TY - JOUR
T1 - 3D reconstruction of the lumbar vertebrae from anteroposterior and lateral dual-energy X-ray absorptiometry
AU - Whitmarsh, Tristan
AU - Humbert, Ludovic
AU - Del Río Barquero, Luis M.
AU - Di Gregorio, Silvana
AU - Frangi, Alejandro F.
N1 - Funding Information:
The authors gratefully acknowledge J. Malouf (Departamento de Medicina Interna, Unidad de Metabolismo Mineral, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain) for technical support and data acquisition and H. Khayyeri and J.M. Pozo (Department of Mechanical Engineering, University of Sheffield, Sheffield, UK) for their kind review and suggestions. The research leading to these results has received funding from: the European Union Seventh Framework Programme (FP7/2007–2013) under Grant Agreement No. 269909 , MySpine project; the ERDF Operational Programme of Catalonia 2007–2013, through the 3D-FemOs project (exp. VALTEC 09-02-0012) and the VERTEX project (exp. RD10-1-0034); the Spanish Ministry Science and Innovation (Ref. TIN2009-14536-C02-01), Plan E and ERDF funds. T. Whitmarsh is supported by the Instituto de Salud Carlos III (FI09/00757).
PY - 2013/5
Y1 - 2013/5
N2 - Current vertebral fracture prevention measures use Dual-energy X-ray Absorptiometry (DXA) to quantify the density of the vertebrae and subsequently determine the risk of fracture. This modality however only provides information about the projected Bone Mineral Density (BMD) while the shape and spatial distribution of the bone determines the strength of the vertebrae. Quantitative Computed Tomography (QCT) allows for the measurement of the vertebral dimensions and volumetric densities, which have been shown to be able to determine the fracture risk more reliably than DXA. However, for the high cost and high radiation dose, QCT is not used in clinical routine for fracture risk assessment. In this work, we therefore propose a method to reconstruct the 3D shape and density volume of lumbar vertebrae from an anteroposterior (AP) and lateral DXA image used in clinical routine. The method is evaluated for the L2, L3 and L4 vertebra. Of these vertebrae a statistical model of the vertebral shape and density distribution is first constructed from a large dataset of QCT scans. All three models are then simultaneously registered onto both AP and lateral DXA image. The shape and volumetric BMD at several regions of the reconstructed vertebrae is then evaluated with respect to the ground truth QCT volumes. For the L2, L3 and L4 vertebrae respectively the shape was reconstructed with a mean (2RMS) point-to-surface distance of 1.00 (2.64). mm, 0.93(2.52). mm and 1.34(3.72). mm and a strong correlation (r>0.82) was found between the trabecular volumetric BMD extracted from the reconstructions and from the same subject QCT scans. These results indicate that the proposed method is able to accurately reconstruct the 3D shape and density volume of the lumbar vertebrae from AP and lateral DXA, which can potentially improve the fracture risk estimation accuracy with respect to the currently used DXA derived areal BMD measurements.
AB - Current vertebral fracture prevention measures use Dual-energy X-ray Absorptiometry (DXA) to quantify the density of the vertebrae and subsequently determine the risk of fracture. This modality however only provides information about the projected Bone Mineral Density (BMD) while the shape and spatial distribution of the bone determines the strength of the vertebrae. Quantitative Computed Tomography (QCT) allows for the measurement of the vertebral dimensions and volumetric densities, which have been shown to be able to determine the fracture risk more reliably than DXA. However, for the high cost and high radiation dose, QCT is not used in clinical routine for fracture risk assessment. In this work, we therefore propose a method to reconstruct the 3D shape and density volume of lumbar vertebrae from an anteroposterior (AP) and lateral DXA image used in clinical routine. The method is evaluated for the L2, L3 and L4 vertebra. Of these vertebrae a statistical model of the vertebral shape and density distribution is first constructed from a large dataset of QCT scans. All three models are then simultaneously registered onto both AP and lateral DXA image. The shape and volumetric BMD at several regions of the reconstructed vertebrae is then evaluated with respect to the ground truth QCT volumes. For the L2, L3 and L4 vertebrae respectively the shape was reconstructed with a mean (2RMS) point-to-surface distance of 1.00 (2.64). mm, 0.93(2.52). mm and 1.34(3.72). mm and a strong correlation (r>0.82) was found between the trabecular volumetric BMD extracted from the reconstructions and from the same subject QCT scans. These results indicate that the proposed method is able to accurately reconstruct the 3D shape and density volume of the lumbar vertebrae from AP and lateral DXA, which can potentially improve the fracture risk estimation accuracy with respect to the currently used DXA derived areal BMD measurements.
KW - 3D reconstruction
KW - lumbar vertebrae
KW - osteoporosis
KW - statistical model
KW - vertebral fracture
UR - https://www.scopus.com/pages/publications/84875818857
U2 - 10.1016/j.media.2013.02.002
DO - 10.1016/j.media.2013.02.002
M3 - Article
C2 - 23466075
AN - SCOPUS:84875818857
SN - 1361-8415
VL - 17
SP - 475
EP - 487
JO - Medical Image Analysis
JF - Medical Image Analysis
IS - 4
ER -