Noninvasive femur bone volume estimation based on X-ray attenuation of a single radiographic image and medical knowledge

Bone Mineral Density (BMD) is an indicator of osteoporosis that is an increasingly serious disease, particularly for the elderly. To calculate BMD, we need to measure the volume of the femur in a noninvasive way. In this paper, we propose a noninvasive bone volume measurement method using x-ray attenuation on radiography and medical knowledge. The absolute thickness at one reference pixel and the relative thickness at all pixels of the bone in the x-ray image are used to calculate the volume and the BMD. First, the absolute bone thickness of one particular pixel is estimated by the known geometric shape of a specific bone part as medical knowledge. The relative bone thicknesses of all pixels are then calculated by x-ray attenuation of each pixel. Finally, given the absolute bone thickness of the reference pixel, the absolute bone thickness of all pixels is mapped. To evaluate the performance of the proposed method, experiments on 300 subjects were performed. We found that the method provides good estimations of real BMD values of femur bone. Estimates shows a high linear correlation of 0.96 between the volume Bone Mineral Density (vBMD) of CT-SCAN and computed vBMD (all P < 0.001). The BMD results reveal 3.23% difference in volume from the BMD of CT-SCAN.