Background We applied an artificial intelligence-based model to predict fragility fractures in postmenopausal women, using different dual-energy x-ray absorptiometry (DXA) parameters. Methods One hundred seventy-four postmenopausal women without vertebral fractures (VFs) at baseline (mean age 66.3 +/- 9.8) were retrospectively evaluated. Data has been collected from September 2010 to August 2018. All subjects performed a spine x-ray to assess VFs, together with lumbar and femoral DXA for bone mineral density (BMD) and the bone strain index (BSI) evaluation. Follow-up exams were performed after 3.34 +/- 1.91 years. Considering the occurrence of new VFs at follow-up, two groups were created: fractured versus not-fractured. We applied an artificial neural network (ANN) analysis with a predictive tool (TWIST system) to select relevant input data from a list of 13 variables including BMD and BSI. A semantic connectivity map was built to analyse the connections among variables within the groups. For group comparisons, an independent-samples t-test was used; variables were expressed as mean +/- standard deviation. Results For each patient, we evaluated a total of n = 6 exams. At follow-up, n = 69 (39.6%) women developed a VF. ANNs reached a predictive accuracy of 79.56% within the training testing procedure, with a sensitivity of 80.93% and a specificity of 78.18%. The semantic connectivity map showed that a low BSI at the total femur is connected to the absence of VFs. Conclusion We found a high performance of ANN analysis in predicting the occurrence of VFs. Femoral BSI appears as a useful DXA index to identify patients at lower risk for lumbar VFs.

Bone Strain Index predicts fragility fracture in osteoporotic women: an artificial intelligence-based study / F.M. Ulivieri, L. Rinaudo, C. Messina, L.P. Piodi, D. Capra, B. Lupi, C. Meneguzzo, L.M. Sconfienza, F. Sardanelli, A. Giustina, E. Grossi. - In: EUROPEAN RADIOLOGY EXPERIMENTAL. - ISSN 2509-9280. - 5:1(2021 Oct 19), pp. 47.1-47.11. [10.1186/s41747-021-00242-0]

Bone Strain Index predicts fragility fracture in osteoporotic women: an artificial intelligence-based study

C. Messina;D. Capra;B. Lupi;C. Meneguzzo;L.M. Sconfienza
;
F. Sardanelli;
2021-10-19

Abstract

Background We applied an artificial intelligence-based model to predict fragility fractures in postmenopausal women, using different dual-energy x-ray absorptiometry (DXA) parameters. Methods One hundred seventy-four postmenopausal women without vertebral fractures (VFs) at baseline (mean age 66.3 +/- 9.8) were retrospectively evaluated. Data has been collected from September 2010 to August 2018. All subjects performed a spine x-ray to assess VFs, together with lumbar and femoral DXA for bone mineral density (BMD) and the bone strain index (BSI) evaluation. Follow-up exams were performed after 3.34 +/- 1.91 years. Considering the occurrence of new VFs at follow-up, two groups were created: fractured versus not-fractured. We applied an artificial neural network (ANN) analysis with a predictive tool (TWIST system) to select relevant input data from a list of 13 variables including BMD and BSI. A semantic connectivity map was built to analyse the connections among variables within the groups. For group comparisons, an independent-samples t-test was used; variables were expressed as mean +/- standard deviation. Results For each patient, we evaluated a total of n = 6 exams. At follow-up, n = 69 (39.6%) women developed a VF. ANNs reached a predictive accuracy of 79.56% within the training testing procedure, with a sensitivity of 80.93% and a specificity of 78.18%. The semantic connectivity map showed that a low BSI at the total femur is connected to the absence of VFs. Conclusion We found a high performance of ANN analysis in predicting the occurrence of VFs. Femoral BSI appears as a useful DXA index to identify patients at lower risk for lumbar VFs.
Neural network models; Dual-energy x-ray absorptiometry; Finite element analysis; Artificial intelligence; Osteoporosis;
Settore MED/36 - Diagnostica per Immagini e Radioterapia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/875296
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