Computerized radiographic texture measures for characterizing bone strength: a simulated clinical setup using femoral neck specimens.

We are investigating computerized methods to ultimately characterize bone trabecular pattern from clinical skeletal radiographs. In this paper, we present a "phantom" for potential use in the development and evaluation of computerized methods for characterizing radiographic trabecular patterns and ultimately bone strength. Femoral neck specimens were excised during total hip arthroplasties from subjects exhibiting a range of diseases. To mimic the femoral neck in vivo, a "simulated clinical" setup was implemented in which specimens were exposed under conditions that yielded radiographs similar in appearance to standard pelvis radiographs. Fourier-based and fractal-based texture measures were used in the computer analysis; including RMS variation, first moment of the power spectrum, angular-dependent forms of these measures, and fractal dimension. The texture measures obtained from the "simulated clinical" specimen films correlated modestly with those from direct exposure "verification" films of the specimens (r= 0.59-0.69; p<0.0001). From our study, we conclude that the femoral neck specimen "phantoms" may be useful in the development and evaluation of computerized methods for analyzing bone trabecular patterns from skeletal radiographs. The use of a phantom that simulates the clinical radiographic examination allows for repeat exposures without the concern of excessive radiation exposure to a patient.