT based In Vivo Methods for the Assessment of Bone Density, Structure, and Strength
K. Engelke (2013)
Cross-calibration of liquid
CC Gluer (1993)
Prediction of femoral fracture
SA Rossi (1997)
Individual density-elasticity relationships
M Göttlinger (2013)
Mapping anisotropy
JS Owoc (2014)
An Improved Method for the Automatic Digital Modulation Classification
L. De Vito (2008)
Cross-calibration of liquid and solid QCT calibration standards: Corrections to the UCSF normative data
K. Faulkner (2005)
Patient-specific bone modeling and analysis: the role of integration and automation in clinical adoption.
A. A. Zadpoor (2015)
QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA
E. Dall’Ara (2011)
Computed - tomographybased finiteelement models of long bones can accurately capture strain response to bending and torsion
B Varghese (2011)
Prediction of New clinical vertebral
X Wang (2012)
Male-female differences in the association between incident hip fracture and proximal femoral strength: a finite element analysis study.
J. Keyak (2011)
Influence of 3D QCT scan protocol on the QCT-based finite element models of human vertebral cancellous bone.
Yongtao Lu (2014)
Torsional stiffness and strength
WB Edwards (2013)
Finite element analysis and CT-based structural rigidity analysis to assess failure load in bones with simulated lytic defects.
L. Anez‐Bustillos (2014)
Estimation of material properties in the equine metacarpus with use of quantitative computed tomography
C. Les (1994)
Assessing the Effects of Teriparatide Treatment on Bone Mineral Density, Bone Microarchitecture, and Bone Strength.
M. Kleerekoper (2014)
Prediction of proximal femur strength by a quantitative computed tomography-based finite element method—Creation of predicted strength data of the proximal femur according to age range in a normal population
M. Kaneko (2016)
Assessment of incident spine and Hip fractures in women and men using FEA of CT scans
DL Kopperdhal (2014)
Patient-specific finite-element analyses of the proximal femur with orthotropic material properties validated by experiments.
N. Trabelsi (2011)
Measurement of structural anisotropy in femoral trabecular bone using clinical-resolution CT images.
M. Kersh (2013)
Noninvasive prediction of vertebral body compressive strength using nonlinear finite element method and an image based technique.
Ahad Zeinali (2010)
Mathematical relationships between bone density and mechanical properties: a literature review.
B. Helgason (2008)
On the dependence of the elasticity and strength of cancellous bone on apparent density.
J. Rice (1988)
Femoral and vertebral strength
MR McClung (2014)
The compressive behavior of bone as a two-phase porous structure.
D. Carter (1977)
Effect of boundary conditions, impact loading and hydraulic stiffening on femoral fracture strength.
I. Haider (2013)
Augmented wedge-shaped glenoid component for the correction of glenoid retroversion: a finite element analysis.
J. Hermida (2014)
Relationships Between Femoral Strength Evaluated by Nonlinear Finite Element Analysis and BMD, Material Distribution and Geometric Morphology
He Gong (2012)
Analyzing bone remodeling patterns after total hip arthroplasty using quantitative computed tomography and patient-specific 3D computational models.
Shanika Arachchi (2015)
Stiffness of compact bone: effects of porosity and density.
M. Schaffler (1988)
Quantitative CT with finite element
VB Shim (2012)
Mapping anisotropy of the proximal femur for enhanced image based finite element analysis.
W. S. Enns-Bray (2014)
Clinical Use of Quantitative Computed Tomography-Based Finite Element Analysis of the Hip and Spine in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part II.
P. Zysset (2015)
Femoral strength in osteoporotic
TM Keaveny (2012)
Advanced CT based in vivo
K Engelke (2013)
Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem
V. Shim (2012)
Assessment of Hip Fracture Risk Using Cross-Section Strain Energy Determined by QCT-Based Finite Element Modeling
H. Kheirollahi (2015)
Orthotropic HR-pQCT-based FE models improve strength predictions for stance but not for side-way fall loading compared to isotropic QCT-based FE models of human femurs.
B. Luisier (2014)
Journal of Experimental Orthopaedics
Knowles (2016)
Incorporating uncertainty in mechanical properties for finite element-based evaluation of bone mechanics.
P. Laz (2007)
Effect of specimen-specific anisotropic material properties in quantitative computed tomography-based finite element analysis of the vertebra.
G. Unnikrishnan (2013)
Prediction of new clinical vertebral fractures in elderly men using finite element analysis of CT scans
Xiang Wang (2012)
Ct-based finite element models can be used to estimate experimentally measured failure loads in the proximal femur.
Janne E. M. Koivumäki (2012)
Quantitative computed tomography estimates of the mechanical properties of human vertebral trabecular bone
D. Kopperdahl (2002)
Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans
D. Kopperdahl (2014)
Collaborative Training Program in Musculoskeletal Health Research, and Bone and Joint Institute
Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip
D. Dragomir-Daescu (2010)
Patient-specific finite element analysis
N Trabelsi (2011)
A comparison of enhanced continuum FE with micro FE models of human vertebral bodies.
D. Pahr (2009)
A nonlinear QCT-based finite element model validation study for the human femur tested in two configurations in vitro.
