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Purpose <p>This study investigated the association of measurements from a clinical X-ray dark-field prototype system and CT-based finite element analysis (FEA) in lumbar spine specimens.</p> Materials and Methods <p>In this prospective study, human cadaveric spine specimens (L2 to L4) were examined using a clinical prototype for dark-field radiography, yielding both attenuation and dark-field images. Specimens were scanned in vertical and horizontal positions. Volumetric bone mineral density (BMD) values were derived from quantitative CT measurements. Bone segmentation masks derived from CT-images were used for FEA-estimated fracture load (FL) calculations. FEA-estimated FL, dark-field, and attenuation signals were compared between osteoporotic/osteopenic (BMD &lt; 120&#xa0;mg/cm<sup>3</sup>) and non-osteoporotic/osteopenic specimens using the paired t-test and the Wilcoxon Mann–Whitney U test. Associations were tested using Spearman correlation.</p> Results <p>Fifty-nine vertebrae from 20 lumbar spine specimens (mean age, 73&#xa0;years ± 13; 11 women) were studied. FEA-estimated FL correlated with BMD (r = 0.75, <i>p</i> &lt; .001) and was significantly lower in osteoporotic/osteopenic vertebrae (1222 ± 566 vs. 2880 ± 1182, <i>p</i> &lt; .001). Dark-field and attenuation signals were positively correlated with FEA-estimated&#xa0;FL, in both vertical (r<sub>darkfield</sub> = 0.64, <i>p</i> &lt; .001, r<sub>attenuation</sub> = 0.82, <i>p&#xa0;</i> &lt; .001) and horizontal position (r<sub>darkfield</sub> = 0.55, <i>p</i> &lt; .001, r<sub>attenuation</sub> = 0.81, <i>p</i> &lt; .001).</p> Conclusion <p>Dark-field and attenuation signals assessed using a clinical X-ray dark-field system significantly correlated with FEA-estimated FL in human spine specimens with and without osteoporosis/osteopenia. Dark-Field imaging may complement existing assessment methods&#xa0;for bone strength as a dose-efficient, accessible tool.</p>

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Finite element fracture load analysis and dark-field X-ray imaging of osteoporotic and healthy vertebrae in human lumbar spine specimens

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月3日

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  • N. Hesse,
  • D. Strack,
  • J. F. Rischewski,
  • F. T. Gassert,
  • A. Kufner,
  • T. Urban,
  • M. E. Lochschmidt,
  • B. J. Schwaiger,
  • C. Braun,
  • D. P. Mueller,
  • D. Pfeiffer,
  • T. Baum,
  • K. Subburaj,
  • F. Pfeiffer,
  • A. S. Gersing

摘要

Purpose

This study investigated the association of measurements from a clinical X-ray dark-field prototype system and CT-based finite element analysis (FEA) in lumbar spine specimens.

Materials and Methods

In this prospective study, human cadaveric spine specimens (L2 to L4) were examined using a clinical prototype for dark-field radiography, yielding both attenuation and dark-field images. Specimens were scanned in vertical and horizontal positions. Volumetric bone mineral density (BMD) values were derived from quantitative CT measurements. Bone segmentation masks derived from CT-images were used for FEA-estimated fracture load (FL) calculations. FEA-estimated FL, dark-field, and attenuation signals were compared between osteoporotic/osteopenic (BMD < 120 mg/cm3) and non-osteoporotic/osteopenic specimens using the paired t-test and the Wilcoxon Mann–Whitney U test. Associations were tested using Spearman correlation.

Results

Fifty-nine vertebrae from 20 lumbar spine specimens (mean age, 73 years ± 13; 11 women) were studied. FEA-estimated FL correlated with BMD (r = 0.75, p < .001) and was significantly lower in osteoporotic/osteopenic vertebrae (1222 ± 566 vs. 2880 ± 1182, p < .001). Dark-field and attenuation signals were positively correlated with FEA-estimated FL, in both vertical (rdarkfield = 0.64, p < .001, rattenuation = 0.82, p  < .001) and horizontal position (rdarkfield = 0.55, p < .001, rattenuation = 0.81, p < .001).

Conclusion

Dark-field and attenuation signals assessed using a clinical X-ray dark-field system significantly correlated with FEA-estimated FL in human spine specimens with and without osteoporosis/osteopenia. Dark-Field imaging may complement existing assessment methods for bone strength as a dose-efficient, accessible tool.