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MDCT-based Finite Element Analysis of Vertebral Fracture Risk: What Dose is Needed?

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Abstract

Purpose

The aim of this study was to compare vertebral failure loads, predicted from finite element (FE) analysis of patients with and without osteoporotic vertebral fractures (OVF) at virtually reduced dose levels, compared to standard-dose exposure from multidetector computed tomography (MDCT) imaging and evaluate whether ultra-low dose derived FE analysis can still differentiate patient groups.

Materials and Methods

An institutional review board (IRB) approval was obtained for this retrospective study. A total of 16 patients were evaluated at standard-dose MDCT; eight with and eight without OVF. Images were reconstructed at virtually reduced dose levels (i. e. half, quarter and tenth of the standard dose). Failure load was determined at L1–3 from FE analysis and compared between standard, half, quarter, and tenth doses and used to differentiate between fracture and control groups.

Results

Failure load derived at standard dose (3254 ± 909 N and 3794 ± 984 N) did not significantly differ from half (3390 ± 890 N and 3860 ± 1063 N) and quarter dose (3375 ± 915 N and 3925 ± 990 N) but was significantly higher for one tenth dose (4513 ± 1762 N and 4766 ± 1628 N) for fracture and control groups, respectively. Failure load differed significantly between the two groups at standard, half and quarter doses, but not at tenth dose. Receiver operating characteristic (ROC) curve analysis also demonstrated that standard, half, and quarter doses can significantly differentiate the fracture from the control group.

Conclusion

The use of MDCT enables a dose reduction of at least 75% compared to standard-dose for an adequate prediction of vertebral failure load based on non-invasive FE analysis.

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Funding

This study received funding by the Deutsche Forschungsgemeinschaft (DFG) BA 4906/2-1 (TB), and TUM Faculty of Medicine KKF grant H01 (TB).

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Authors and Affiliations

  1. Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), 8 Somapah Road, 487372, Singapore, Singapore

    D. Anitha & Karupppasamy Subburaj

  2. Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

    Kai Mei, Michael Dieckmeyer, Felix K. Kopp & Peter B. Noel

  3. Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

    Nico Sollmann, Claus Zimmer, Jan S. Kirschke & Thomas Baum

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  1. D. Anitha
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  2. Kai Mei
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  3. Michael Dieckmeyer
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  4. Felix K. Kopp
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  7. Jan S. Kirschke
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  8. Peter B. Noel
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  9. Thomas Baum
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  10. Karupppasamy Subburaj
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Correspondence to Karupppasamy Subburaj.

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Conflict of interest

D. Anitha, K. Mei, M. Dieckmeyer, F.K. Kopp, N. Sollmann, C. Zimmer, J.S. Kirschke, P.B. Noel, T. Baum and K. Subburaj declare that they have no competing interests.

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Anitha, D., Mei, K., Dieckmeyer, M. et al. MDCT-based Finite Element Analysis of Vertebral Fracture Risk: What Dose is Needed?. Clin Neuroradiol 29, 645–651 (2019). https://doi.org/10.1007/s00062-018-0722-0

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  • DOI: https://doi.org/10.1007/s00062-018-0722-0

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