AbstractFracture liaison services are essential to mitigate underdiagnosis and undertreatment of osteoporosis-related fractures. However, it often suffers from limited access to dual-energy X-ray absorptiometry (DXA) or high-resolution peripheral quantitative CT equipment. This in vivo study of 21 patients aims to evaluate the feasibility of dental cone beam CT (dCBCT) to analyse bone properties of human wrists, comparing with DXA and finite element (FE) analysis.

摘要骨折联络服务对于缓解骨质疏松症相关骨折的诊断不足和治疗不足至关重要。然而，它经常受到双能X射线吸收仪（DXA）或高分辨率外围定量CT设备的限制。这项针对21名患者的体内研究旨在评估牙科锥形束CT（dCBCT）分析人类手腕骨特性的可行性，并与DXA和有限元（FE）分析进行比较。

dCBCT grey-scale values were transformed to HU using a phantom containing materials with known HU values. Strong correlations were found between bone mineral content (BMC) from dCBCT and DXA (r = 0.78 to 0.84, p < 0.001), as well as between BMC from dCBCT FE-predicted stiffness (r = 0.91) and maximum force (r = 0.93), p < 0.001.

使用包含具有已知HU值的材料的幻影将dCBCT灰度值转换为HU。dCBCT和DXA的骨矿物质含量（BMC）之间存在很强的相关性（r=0.78至0.84，p < 0.001), 以及来自dCBCT FE的BMC预测刚度（r=0.91）和最大力（r=0.93），p<0.001。

BMC values from dCBCT were higher than DXA measurements (2.34 g vs. 1.5 g, p < 0.001). Cortical thickness strongly correlated to bone mineral density (BMD) from dCBCT (r = 0.83, p < 0.001). No statistically significant correlations were found between trabecular bone microstructure and FE predictions.

dCBCT的BMC值高于DXA测量值（2.34 g对1.5 g，p<0.001）。皮质厚度与dCBCT的骨矿物质密度（BMD）密切相关（r = 0.83, p<0.001）。在小梁骨微观结构和FE预测之间没有发现统计学上显着的相关性。

The results indicate the feasibility to analyse osteoporosis related bone properties of human wrists from corrected dCBCT data. The dCBCT values of BMD and BMC were strongly correlated with DXA..

结果表明，从校正的dCBCT数据分析人类手腕骨质疏松症相关骨特性的可行性。。。

IntroductionOsteoporosis-related fractures, of e.g., the wrist, hip and vertebrae are common and recurrent and often interfere with the ability to perform daily activities1,2. These fractures result in high healthcare costs and great suffering for the affected individuals3. North European countries like Sweden and Denmark have an incidence of > 500 hip fractures per 100,000 individuals annually, affecting every second woman and every fourth man after the age of 504.

引言骨质疏松症相关的骨折，例如手腕，髋部和椎骨，是常见的和复发性的，并且经常干扰日常活动的能力1,2。这些骨折导致高昂的医疗费用和受影响个体的巨大痛苦3。北欧国家（如瑞典和丹麦）每年每10万人中髋部骨折的发生率>500，这影响了504岁以后的每一位女性和每四位男性。

The condition is extensively undertreated5. An important step to improve the underdiagnosis and undertreatment after an osteoporosis-related fracture is by implementing fracture liaison services (FLS) to secure a coordinated handling, including diagnostic assessment and treatment6. The FLS is normally coordinator-based and aims to identify and correctly investigate and treat all women and men over the age of 50 suffering an osteoporosis-related fracture6.Today’s reference method for evaluating osteoporosis is dual-energy X-ray absorptiometry (DXA).

这种情况普遍未得到治疗5。改善骨质疏松症相关骨折后诊断不足和治疗不足的一个重要步骤是实施骨折联络服务（FLS），以确保协调处理，包括诊断评估和治疗6。FLS通常以协调员为基础，旨在识别并正确调查和治疗所有50岁以上患有骨质疏松症相关骨折的女性和男性6。今天评估骨质疏松症的参考方法是双能X射线吸收仪（DXA）。

This method was introduced over three decades ago7 and is widely used today8. DXA can measure areal bone mineral density (aBMD) in the central and peripheral skeleton. Another established method for osteoporosis detection is high-resolution peripheral quantitative computed tomography (HR-pQCT), which can analyse volume BMD (vBMD) and the cortical and trabecular bone structure in the wrist and ankle9,10.

