Adaptive local thresholding can enhance the accuracy of HR-pQCT-based trabecular bone morphology assessment

Mys, Karen; Stockmans, Filip; Gueorguiev, Boyko; Wyers, Caroline E.; van den Bergh, Joop P.W.; van Lenthe, G. Harry; Varga, Peter

Affiliations

¹Biomechanics Section, Mechanical Engineering, KU Leuven, Leuven, Belgium

²AO Research Institute Davos, Davos, Switzerland

³Muscles & Movement, Department of Development and Regeneration, KU Leuven Campus Kulak, Kortrijk, Belgium

⁴Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands

⁵NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands

⁶Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, the Netherlands

Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT) devices can scan extremities at bone microstructural level in vivo and are used mainly in research of bone diseases. Two HR-pQCT scanners are commercially available to date: XtremeCT (first generation) and XtremeCT-II (second generation) from Scanco Medical AG (Switzerland). Recently, we have proposed an adaptive local thresholding (AT) technique and showed that it can improve quantification accuracy of bone microstructural parameters, with visually less sharp cone-beam CT (CBCT) images providing a similar accuracy than XtremeCT. The aim of this study was to evaluate whether the AT segmentation technique could enhance the accuracy of HR-pQCT in quantifying bone microstructural images and to assess whether the agreement between XtremeCT and XtremeCT-II could be improved.

Nineteen radii were scanned with three scanners from Scanco Medical AG: (1) XtremeCT at 82 μm, (2) XtremeCT-II at 60.7 μm and (3) the small animal microCT scanner VivaCT40 at 19 μm voxel size. The scans were segmented applying two different methods, once following the manufacturer standard technique (ST), and once by means of AT. Three-dimensional (3D) morphological analysis was performed on the trabecular volume of the segmented images using the manufacturer's standard software to calculate bone volume fraction (BV/TV), trabecular thickness (Tb.Th), separation (Tb.Sp) and number (Tb.N).

The average accuracy of XtremeCT improved from R2 = 0.76 (ST) to 0.85 (AT) and reached the same level of accuracy as XtremeCT-II with ST (R2 = 0.86). The largest improvements were obtained for BV/TV and Tb.Th. For XtremeCT-II, mean accuracy improved slightly from R2 = 0.86 (ST) to 0.89 (AT). For both segmentations and both scanners, the standard section was quantified slightly more accurate than the subchondral section. The agreement between the scanners was enhanced from R2 = 0.89 (ST) to 0.98 (AT).

In conclusion, AT can enhance the accuracy of XtremeCT to quantify distal radius bone microstructural parameters close to XtremeCT-II level and increases the agreement between the two HR-pQCT scanners.

High-resolution peripheral quantitative computed tomography, segmentation, bone microstructural parameters.

Links

DOI: 10.1016/j.bone.2021.116225

PubMed: 34634527

WoS: 000717964700003

History

Received: 2021-05-23

Revised: 2021-09-28

Accepted: 2021-09-28

Online: 2021-10-9

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Cited By (1)

Year	Entry
2023	Sadoughi S, Subramanian A, Ramil G, Burghardt AJ, Kazakia GJ. A Laplace–Hamming binarization approach for second-generation HR-pQCT rescues fine feature segmentation. J Bone Miner Res. July 2023;38(7):1006-1014.