Hip fracture discrimination using 3D reconstructions from Dual-energy X-ray Absorptiometry

Due to the aging of our society, osteoporosis and the subsequent fractures is becoming an increasingly important problem. Currently, Dual-energy X-ray Absortiometry (DXA) derived areal Bone Mineral Density (BMD) is the gold standard for diagnosing osteoporosis, but is limited to a two-dimensional analysis. In this work, we propose a method to discriminate between healthy and fracture patients from DXA images by incorporating a 3D reconstruction method. A statistical model of the 3D shape and BMD distribution was registered onto the DXA scans of fracture and non-fracture patients. The resulting values for the scale and the first model parameter, together with the femoral neck areal BMD, was processed by Linear Discriminant Analysis and the discriminating accuracy was evaluated by generating the Receiver Operating Characteristic curve. The Area Under the Curve using the proposed method was approximately 0.080 and 0.063 higher than using only areal BMD, indicating an improved power of discrimination.