Computed Tomography Imaging Technology Research Articles

CT-Assisted Management with Biodentine Obturation and Aesthetic Rehabilitation of a Geminated Maxillary Central Incisor with Mid-Root Fracture: A Rare Case Report

Gemination, a rare aberration in tooth development, results from the incomplete division of one tooth germ into two. In this case report, a true geminated permanent maxillary central incisor tooth with a horizontal mid-root fracture is successfully treated by non-surgical endodontic treatment. To elucidate the intricate root canal anatomy of this rare geminated incisor, we employed computed tomography imaging technology, enhancing our understanding of this complex case. Utilizing biodentine for obturation proved pivotal, as its capacity to accelerate reparative dentin formation facilitated prompt healing, particularly beneficial in fracture cases. This was followed by aesthetic rehabilitation to achieve a pleasing mesio-distal dimension for both the central incisors using a zirconia-reinforced porcelain crowns. Keywords: Computed Tomography (CT), Gemination, Horizontal root fracture, Biodentine Obturation

Technical challenges and benefits of photon counting detector computed tomography

X-ray detector is the essential part of a computed tomography (CT) system that controls dose efficiency and image quality. All clinical CT scanners utilized scintillating detectors up until the first clinical photon-counting-detector (PCD) system was approved in 2021. These detectors do not record information about individual photons during the two-step detection process. PCDs, on the other hand, employ a single step process that transforms X-ray radiation straight into an electrical signal. This retains information on individual photons, allowing one to count the quantity of X-rays in various energy ranges. Better spatial resolution, reduced dosages of iodinated contrast material, enhanced iodine signal, enhanced radiation dose efficiency, and the lack of electronic noise are the main benefits of PCDs. PCDs with multiple energy thresholds are able to separate detected photons into two or more energy bins, allowing for the availability of energy-resolved data for each record. In the event of dual-source CT, this permits high pitch or high temporal resolution acquisitions in addition to high spatial resolution for tasks involving material quantification or classification. PCDCT imaging of anatomy, where excellent spatial resolution provides clinical benefit, is one of the most promising uses of the technology. Inner ear, bone, small blood artery, heart, and lung imaging are among them. Photon-counting CT will become the wave of the future for workhorse CT imaging systems. An overview of the PCDCT principle, possible clinical benefits, and limitations of conventional CT is provided in this review paper, along with potential future developments for this CT imaging technology.

Sparse-View Spectral CT Reconstruction Based on Tensor Decomposition and Total Generalized Variation

Spectral computed tomography (CT)-reconstructed images often exhibit severe noise and artifacts, which compromise the practical application of spectral CT imaging technology. Methods that use tensor dictionary learning (TDL) have shown superior performance, but it is difficult to obtain a high-quality pre-trained global tensor dictionary in practice. In order to resolve this problem, this paper develops an algorithm called tensor decomposition with total generalized variation (TGV) for sparse-view spectral CT reconstruction. In the process of constructing tensor volumes, the proposed algorithm utilizes the non-local similarity feature of images to construct fourth-order tensor volumes and uses Canonical Polyadic (CP) tensor decomposition instead of pre-trained tensor dictionaries to further explore the inter-channel correlation of images. Simultaneously, introducing the TGV regularization term to characterize spatial sparsity features, the use of higher-order derivatives can better adapt to different image structures and noise levels. The proposed objective minimization model has been addressed using the split-Bregman algorithm. To assess the performance of the proposed algorithm, several numerical simulations and actual preclinical mice are studied. The final results demonstrate that the proposed algorithm has an enormous improvement in the quality of spectral CT images when compared to several existing competing algorithms.

Reference Range of CT Value in NC-CBBCT Based on Female Breast Structure.

