Proximal Femur Specimens: Automated 3D Trabecular Bone Mineral Density Analysis at Multidetector CT—Correlation with Biomechanical Strength Measurement

Purpose: To prospectively evaluate an automated volume of interest (VOI)-fitting algorithm for quantitative computed tomography (CT) of proximal femur specimens, correlate bone mineral density (BMD) with biomechanically determined bone strength in vitro, and compare that correlation with those observed at dual-energy x-ray absorptiometry (DXA) measurement of BMD. Materials and Methods: The study was compliant with institutional and legislative requirements; donors had dedicated their body for education and research before death. Multidetector CT and DXA scans were acquired in 178 proximal femur specimens harvested from human cadavers (91 women, 87 men; mean age at death, 79 years ± 10.2; range, 52–100 years). An automated VOI-fitting algorithm was used to calculate BMD and bone mineral content (BMC) in the head, neck, and trochanter from CT findings and pixel distribution parameters. The femur failure load (FL) was determined by using a mechanical test. Quantitative CT BMD, quantitative CT pixel distribut...