In vivo assessment of trabecular bone microarchitecture could improve the prediction of fracture risk and the efficacy of osteoporosis treatment and prevention. Geodesic topological analysis (GTA) is introduced as a novel technique to quantify the trabecular bone microarchitecture from high-spatial resolution magnetic resonance (MR) images. Trabecular bone parameters that quantify the scale, topology, and anisotropy of the trabecular bone network in terms of its junctions are the result of GTA. The reproducibility of GTA was tested with in vivo images of human distal tibiae and radii (n = 6) at 1.5 Tesla; and its ability to discriminate between subjects with and without vertebral fracture was assessed with ex vivo images of human calcanei at 1.5 and 3.0 Tesla (n = 30). GTA parameters yielded an average reproducibility of 4.8%, and their individual areas under the curve (AUC) of the receiver operating characteristic curve analysis for fracture discrimination performed better at 3.0 than at 1.5 Tesla reaching values of up to 0.78 (p < 0.001). Logistic regression analysis demonstrated that fracture discrimination was improved by combining GTA parameters, and that GTA combined with bone mineral density (BMD) allow for better discrimination than BMD alone (AUC = 0.95; p < 0.001). Results indicate that GTA can substantially contribute in studies of osteoporosis involving imaging of the trabecular bone microarchitecture.
Copyright 2009 Wiley-Liss, Inc.