As a new high-resolution three-dimensional CT imaging technology, the essential reference range of CT values in Cone-beam breast computed tomography (CBBCT) has not been established to date. To determine the reference range of computed tomography (CT) values in CBBCT for clinical breast examination. In total, 913 cases (1167 lateral) were subject to CBBCT. CT values of the glandular tissue, fat and different quadrants and different distances of CBBCT images were analyzed. The nipple and muscle were also evaluated. A total of 672 lateral breasts were included in the normal group for investigation. The reference range of the absolute CT value of the chest wall muscle is -136.68~43.36 HU. The reference range of the absolute CT value of the nipple is 176.39~334.02 HU. The reference range of the absolute CT value of fat is -190.4~-63.67HU, and of glandular tissue is -12.2~199.07HU. Our results firstly established the baseline CT values of Non-contrast CBBCT in female breasts, which will benefit cancer screening and lesion locating. The closer the normal breast fat and glandular tissue is to the nipple, the greater the CT value. The older the age, the lower the density. The CT values of fat are unstable in a distance of less than 5 cm, and the CT values of glandular tissues are relatively stable. The difference between the upper and lower quadrants is significant in the same lateral breast and the same section.

Computed tomography Osteoabsorptiometry: Review of bone density, mechanical strength of material and clinical application.

Computed Tomography (CT) imaging is an effective non-invasive examination. It is widely used in the diagnosis of fractures, arthritis, tumor, and some anatomical characteristics of patients. The density value (Hounsfield unit, HU) of a material in computed tomography can be the same for materials with varying elemental compositions. This value depends on the mass density of the material and the degree of X-ray attenuation. Computed Tomography Osteoabsorptiometry (CTOAM) imaging technology is developed on the basis of CT imaging technology. By applying pseudo-color image processing to the articular surface, it is used to analyze the distribution of bone mineralization under the articular cartilage, evaluate the position of prosthesis implantation, track the progression of osteoarthritis, and determine the joint injury prognosis. Furthermore, this technique was combined with indentation testing to discuss the relationship between the high bone density area of the articular surface, the mechanical strength of the bone, and the anchorage stability of the implant, in addition to the study of the relationship between mechanical strength and bone density. This narrative study discusses the pre- and postoperative evaluation of medical device implantation position, orthopedic surgery, and the clinical treatment of bone injury and degeneration. It also discusses the research status of CTOAM technology in image post-processing engineering and the relationship between bone material and mechanical strength.

A Computed Tomographic Investigation of the Ophthalmic Artery Volume and Its Relevance to Soft Tissue Filler Injections.

The measured intraarterial volume of cadaveric ophthalmic arteries was utilized for safety recommendations during facial soft tissue filler injections. However, its clinical practicability and model applicability have become questionable. To measure the volume of the ophthalmic artery in living individuals by utilizing computed tomography (CT) imaging technology. A total of 40 Chinese patients (23 males, 17 females) were included in this study with a mean age of 61.0 (14.2) years and a mean body mass index of 23.7 (3.3) kg/m2. Patients were investigated with CT imaging technology to evaluate the length, diameter, and volume of the bilateral ophthalmic arteries as well as the length of the bony orbits, resulting in a total of 80 investigated ophthalmic arteries and orbits. Independent of gender, the average length of the ophthalmic artery was 80.6 (18.7) mm, the calculated volume of the ophthalmic artery was 0.16 (0.05) mL and the minimal and maximal internal diameter of the ophthalmic artery were 0.50 (0.05) mm and 1.06 (0.1) mm, respectively. Based on the results obtained from the investigation of 80 ophthalmic arteries it must be concluded that current safety recommendations should be reevaluated. The volume of the ophthalmic artery appears to be 0.2 mL rather than 0.1 mL as previously reported. In addition, it appears impractical to limit the volume of soft tissue filler bolus injections to 0.1 mL due to the aesthetic requirements of each individual patient and treatment plan.