这种方法是三十多年前引入的7，今天被广泛使用8。DXA可以测量中央和周围骨骼的面积骨矿物质密度（aBMD）。另一种已建立的骨质疏松症检测方法是高分辨率外周定量计算机断层扫描（HR-pQCT），它可以分析体积BMD（vBMD）以及手腕和脚踝的皮质和小梁骨结构9,10。

A drawback is that examinations with both these methods often require an extra visit and risk delayed diagnosis. Another drawback with HR-pQCT is the limited number of these devices available worldwide.Dental cone beam CT (dCBCT) is a diagnostic high-resolution 3D-CT device for imaging the maxillo-facial region at isotropic voxels11.

缺点是，使用这两种方法进行检查通常需要额外的就诊和风险延迟诊断。HR pQCT的另一个缺点是全球可用的这些设备数量有限。牙科锥形束CT（dCBCT）是一种诊断性高分辨率3D-CT设备，用于在各向同性体素上成像上颌骨区域11。

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经过一些调整，这些de。

Data availability

数据可用性

Pseudonymised data may be made availible upon reasonable request made to the corresponding author.

在向通讯作者提出合理要求后，可以使用假名数据。

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Guha, I. et al. Computed tomography-based stiffness measures of trabecular bone microstructure: cadaveric validation and in vivo application. https://doi.org/10.1002/jbm4.10627 (2022).Download referencesAcknowledgementsALF Grants, Region Östergötland. RÖ-965636.FundingOpen access funding provided by Linköping University.Author informationAuthors and AffiliationsDepartment of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, SwedenBenjamin KlintströmDivision of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenAnna SpångeusDepartment of Acute Internal Medicine and Geriatrics, Linköping University Hospital, Linköping, SwedenAnna SpångeusCenter for Medical Image Science and Visualization, CMIV, Linköping, SwedenAnna Spångeus, Mischa Woisetschläger & Eva KlintströmDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenAlexandr MalusekInstitute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7, Vienna, 1060, AustriaAlexander Synek & Dieter PahrDepartment of Radiology in Linköping and Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, SwedenMischa Woisetschläger & Eva KlintströmAuthorsBenjamin KlintströmView author publicationsYou can also search for this author in.

Guha，I.等人。基于计算机断层扫描的骨小梁微观结构刚度测量：尸体验证和体内应用。https://doi.org/10.1002/jbm4.10627（2022年）。下载referencesAcknowledgementsALF Grants，RegionÖstergötland。RÖ-965636.FundingOpen access由林克平大学提供资金。作者信息作者和附属机构KTH皇家理工学院生物医学工程与健康系统系，瑞典哈丁格Benjamin KlintströmDivision of Diagnostics and Specialist Medicine，林克平大学健康、医学与护理科学系，林克平，斯维登纳Spångeus，林克平大学医院急性内科和老年医学系，林克平，斯维登纳Spångeus医学图像科学与可视化中心，CMIV，林克平，斯维登纳Spångeus，Mischa Woisetschläger＆Eva Klingus林克平大学健康、医学和护理科学系，林克平，瑞典亚历山大·马卢塞金轻量级设计和结构生物力学研究所，TU Wien，Gumpendorfer Straße 7，维也纳，1060，澳大利亚亚历山大·西内克和迪特·帕尔德，林克平放射学系，林克平大学诊断和专科医学系，健康、医学和护理科学系，林克平，SwedenMischa Woisetschläger＆Eva KlintströmAuthorsBenjamin KlintströmView作者出版物您也可以在中搜索这位作者。

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PubMed Google ScholarContributionsBK, ASp, MW and EK conceptualized and designed the study.BK and ASy performed the primary data analysis.BK and EK wrote the first draft. All authors have substantially contributed to the manuscript, reviewed and approved the submitted version.Corresponding authorsCorrespondence to.

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Reprints and permissionsAbout this articleCite this articleKlintström, B., Spångeus, A., Malusek, A. et al. Automated bone property analysis using corrected in vivo dental cone-beam CT data of human wrists.

转载和许可本文引用本文Klintström，B.，Spångeus，A.，Malusek，A。等人。使用校正的人体手腕体内牙齿锥形束CT数据进行自动骨特性分析。

Sci Rep 14, 30466 (2024). https://doi.org/10.1038/s41598-024-75222-6Download citationReceived: 30 June 2024Accepted: 03 October 2024Published: 16 December 2024DOI: https://doi.org/10.1038/s41598-024-75222-6Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsCBCTDXABone structureSegmentationStructure analysis

关键词SCBCTDXABone结构分段结构分析