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Related Concept Videos

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Related Experiment Video

Updated: Jan 9, 2026

Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population
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Assessment of Local Pelvic Bone Volumetric Density and Cortical Thickness Using Multi-Energy Bi-Planar Radiography.

Ningxin Qiao1,2, Isabelle Villemure1,2, Carolina Solorzano Barrera3

  • 1Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Canada.

Journal of Musculoskeletal & Neuronal Interactions
|December 1, 2025
PubMed
Summary

This study introduces a novel method using bi-planar multi-energy X-ray (BMEX) to accurately measure pelvic bone density and cortical thickness for S2 alar-iliac (S2AI) screw placement, improving implant planning.

Keywords:
Adult Spine DeformityBi-planar Multi-energy X-rayRandom Forest RegressorVolumetric Bone Density

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Area of Science:

  • Medical Imaging
  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Accurate assessment of bone quality is crucial for successful orthopedic implant placement.
  • The S2 alar-iliac (S2AI) screw trajectory requires precise evaluation of pelvic bone density and cortical thickness.
  • Existing imaging methods may have limitations in comprehensively assessing bone quality for S2AI screw fixation.

Purpose of the Study:

  • To develop and validate a method for determining volumetric bone density and cortical bone thickness.
  • To assess the S2 alar-iliac (S2AI) screw trajectory using bi-planar multi-energy X-ray (BMEX).
  • To enhance bone quality prediction for improved implant placement planning.

Main Methods:

  • Simulated bi-planar multi-energy X-rays (BMEX) were generated from CT data of eight patients.
  • A random forest regressor model was trained using pixel attenuation values and coordinates to predict voxel attenuation (Hounsfield Units, HU).
  • Coordinate matching linked pixel data to corresponding voxel density values for model training.

Main Results:

  • The model achieved adequate trabecular bone density prediction with a root mean square error of 32.8 mg/cm³.
  • Cortical thickness accuracy was within an error of ≤1.2 mm.
  • Minor overestimation of trabecular bone density (max 83 HU) and underestimation of cortical bone thickness (max 118 HU) were observed.

Conclusions:

  • The developed BMEX-based method shows significant advancement in predicting bone quality.
  • The capability to estimate both bone density and cortical thickness improves pre-operative planning for S2AI screw placement.
  • This approach offers a more comprehensive modality for assessing bone quality relevant to implant surgery.