E. Dallara (2013)
A Robust 3D Finite Element Simulation of Human Proximal Femur Progressive Fracture Under Stance Load with Experimental Validation
R. Hambli (2013)
Patient-specific finite element analysis of the human femur--a double-blinded biomechanical validation.
N. Trabelsi (2011)
Individual density-elasticity relationships improve accuracy of subject-specific finite element models of human femurs.
Sebastian Eberle (2013)
The Effect of Quantitative Computed Tomography Acquisition Protocols on Bone Mineral Density Estimation.
H. Giambini (2015)
Bone Miner Metab 29:645–651
J method (2015)
Patient-specific finite-element analyses
N Trabelsi (2011)
Correlations between orthogonal mechanical
IY Lee (1994)
S. Gupta (2004)
Effects of densitometry, material mapping and load estimation uncertainties on the accuracy of patient-specific finite-element models of the scapula
G. Campoli (2014)
Classification of women with and without hip fracture based on quantitative computed tomography and finite element analysis
K. Nishiyama (2013)
Prediction of femoral fracture load using automated finite element modeling.
J. Keyak (1998)
Computed-tomography-based finite-element models of long bones can accurately capture strain response to bending and torsion.
Bino Varghese (2011)
In situ parameter identification of optimal density-elastic modulus relationships in subject-specific finite element models of the proximal femur.
A. Cong (2011)
Mechanical Contributions of the Cortical and Trabecular Compartments Contribute to Differences in Age-Related Changes in Vertebral Body Strength in Men and Women Assessed by QCT-Based Finite Element Analysis
B. Christiansen (2011)
A calibration methodology of QCT BMD for human vertebral body with registered micro-CT images.
E. Dallara (2011)
Association of Hip Strength Estimates by Finite Element Analysis with Fractures in Women and Men
B. Clarke (2011)
Trabecular bone modulus-density relationships depend on anatomic site.
E. Morgan (2003)
A new material mapping procedure for quantitative computed tomography-based, continuum finite element analyses of the vertebra.
G. Unnikrishnan (2011)
Patient-specific finite element modeling of bones
S. Poelert (2013)
A new material mapping procedure
EF Morgan (2011)
Correlations between orthogonal mechanical properties and density of trabecular bone: use of different densitometric measures.
J. Keyak (1994)

This paper is referenced by
Opportunistic screening for osteoporosis in abdominal computed tomography for Chinese population
Y. Li (2018)
Elementwise material assignment in reconstructed or transformed patient-specific FEA models developed from CT scans
Peter Schwarzenberg (2019)
Spinal (in)stability in metastatic bone disease. Experimental, computational, and clinical perspectives
K.H.J. Groenen (2018)
Potential for estimation of Young's modulus based on computed tomography numbers in bone: A validation study using a nano-indentation test on murine maxilla
Hideaki Inagawa (2018)
Étude biomécanique des pathomécanismes du rachis lombaire en conditions traumatiques et sportives : influence des propriétés ligamentaires
Manon Sterba (2019)
Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis—A Survey
Amadeus C S de Alcântara (2019)
Influence of Vitamin D Status and Mechanical Loading on the Morphometric and Mechanical Properties of the Mouse Tibia
Yongtao Lu (2019)
Patient-Specific Phantomless Estimation of Bone Mineral Density and Its Effects on Finite Element Analysis Results: A Feasibility Study
Young Han Lee (2019)
The effect of stemless humeral component fixation feature design on bone stress and strain response: a finite element analysis.
J. Reeves (2018)
What is the future of patient-specific vertebral fracture prediction?
Hugo Giambini (2017)
Practical considerations for obtaining high quality quantitative computed tomography data of the skeletal system.
Karen L. Troy (2018)
An In-Silico Assessment of Stemless Shoulder Arthroplasty: from CT to Predicted Bone Response
Jacob M. Reeves (2018)
A novel phase field method for modeling the fracture of long bones.
Rilin Shen (2019)
A comparison of density-modulus relationships used in finite element modeling of the shoulder.
N. Knowles (2019)
Material Mapping of QCT-Derived Scapular Models: A Comparison with Micro-CT Loaded Specimens Using Digital Volume Correlation
N. Knowles (2019)
Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift
L. Lenchik (2018)
A critical review on the three-dimensional finite element modelling of the compression therapy for chronic venous insufficiency
Yongtao Lu (2019)
Effect of the intervertebral disc on vertebral bone strength prediction: a Finite-Element Study.
D. Anitha (2019)
Effect of CT imaging on the accuracy of the finite element modelling in bone
E. Benca (2020)
Functional Design and Analysis of a Linked Shoulder Prosthesis
Emily West (2017)
Development of a validated glenoid trabecular density-modulus relationship.
N. Knowles (2019)
Evaluation of the capability of the simulated dual energy X-ray absorptiometry-based two-dimensional finite element models for predicting vertebral failure loads.
Yongtao Lu (2019)
Comparison of femur stiffness measured from DXA and QCT for assessment of hip fracture risk
Yunhua Luo (2018)
Semantic Scholar Logo Some data provided by SemanticScholar