The impact of segmentation approach on HR-pQCT microarchitectural and biomechanical metrics depends on bone structure.

IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Minhao Zhou, Gabriella Ramil, Isabel Yu, Saghi Sadoughi, Isra Saeed, Bo Fan, Andrew J Burghardt, Tiffany Y Kim, Joachim H Ix, Galateia J Kazakia
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引用次数: 0

Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT), combined with micro-finite element (μFE) models, provide a powerful clinical research tool for evaluating bone structure-function relationships with musculoskeletal disorders and bone-targeting treatments. Based on ex vivo cadaveric phantom scans, the Laplace-Hamming (LH) segmentation approach, compared to the standard segmentation approach, improves the accuracy and precision of microarchitecture evaluation using second-generation HR-pQCT scanners. However, the effect of LH segmentation on in vivo scans acquired from clinically relevant cohorts with disease-specific bone microarchitecture (eg, patients with end-stage kidney disease) has not been investigated. Additionally, the effect of LH segmentation on μFE biomechanical estimations remains unexplored, defining the objectives of the current study. Findings from the current study demonstrated that LH segmentation, compared to standard segmentation, reduced structure-dependent bias in HR-pQCT microarchitectural and μFE biomechanical metrics. Specifically, trabecular bone volume fraction (Tb.BV/TV), trabecular thickness (Tb.Th), and cortical pore diameter (Ct.Po.Dm) were particularly sensitive to segmentation strategy. Due to the structure dependence of the standard segmentation approach, applying LH segmentation can alter the results of between-cohort comparisons, potentially leading to different clinical interpretations. For example, differences in cortical porosity (Ct.Po) between healthy participants and patients with end-stage kidney disease were only significant when evaluated using the standard segmentation approach. Thus, it is important that investigators consider the segmentation approach utilized when interpreting HR-pQCT outcome metrics for disease progression or drug effects assessments. Additionally, a structure-based parameter (Tb.Th$\times$Ct.Po.Dm) that robustly predicted the effect of LH segmentation on μFE biomechanical estimations was established. The predictive power of this parameter highlights the importance of incorporating LH segmentation when evaluating cohorts with documented disease-specific alterations in bone microstructure (eg, changes in Tb.Th and Ct.Po.Dm), such as patients with type 2 diabetes.

分割方法对HR-pQCT微结构结果指标和微有限元生物力学估计的影响取决于骨微结构。
高分辨率外周定量计算机断层扫描(HR-pQCT)与微有限元(μFE)模型相结合,为评估骨骼结构-功能与肌肉骨骼疾病的关系和骨靶向治疗提供了强大的临床研究工具。基于离体尸体幻影扫描,与标准分割方法相比,Laplace-Hamming (LH)分割方法提高了第二代HR-pQCT扫描仪微架构评估的准确性和精密度。然而,尚未研究LH分割对具有疾病特异性骨微结构的临床相关队列(例如终末期肾病患者)获得的体内扫描的影响。此外,LH分割对μFE生物力学估计的影响仍未被探索,这确定了当前研究的目标。目前的研究结果表明,与标准分割相比,LH分割减少了HR-pQCT微结构和μFE生物力学结果指标的结构依赖偏差。其中,骨小梁体积分数(Tb.BV/TV)、骨小梁厚度(Tb.Th)和皮质孔径(Ct.Po.Dm)对分割策略尤为敏感。由于标准分割方法的结构依赖性,应用LH分割可能会改变队列间比较的结果,可能导致不同的临床解释。例如,健康参与者和终末期肾病患者之间皮质孔隙度(Ct.Po)的差异只有在使用标准分割方法进行评估时才显着。因此,研究人员在解释HR-pQCT结果指标用于疾病进展或药物效应评估时,考虑使用分割方法是很重要的。此外,建立了一个基于结构的参数(Tb.Th$\times$Ct.Po.Dm),该参数稳健地预测了LH分割对μFE生物力学估计的影响。该参数的预测能力强调了在评估具有记录的骨微观结构疾病特异性改变(例如Tb的变化)的队列时纳入LH分割的重要性。Th和Ct.Po.Dm),如2型糖尿病患者。
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来源期刊
Journal of Bone and Mineral Research
Journal of Bone and Mineral Research 医学-内分泌学与代谢
CiteScore
11.30
自引率
6.50%
发文量
257
审稿时长
2 months
期刊介绍: The Journal of Bone and Mineral Research (JBMR) publishes highly impactful original manuscripts, reviews, and special articles on basic, translational and clinical investigations relevant to the musculoskeletal system and mineral metabolism. Specifically, the journal is interested in original research on the biology and physiology of skeletal tissues, interdisciplinary research spanning the musculoskeletal and other systems, including but not limited to immunology, hematology, energy metabolism, cancer biology, and neurology, and systems biology topics using large scale “-omics” approaches. The journal welcomes clinical research on the pathophysiology, treatment and prevention of osteoporosis and fractures, as well as sarcopenia, disorders of bone and mineral metabolism, and rare or genetically determined bone diseases.
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