Hip Fracture Discrimination Based on Statistical Multi-parametric Modeling (SMPM)
| Autor: | Thomas Lang, Julio Carballido-Gamio, Ling Wang, Andrew J. Burghardt, Aihong Yu, Xiaoguang Cheng, Yongbin Su |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Bone density
Th) Medical and Health Sciences Engineering Absorptiometry Photon Lasso (statistics) Models Bone Density 80 and over Quantitative computed tomography Tomography Cortical bone thickness (Ct Mathematics Aged 80 and over Orthodontics Bone mineral Hip fracture medicine.diagnostic_test Femur Neck Statistical Middle Aged Photon X-Ray Computed medicine.anatomical_structure Area Under Curve Female musculoskeletal diseases Biomedical Engineering Cortical bone thickness Article Statistical multi-parametric modeling Bone mineral density Cortical Bone medicine Humans Absorptiometry Aged Hip Models Statistical Receiver operating characteristic Hip Fractures medicine.disease Fracture ROC Curve Case-Control Studies Fracture (geology) Cortical bone Tomography X-Ray Computed |
| Zdroj: | Ann Biomed Eng Annals of biomedical engineering, vol 47, iss 11 |
| ISSN: | 1573-9686 0090-6964 |
| Popis: | Studies using quantitative computed tomography (QCT) and data-driven image analysis techniques have shown that trabecular and cortical volumetric bone mineral density (vBMD) can improve the hip fracture prediction of dual-energy X-ray absorptiometry areal BMD (aBMD). Here, we hypothesize that (1) QCT imaging features of shape, density and structure derived from data-driven image analysis techniques can improve the hip fracture discrimination of classification models based on mean femoral neck aBMD (Neck.aBMD), and (2) that data-driven cortical bone thickness (Ct.Th) features can improve the hip fracture discrimination of vBMD models. We tested our hypotheses using statistical multi-parametric modeling (SMPM) in a QCT study of acute hip fracture of 50 controls and 93 fragility fracture cases. SMPM was used to extract features of shape, vBMD, Ct.Th, cortical vBMD, and vBMD in a layer adjacent to the endosteal surface to develop hip fracture classification models with machine learning logistic LASSO. The performance of these classification models was evaluated in two aspects: (1) their hip fracture classification capability without Neck.aBMD, and (2) their capability to improve the hip fracture classification of the Neck.aBMD model. Assessments were done with 10-fold cross-validation, areas under the receiver operating characteristic curve (AUCs), differences of AUCs, and the integrated discrimination improvement (IDI) index. All LASSO models including SMPM-vBMD features, and the majority of models including SMPM-Ct.Th features performed significantly better than the Neck.aBMD model; and all SMPM features significantly improved the hip fracture discrimination of the Neck.aBMD model (Hypothesis 1). An interesting finding was that SMPM-features of vBMD also captured Ct.Th patterns, potentially explaining the superior classification performance of models based on SMPM-vBMD features (Hypothesis 2). Age, height and weight had a small impact on model performances, and the model of shape, vBMD and Ct.Th consistently yielded better performances than the Neck.aBMD models. Results of this study clearly support the relevance of bone density and quality on the assessment of hip fracture, and demonstrate their potential on patient and healthcare cost benefits. |
| Databáze: | OpenAIRE |
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