An in-situ X-ray computed tomography imaging apparatus with stack pressures for rechargeable batteries

Herein, a novel in-situ X-ray computed tomography (CT) imaging apparatus with stack pressures is proposed to detect the micro-structural evolution at the interface during the electrochemical process. And the relationship between the electrochemical performance and the interface morphology of lithium metal batteries has been effectively investigated through this in-situ technology. It can be observed that the growth of Li dendrites and their morphology evolution are directly dependent on the stack pressures. The Li dendrite grows from the needle-structure to the island-structure, accompanied by the tip-growth mode transferring to the base-growth mode in the range of the critical pressure. Moreover, the growth of Li dendrites can also be effectively inhibited when loading a suitable stack pressure. This novel in-situ CT imaging technology provides a feasible way to underlying the interface micro-structure evolution, electrochemical-pressure complexions, and safety of next-generation rechargeable batteries.

Enhancing Nodule Biopsy Through Technology Integration.

Technology in navigating to peripheral pulmonary nodules has improved in recent years. The recent integration of a robotic platform using shape-sensing technology and mobile cone-beam computed tomography imaging technology has enhanced confidence in sampling lesions with intraprocedural imaging by complimenting the pre-planned navigation to peripheral pulmonary nodules. We present 2 cases using the software integration that improved the robotic catheter positioning to allow for diagnostic specimens to be obtained in the initial biopsies.

MedNeRF: Medical Neural Radiance Fields for Reconstructing 3D-aware CT-Projections from a Single X-ray.

Computed tomography (CT) is an effective med-ical imaging modality, widely used in the field of clinical medicine for the diagnosis of various pathologies. Advances in Multidetector CT imaging technology have enabled additional functionalities, including generation of thin slice multi planar cross-sectional body imaging and 3D reconstructions. However, this involves patients being exposed to a considerable dose of ionising radiation. Excessive ionising radiation can lead to deterministic and harmful effects on the body. This paper proposes a Deep Learning model that learns to reconstruct CT projections from a few or even a single-view X-ray. This is based on a novel architecture that builds from neural radiance fields, which learns a continuous representation of CT scans by disentangling the shape and volumetric depth of surface and internal anatomical structures from 2D images. Our model is trained on chest and knee datasets, and we demonstrate qual-itative and quantitative high-fidelity renderings and compare our approach to other recent radiance field-based methods. Our code and link to our datasets are available at https://qithub.com/abrilcf/mednerf Clinical relevance- Our model is able to infer the anatomical 3D structure from a few or a single-view X-ray showing future potential for reduced ionising radiation exposure during the imaging process.

How Egg Storage Duration Prior to Incubation Impairs Egg Quality and Chicken Embryonic Development: Contribution of Imaging Technologies.

Storing fertilised eggs prior to incubation is a frequent practice in commercial hatcheries to coordinate activities and synchronise hatchings. However, the conditions used to store eggs can have major impacts on egg quality and the subsequent viability of chicken embryos. While storage temperatures of 16–18°C are classically used in hatcheries, the duration of storage varies from three to more than 10 days. We explored the effect of storage duration (zero, three or 10 days; D0, D3 and D10, respectively) at 16°C, 80% relative humidity (RH) on egg quality (Broiler, Ross 308), using computed tomography (CT) and classical measurements (egg weight, eggshell strength, egg white pH, Haugh units, yolk index and colour). The results revealed that a storage duration of up to 10 days negatively affected some egg quality traits (yolk index and volume, air chamber volume and egg white pH). Eggs stored for three or 10 days were further incubated for 11, 13 or 15 days (37.8°C, 55% RH). Eggs were analysed by magnetic resonance imaging (MRI) and CT to assess the development of the embryo and internal egg changes occurring during incubation. First, data showed that the fertility and sex ratio of eggs were not affected by storage duration. However, the mortality of viable eggs was increased in the D10 group compared to the D3 group. Results of non-invasive imaging technologies revealed that the storage of eggs for 10 days impaired embryo growth as early as 11 days of incubation (decrease in brain and embryo volumes). Collectively, these data provide new evidence that the duration of egg storage negatively affects embryonic growth. They further corroborate that this parameter is likely to be crucial to synchronising embryonic stages and maybe reducing the hatching window, hence limiting the time spent by newborn chicks in hatchers. In addition, our results highlight that CT and MRI imaging technologies are useful non-invasive tools to evaluate egg quality prior to incubation and the impact of storage (or incubation) practices on developmental growth of the embryo.

