Texture analysis of X-ray radiographs of iliac bone is correlated with bone micro-CT

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Alteration of bone trabecular architecture is a predictor of fracture risk in osteoporosis. Until now, microarchitecture can only be measured on a bone biopsy, thus limiting microarchitecture analysis in routine clinical practice for osteoporosis. Texture analysis on X-ray images has been advocated to be a suitable means to assess two-dimensional (2-D) microarchitecture in the research field. But little is known about the relationships between three-dimensional (3-D) architecture and texture analysis, particularly in clinical practice. The purposes of the study were: (1) to explore the relationship between 3-D histomorphometric parameters and 2-D texture analysis, and (2) to see if cortical assessment may influence results. In this study, the anterosuperior part of the iliac bone was removed from 24 cadavers. Large samples were prepared and comprised of the crest and a strip of bone approximately 3 cm wide and 5 cm long. These large specimens were used in order to preserve bone architecture; they also corresponded to the location used by histomorphometrists for the diagnosis of metabolic bone diseases on iliac crest biopsies. Bone samples were examined with a microcomputed tomograph for 3-D microarchitecture [BV/TV, C.BV/C.TV, Tb.P(f), structure model index (SMI), Tb.Th, Tb.N, Tb.Sp]. Texture analysis was done by several methods (skeletonization, run lengths, fractal techniques) from X-ray projection images. No correlation was found between bone mass parameters (BV/TV and C.BV/C.TV, which take into account both cortical and trabecular bone) and texture parameters. However, when specific descriptors of trabecular bone microarchitecture were used, several relationships with texture parameters were found [(Tb.N)/BOUND, r=0.628;/VGLN, r=0.596;/Fractal D, r=0.569]. When multiple correlations were used, the correlation coefficients were markedly improved with trabecular characteristics. X-ray texture analysis seemed to be a suitable approach for 2-D bone microarchitecture assessment. Furthermore, there is a good correlation between texture analysis of X-ray radiographs and 3-D bone microarchitecture assessed by microcomputed tomography.