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Faculty of Engineering
King Mongkut's University of Technology Thonburi, Prachautid Road, Bangkok, Thailand
Tel: +66-2-470-9064, Fax: +66-2-470-9070
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Abstract - BMD (Bone Mineral Density) is an indicator of fractures is reduced. Several such methods exist, some of them
osteoporosis that is serious disease, particularly for elderly. To being based on of absorption of X-rays. Noninvasive
calculate BMD, we need to measure volume by noninvasive way. assessment of bone structure in patients with osteoporosis
This paper proposes noninvasive bone volume measurement typically use bone mineral density (BMD). Bone mineral
method. A novel method is presented for a volumetric of femur
bone which uses a computer-based procedure to estimate density (BMD) supplemented by femoral geometry has been
volumetric from a single x-ray image. We use an active contour shown to be more predictive of breaking strength than BMD
model (ACM) for 2D segmentation. Volumetric technique that the alone [2].Bone mineral density (BMD) measured by dual
thickness of femur region mapping to a pixels are determined energy X-ray absorptiometry (DXA) is a primary predictor of
using a physical model of image acquisition and knowledge base of osteoporosis fracture. Nowadays BMD can be measured by the
the doctor. From above, we can construct a femur bone of each areal and volume density. Areal bone mineral density (aBMD)
pixel. Therefore we can determine a volumetric of femur bone. In is a measure relative to a two-dimensional cross-sectional area
this paper, we also present a volumetric of femur bone, to evaluate (g/cm2), while volumetric bone mineral density (vBMD) is a
results of the proposed method by actual experiments. We measure of bone mass, related to the three-dimensional bone
compare a BMD of the proposed method results with a BMD of
CT-SCAN results. volume (g/cm3). Since aBMD is influenced by sex, body size,
geometry, quality and composition (2-7), using vBMD may
I. INTRODUCTION more accurately reflect bone density [3].Osteoporosis in
Osteoporosis is a skeleton disorder in which bones weaken postmenopausal Caucasian women is defined as a value for
and risk of fracture is increased. Osteoporosis is a serious and bone mineral density (BMD) or bone mineral content (BMC)
one of the most prevalent diseases of aging. The most common more than 2.5 standard deviations below the young average
osteoporosis fractures are those of the vertebrae, hip and wrist value. aBMD technique is called dual x-ray absorptiometry
and their incidences increases with age. In 1994 the WHO (DXA). vBMD technique is called quantitative CT (QCT) to
proposed guidelines for the diagnosis of osteoporosis based on differentiate it from imaging QCT. QCT is the only
measurement of bone mineral density. They have been widely noninvasive three-dimensional bone mass measurement
used for epidemiological studies, clinical research and for technique available. QCT reports a volumetric density (g/cm3)
treatment strategies. An increasing awareness of osteoporosis as opposed to the area density in (g/cm2) from other techniques.
and the development of treatments with proven efficacy are CT scan uses a multiple images that are a cross section image,
likely to increase the demand for management of patients with but DXA use an only single image. Comprehensive 3-D
osteoporosis. This in turn will require widespread facilities for information about the tissues can be obtained by computerized
its diagnosis and assessment. Measurements of bone mineral tomography (CT) imaging. The basic philosophy of CT is to
are a central component since this forms an integral component use a large scanner to measure an extensive set of projections
of the definition of osteoporosis. It is the increased fracture risk from full view angle for the 3-D reconstruction. Reconstruction
due to osteoporosis. Worldwide, the number of hip fractures quality is extremely good, and CT scans are an indispensable
has been estimated to rise from 1.7 million in 1990 to 6.26 part of radiology today. However, QCT and DXA imaging has
million by the year 2050 and this is mostly due to the also some disadvantages such as high radiation dose and high
increasing life expectancy and increasing size of the population cost of equipment. Therefore, the use of CT has been mainly
in nearly all countries [1]. limited to diagnosing serious diseases and it is typically
utilized in large hospital units. Unfortunately QCT and DXA
Therefore a diagnostic method able of telling whether a machines are not often found in hospital equipment, while
patient is suffering from osteoporosis or not is very important. radiographic devices are widely available. Consequently, the
Such a method makes it possible to start a treatment that can applicability of the system to conventional radiographic images
increase the bone mineral density to a level where the risk of was tested [1].
0
_ The-1 Canny edge detector [4] takes as input a gray image and
produces as output an image that showing the position of the
edges. It works as follows. The image is first smoothed by
Gaussian convolution. Next, a simple 2D first derivative
Fig. 1. Illustration of a section of bone within tissue irradiated with an operator is applied to the smoothed image to highlight regions
incident beam of intensity, Io, to give transmitted intensities of I1 and 12. of the image with high first derivatives.
1151
B. Contour Extraction Active Contour and Gradient Vector
Flow
The contour extraction module makes use of snake to snap tbp2 I1nn 2]+tbpl =
(7)
onto the contour of the femur. Snakes are formulated as
energy-minimizing contours controlled by two forces:
1) Internal contour forces which enforce the smoothness
constraint. - Volumetric and Bone Mineral Density
2) Image forces which attracts the contour to the desired
features, in this case, edges [5,6]. Volume is the last step of the entire process. All the
reconstruction result can be viewed directly in three-
dimensional and in an interactive way. User can change the
Esrnke = / t(v(fihI) ± Lmge(V ))tlS (3) surface geometry in three dimensional. Fig. 3 shown the result
of volume of femur bone.
Representing the position of the snake parametrically by v(s)
(x(s); y(s)), the energy of a snake Esnke (Eqn 1) is a sum of the
internal energy Eint of the snake and the image energy Eimage.
The GVF was created to overcome two shortcomings of the
original active contour formulationGVF is computed as a
diffusion of the gradient vectors of a gray-level edge map
derived from the image. The GVF field is defined as the vector
field G(x; y) = (q(x,y),r(x,y)) that minimizes the energy
functional
1 2 3 4 5 6 7 8 1 2 3 4 5 0 7 8
subject subject
(a) (b)
Grap h: p eri eiitag e o f vo ltiiie eior
10.00% e
45~
:3.00% j
25.00%
0 .00%A
1 2 3 4 5 0 7 8
(c)
Fig. 41. Grapgh of Group 1 testing. (a) Comparing between plastic ball radius and result.
(b) Comparing between plastic ball volumetric and result.
(c) Comparing percentage of volume error between plastic ball and result.
TABLE I. Group 2 testing. Descriptive statistics for DEXA and QCT measurements of the femur (n=50)
phalanges presented as mean (standard deviation). *p < 0.0001 for comparison of middle vs. proximal BMD.
V. CONCLUSSION REFERENCES