Diffraction enhanced x-ray imaging of the distal radius: a novel approach for visualization of trabecular bone architecture

In Canada, osteoporotic fractures result in direct health care costs that exceed CAD$1.3 billion annually [1]. Fractures are related to compromised bone strength, a parameter that reflects both density (quantity) and architecture (quality) [2]. The current clinical standard for bone assessment, dual energy x-ray absorptiometry, provides only a 2-dimensional areal measurement of density and no architectural information [3]; therefore, the development of improved methods for visualizing and quantifying of bone architecture remains an important goal with respect to improving detection and treatment of osteoporosis. Advances are currently being sought in the development of new technologies [3], such as high-resolution peripheral quantitative tomography [4], and through texture-based analysis of trabecular structure from radiographs [5]. In this pictorial essay, we explore the use of x-ray-based diffraction enhanced imaging (DEI) by using synchrotron radiation [6] as a novel means of visualizing the internal architecture of the human distal radius, a clinically significant fracture site. Imaging for this study was conducted at the Canadian Light Source (CLS) synchrotron during commissioning of the BioMedical Imaging and Therapy (BMIT) bending magnet beam line [7]. As such, our goal here is 2-fold: (1) establishment of proof-of-principle for this new approach for bone assessment; and (2) the wider exposure of this powerful new Canadian research facility to the clinical imaging community. (author)