Bone Quality Assessment Using High Resolution Peripheral Quantitative Computed Tomography (HR-pQCT)

Osteoporosis is a major metabolic bone disease that causes reduced bone mass, deteriorated bone microstructural and increased fracture risk. In clinical practice, the gold standard to examine bone quality and evaluate fracture risk is using dual energy X-ray absorptiometry through measurements of areal bone mineral density (aBMD). However, it has been well accepted that in addition to aBMD, bone geometry, microstructure and material properties also play important roles in determining overall bone mechanical competence, which is directly related to fracture risk. High-resolution peripheral quantitative computed tomography (HR-pQCT) has the capability to image three-dimensional (3D) bone microstructures in vivo and provide quantitative measurements of bone mineral density as well as cortical and trabecular microstructure. Based on the HR-pQCT images, micro finite element (µFE) models can be constructed to directly estimate bone strength. HR-pQCT has become a widely used imaging tool in clinical research to evaluate the effect of aging, drug treatment, and metabolic bone disease on bone quality. The work in this thesis focuses on evaluating the accuracy and capability of HR-pQCT in qu