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Finite Element Assessment of Bone Fragility from Clinical Images

  • Imaging (H Isaksson and S Boyd, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We re-evaluated clinical applications of image-to-FE models to understand if clinical advantages are already evident, which proposals are promising, and which questions are still open.

Recent Findings

CT-to-FE is useful in longitudinal treatment evaluation and groups discrimination. In metastatic lesions, CT-to-FE strength alone accurately predicts impending femoral fractures. In osteoporosis, strength from CT-to-FE or DXA-to-FE predicts incident fractures similarly to DXA-aBMD. Coupling loads and strength (possibly in dynamic models) may improve prediction. One promising MRI-to-FE workflow may now be tested on clinical data. Evidence of artificial intelligence usefulness is appearing.

Summary

CT-to-FE is already clinical in opportunistic CT screening for osteoporosis, and risk of metastasis-related impending fractures. Short-term keys to improve image-to-FE in osteoporosis may be coupling FE with fall risk estimates, pool FE results with other parameters through robust artificial intelligence approaches, and increase reproducibility and cross-validation of models. Modeling bone modifications over time and bone fracture mechanics are still open issues.

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Acknowledgements

This work was partially supported by the Italian Ministry of Health (qSINS project, grant number: RF-2016-02364359).

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  1. Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Enrico Schileo & Fulvia Taddei

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  1. Enrico Schileo
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  2. Fulvia Taddei
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Correspondence to Enrico Schileo.

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Schileo, E., Taddei, F. Finite Element Assessment of Bone Fragility from Clinical Images. Curr Osteoporos Rep 19, 688–698 (2021). https://doi.org/10.1007/s11914-021-00714-7

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