A new algorithm for trabecular bone thickness computation at low resolution achieved under in vivo condition

Adult bone diseases, especially osteoporosis, lead to increased risk of fracture associated with substantial morbidity, mortality, and financial costs. Clinically, osteoporosis is defined by low bone mineral density (BMD); however, increasing evidence suggests that the micro-architectural quality of trabecular bone (TB) is an important determinant of bone strength and fracture risk. Accurate measurement of trabecular thickness and marrow spacing is of significant interest for early diagnosis of osteoporosis or treatment effects. Here, we present a new robust algorithm for computing TB thickness and marrow spacing at a low resolution achievable in vivo. The method uses a star-line tracing technique that effectively deals with partial voluming effects of in vivo imaging where voxel size is comparable to TB thickness. Experimental results on cadaveric ankle specimens have demonstrated the algorithm's robustness (ICC > 0.98) under repeat scans of multi-row detector computed tomography (MD-CT) imaging. It has been observed in experimental results that TB thickness and marrow spacing measures as computed by the new algorithm have strong association (R2 ∈ {0.85, 0.87} ) with TB's experimental mechanical strength measures.