Review of CT image reconstruction open source toolkits.

Computed tomography (CT) has been widely applied in medical diagnosis, nondestructive evaluation, homeland security, and other science and engineering applications. Image reconstruction is one of the core CT imaging technologies. In this review paper, we systematically reviewed the currently publicly available CT image reconstruction open source toolkits in the aspects of their environments, object models, imaging geometries, and algorithms. In addition to analytic and iterative algorithms, deep learning reconstruction networks and open codes are also reviewed as the third category of reconstruction algorithms. This systematic summary of the publicly available software platforms will help facilitate CT research and development.

The Use of Abdominal Computed Tomography Imaging Technology in the Treatment of Surgical Acute Abdominal Perforation

Objective: The objective of this study is to explore the imaging features of abdominal Computed Tomography (CT) in patients with surgical acute abdominal perforation and to improve the diagnostic ability of perforated acute appendicitis (PAA). Method: Patients with suspected acute appendicitis and abdominal pain are selected as the study objects. According to the surgical records and pathological results, the patients are divided into PAA group and nonperforated acute appendicitis (NPAA) group. All patients are examined by abdominal CT. Postprocessing reconstruction technology such as multiple planar reconstruction (MPR) algorithm and curved planar reformat (CPR) algorithm are used as assistance to display the appendix, analyze and compare the images, observe the image performance of abdominal CT, and measure the diameter of the appendix. Results: The incidence of PAA specific signs (i.e. cellulitis around the appendix, abscess around the appendix, enhancement defect of the appendix wall, air accumulation outside the appendix cavity, fecal stone outside the appendix cavity) in PAA group is significantly higher than that in NPAA group (P < 0.05). Appearance of at least one specific sign for the diagnosis of PAA is 95.65%, the specificity is 92.59%, and the accuracy is 94.00%. The diameter of appendix in PAA group is significantly larger than that in NPAA group (P < 0.05). Compared with the diagnosis of simple specific signs, the specificity and accuracy of the combination of appendiceal diameter and specific signs in the diagnosis of PAA have been improved. Conclusion: With the help of MPR algorithm and CPR algorithm, abdominal CT imaging technology can accurately identify PAA and NPAA, which has important diagnostic value.

CT Image Measurement and Analysis of the Influence of Different Motion Modes on the Geometrical Morphology of Carpal Bone

The purpose of this study is to explore the influence of different movement modes on the geometrical morphology of carpal bones. In this study, Computed Tomography (CT) imaging is used for measurement and analysis. The results show that the changes of wrist bone volume of athletes are not significant compared with that of non-athletes, and the changes of bone density of the wrist bone are more obvious under the motion stress stimulation. According to results of CT imaging measurement and calculation, the average CT values of triangular bone, trapezoid bone, capitate bone and pisiform bone in the left hand and hamate bone in the right hand of the athlete are greater than that of the non-athlete, and the difference is statistically significant. Therefore, CT imaging technology can help to reconstruct the three-dimensional image of the carpal bone and deeply understand the geometric shape of the carpal bone of athletes.

Sex identification from foramen magnum using computed tomography scanning in a sample of Egyptian population

