Semiautomated computerized system for fracture assessment of spinal x-ray films

This report describes a computerized system for assisting with the image analysis of digitized spine x-ray films. It was developed for vertebral height assessment (morphometry), a procedure widely used in research and clinical trials of spinal osteoporosis. Good image presentation is important for effective, interactive analysis of x-ray images, and was achieved by using a 12-bit color map for the image display. This provides virtually instantaneous updating of image display parameters even with large (4 - 10 MB) image files. The software has both semi-automated and automated features, and is integrated with a relational database for the storage and retrieval of images and textual information. It contains an on-line tutorial and facilities for later review and editing of the analyzed data. An active contour model for obtaining additional indices of vertebral fracture has been incorporated, and is undergoing further development. We discuss the organization of the analysis software, the database and on-line tutorial, and present some of the details of the implementation of the active contour model.