Objective

Bone strength depends on both mineral content and bone structure. The aim of this in vitro study was to develop a method of quantitatively assessing trabecular bone structure by applying three-dimensional image processing to data acquired with multi-slice and cone-beam computed tomography using micro-computed tomography as a reference.

Materials and Methods

Fifteen bone samples from the radius were examined. After segmentation, quantitative measures of bone volume, trabecular thickness, trabecular separation, trabecular number, trabecular nodes, and trabecular termini were obtained.

Results

The clinical machines overestimated bone volume and trabecular thickness and underestimated trabecular nodes and number, but cone-beam CT to a lesser extent. Parameters obtained from cone beam CT were strongly correlated with μCT, with correlation coefficients between 0.93 and 0.98 for all parameters except trabecular termini.

Conclusions

The high correlation between cone-beam CT and micro-CT suggest the possibility of quantifying and monitoring changes of trabecular bone microarchitecture in vivo using cone beam CT.

Objectives: The aim of this study was to evaluate how imaging parameters at clinical dental CBCT affect the accuracy in quantifying trabecular bone structures, contrast-to-noise ratio (CNR) and radiation dose.

Methods: 15 radius samples were examined using CBCT (Accuitomo FPD; J. Morita Mfg., Kyoto, Japan). Nine imaging protocols were used, differing in current, voltage, rotation degree, voxel size, imaging area and rotation time. Radiation doses were measured using a KAP-meter. After segmentation, six bone structure parameters and CNR were quantified. Micro-CT images with an isotropic resolution of 20 microns were used as a gold standard.

Results: Structure parameters obtained by CBCT were strongly correlated to those by micro CT, with correlation coefficients .0.90 for all studied parameters. Bone volume and trabecular thickness were not affected by changes in imaging parameters. Increased tube current from 5 to 8 mA, decreased isotropic voxel size from 125 to 80 microns and decreased rotation anglefrom 360° to 180° affected correlations for trabecular termini negatively. Decreasing rotation degree also weakened correlations for trabecular separation and trabecular number at 80 microns voxel size. Changes in the rotation degree and tube current affected CNR significantly. The radiation dose varied between 269 and 1284 mGy cm2.

Conclusions: Trabecular bone structure can be accurately quantified by clinical dental CBCT in vitro, and the obtained structure parameters are strongly related to those obtained by micro CT. A fair CNR and strong correlations can be obtained with a low radiation dose, indicating the possibility for monitoring trabecular bone structure also in vivo.

Stiffness and shear moduli of human trabecular bone may be analyzed in vivo by finite element (FE) analysis from image data obtained by clinical imaging equipment such as high resolution peripheral quantitative computed tomography (HR-pQCT). In clinical practice today, this is done in the peripheral skeleton like the wrist and heel. In this cadaveric bone study, fourteen bone specimens from the wrist were imaged by two dental cone beam computed tomography (CBCT) devices and one HR-pQCT device as well as by dual energy X-ray absorptiometry (DXA). Histomorphometric measurements from micro-CT data were used as gold standard. The image processing was done with an in-house developed code based on the automated region growing (ARG) algorithm. Evaluation of how well stiffness (Young’s modulus E3) and minimum shear modulus from the 12, 13, or 23 could be predicted from the CBCT and HR-pQCT imaging data was studied and compared to FE analysis from the micro-CT imaging data. Strong correlations were found between the clinical machines and micro-CT regarding trabecular bone structure parameters, such as bone volume over total volume, trabecular thickness, trabecular number and trabecular nodes (varying from 0.79 to 0.96). The two CBCT devices as well as the HR-pQCT showed the ability to predict stiffness and shear, with adjusted R2 -values between 0.78 and 0.92, based on data derived through our in-house developed code based on the ARG algorithm. These findings indicate that clinically used CBCT may be a feasible method for clinical studies of bone structure and mechanical properties in future osteoporosis research.