Image Analysis for Trabecular Bone Properties on Cone-Beam CT Data

...................................................................................................................................... 7 Populärvetenskaplig sammanfattning ...................................................................................... 9 List of publications ................................................................................................................... 11 Papers included in the thesis ................................................................................................... 11 Papers published as part of the project, not included in the thesis ......................................... 11 Scientific paper related to, but not part of, the project............................................................ 11 Conference papers published as part of the project ................................................................ 12 Author contributions ............................................................................................................... 13 Abbreviations ............................................................................................................................ 15 Acknowledgements ................................................................................................................... 17 Preface ....................................................................................................................................... 19 Introduction .............................................................................................................................. 21 Skeleton .................................................................................................................................. 21 Bone ........................................................................................................................................ 21 Bone tissue ........................................................................................................................... 21 Cortical bone ....................................................................................................................... 22 Trabecular bone ................................................................................................................... 22 Bone structure and dental implants ..................................................................................... 23 Osteoporosis – Skeletal failure ............................................................................................... 24 Imaging techniques ................................................................................................................. 26 Dual-energy x-ray absorptiometry DXA .......................................................................... 26 Computed tomography – CT ............................................................................................... 27 Highresolution peripheral quantitative computed tomography – HR-pQCT .................... 29 Micro-computed tomography – micro-CT or μCT ............................................................. 30 Cone-beam computed tomography – CBCT ....................................................................... 31 Image processing and analysis ................................................................................................ 33 Image processing in skeletal failure quantification ............................................................. 33 Intensity thresholding .......................................................................................................... 33 Homogeneity thresholding – ARG ...................................................................................... 35 Biomechanical studies ............................................................................................................ 36 Destructive mechanical testing ............................................................................................ 36 Finite element methods – FEM ........................................................................................... 36 Aims ........................................................................................................................................... 37 Material and methods .............................................................................................................. 39 Material Study I-IV ................................................................................................................. 39 Scanners .................................................................................................................................. 39 Image acquisition .................................................................................................................... 39 Image processing .................................................................................................................... 40 Biomechanical analysis ........................................................................................................... 40 Reproducibility ....................................................................................................................... 40 Statistics .................................................................................................................................. 41 Results ....................................................................................................................................... 43 Discussion .................................................................................................................................. 47 Conclusions ............................................................................................................................... 53 Future perspectives .................................................................................................................. 55 References ................................................................................................................................. 57 Appendix (Paper I – IV)