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Personalised 3D Assessment of Trochanteric Soft Tissues Improves HIP Fracture Classification Accuracy
Alessandra Aldieri1,2,3, Mara Terzini1, Alberto L Audenino1
1PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
Annals of Biomedical Engineering
|February 1, 2022
Summary
Personalized, 3D soft tissue thickness (STT) from CT scans improves hip fracture risk classification accuracy more than BMI-based estimates. Orientation-specific measurements offer further benefits for predicting hip fracture risk.
Area of Science:
- Biomechanics
- Medical Imaging
- Orthopedics
Background:
- Passive soft tissues around the hip attenuate fall impact, influencing hip fracture risk.
- Soft Tissue Thickness (STT) is a key factor, previously estimated using Body Mass Index (BMI).
- Prior studies linked BMI-based STT to hip fracture risk and classification accuracy.
Purpose of the Study:
- To investigate if fracture classification accuracy improves using personalized, 3D-specific STT from Computed-Tomography (CT) scans.
- To compare the accuracy of CT-derived STT with BMI-based STT estimates for hip fracture risk.
- To assess the impact of orientation-specificity and personalization on STT measurements.
Main Methods:
- Calculated personalized STT as the shortest distance between segmented femur and soft tissue/air boundary across 33 impact orientations.
- Utilized semi-automatic segmentation of femur and automatic segmentation of soft tissue/air boundary from CT scans.
- Compared fracture classification accuracy (Area Under the Curve - AUC) using personalized 3D STT, BMI-based STT, and variations thereof.
Main Results:
- Personalized 3D STT from CT scans yielded higher fracture classification accuracy (AUC = 0.87) than BMI-based STT (AUC = 0.85).
- Orientation-specific CT-based STT showed improved accuracy (AUC = 0.86) compared to non-specific CT-based STT.
- Suppression of personalization significantly reduced accuracy, indicating its critical role.
Conclusions:
- Using CT scans for personalized STT estimation enhances hip fracture risk classification.
- Orientation-specific personalized STT provides further improvements in fracture classification accuracy.
- Personalized, orientation-specific CT-derived STT is a more accurate predictor of hip fracture risk than traditional BMI-based methods.
