Semi-automatic proximal humeral trabecular bone density assessment tool: technique application and clinical...

Area of Science:

• Radiology
• Orthopedics
• Bone Densitometry

Background:

• Proximal humerus fractures are common, increasing with age.
• Accurate bone density assessment is crucial for osteoporosis diagnosis and fracture risk prediction.
• Existing methods for proximal humerus bone density measurement can be limited.

Purpose of the Study:

• To apply a novel semi-automatic phantom-less quantitative CT (PL-QCT) for proximal humerus trabecular bone density measurement.
• To verify the accuracy and precision of this PL-QCT method using chest CT data.
• To establish PL-QCT as a reliable tool for shoulder bone quality assessment.

Main Methods:

• Utilized subcutaneous shoulder fat and trapezius muscle as calibration references for PL-QCT bone mineral density (BMD) measurements.
• Employed a self-developed convolution map-based algorithm for semi-automatic BMD assessment.
• Compared PL-QCT measurements with phantom-based quantitative CT (PB-QCT) in 376 proximal humerus specimens.
• Assessed repeatability and reproducibility using 100 proximal humerus samples for both methods.

Main Results:

• PL-QCT demonstrated good agreement with PB-QCT, with an average bias of 1.0 mg/cc (P > 0.05).
• A strong correlation was observed between PL-QCT and PB-QCT (R-square = 0.9723).
• PB-QCT showed slightly superior short-term repeatability and reproducibility (CV: 5.10% and 3.41%) compared to PL-QCT (CV: 6.17% and 5.64%).

Conclusions:

• The semi-automatic PL-QCT system, applied to chest CT, is a novel and effective method for evaluating proximal humerus bone quality.
• PL-QCT offers acceptable accuracy and precision, proving to be a reliable tool for shoulder BMD assessment.
• This validated PL-QCT system can aid in diagnosing proximal humeral osteoporosis and guiding individualized treatment strategies.