In vitro comparison of DE-QCT parameters with the compressive strength of cancellous bone

Quantitative computed tomography (QCT) is used as a method for assessing bone mineral in patients with osteoporosis. The implication being that if the mass of bone mineral is low enough then the patient is at risk for developing symptoms, i.e., fracture. The authors performed an in vitro test which compared dual-energy-QCT (DE-QCT) parameters with compressive strength. The bone samples were placed in a water bath and CT scanned using a Siemens DR-3. Alternating x-ray pulses of 125 and 85 kVp were used to generate the dual energy images. Four images, high kVp, low kVp, monoenergenic, and calcium equivalent, were reconstructed from each scan. A specially constructed bone mineral calibration phantom, consisting of a polyethylene rod and varying tubes of K2HP04, was placed within the water bath along with the specimens. Comparisons will be made between the various DE parameters and their relationship to the compressive strength of cancellous bone. The critical effect of trabecular bone orientation will also be discussed