ABSTRACT Background Foramen magnum (FM) attains an increasing interest regarding sex identification among different populations. Computed tomography (CT) is considered a reliable modality for FM examination for forensic purposes. Aim of the study The current study is aiming to investigate FM measurements and shape as a forensic tool for sex identification in a sample of Egyptian population using CT imaging technology. Subjects and Methods The study included cranial CT images of 200 adult Egyptian individuals (100 males, 100 females) using 320-row multi-detector CT scanner. Sagittal and transverse diameters, index, circumference and area of FM were obtained. FM area was measured automatically and also calculated according to Radinsky's and Teixeria's formulae. FM morphology was also reported. Results All FM measurements except FM index were significantly higher in males compared to females. There was no statistical correlation between FM measurements and age. The best overall sex prediction was reported for FM circumference and area measured automatically (67% each), followed by FM area calculated by Radinsky's and Teixeria's formulae (65.5% and 65% respectively), then FM transverse and sagittal diameters (63.5% and 60% respectively). The prediction was raised to 69% when FM circumference, area measured automatically and transverse diameter were combined. Hexagonal and irregular shapes were the most commonly reported shapes in males and females respectively with no statistical difference regarding shape distribution between males and females. Conclusions FM measurements are valid sex discriminators in the present Egyptian sample.

Validation of lesion simulations in clinical CT data for anonymized chest and abdominal CT databases.

To make available to the medical imaging community a computed tomography (CT) image database composed of hybrid datasets (patient CT images with digitally inserted anthropomorphic lesions) where lesion ground truth is known a priori. It is envisioned that such a dataset could be a resource for the assessment of CT image quality, machine learning, and imaging technologies [e.g.,computer aided detection (CAD) and segmentation algorithms]. This HIPPA compliant, IRB waiver of approval study consisted of utilizing 120 chest and 100 abdominal clinically acquired adult CT exams. One image series per patient exam was utilized based on coverage of the anatomical region of interest (either the thorax or abdomen). All image series were de-identified. Simulated lesions were derived from a library of anatomically informed digital lesions (93 lung and 50 liver lesions) where six and four digital lesions with nominal diameters ranging from 4 to 20mm were inserted into lung and liver image series, respectively. Locations for lesion insertion were randomly chosen. A previously validated lesion simulation and virtual insertion technique were utilized. The resulting hybrid images were reviewed by three experienced radiologists to assure similarity with routine clinical imaging in a diverse adult population. The database is composed of four datasets that contain 100 patient cases each, for a total of 400 image series accompanied by Matlab.mat tables that provide descriptive information about the virtually inserted lesions (i.e., size, shape, opacity, and insertion location in physical (world) coordinates and voxel indices). All image and metadata are stored in DICOM format on the Quantitative Imaging Data Warehouse (https://qidw.rsna.org/#collection/57d463471cac0a4ec8ff8f46/folder/5b23dceb1cac0a4ec800a770?dialog=login), in two sets: (a) QIBA CT Hybrid Dataset I which contains Lung I and Liver I datasets, and (b) QIBA CT Hybrid Dataset II which contains Lung II and Liver II datasets. The QIDW is supported by the Radiological Society of North America (RSNA). Registration is required upon initial log in. By simulating lesion opacity (full solid, part solid and ground glass), size, and texture, the relationship between lesion morphology and segmentation or CAD algorithm performance can be investigated without the need for repetitive patient exams. This database can also serve as a reference standard for device and reader performance studies.

Medical Diagnosis of Upper Urinary Calculi Based on Image Filtering in Ureteroscopic Lithotripsy

Objective: Based on improved image processing techniques, we investigate the therapeutic effect and safety of a flexible ureteroscope applied in treatment of upper urinary calculi with and without preoperative ureteral stent, and analyzed their outcome based on CT and ultrasound medical imaging technology, as well as other clinical data. Methods: These identified patients were randomly divided into two groups, 89 patients suffering from upper urinary calculi in Group A were treated with flexible ureteroscopy lithotripsy and Holmium laser, without preoperative ureteral stent. On the other hand, another 114 patients in Group B received preoperative ureteral stent. In terms of measurement indicators, the total operation time, hospitalization time, hospital costs, success rate of operation, clearance rate of stone, occurrence rate of complications, and the probability of a second operation were recorded, respectively. In order to verify the effect of the operation, we performed Computed Tomography (CT), Nuclear Magnetic Resonance Imaging (MRI), Ultrasound Examination on the patient before and after the operation, and processed the image by downhill filtering algorithm and adaptive median filtering to ensure the validity and accuracy of the experiment. Results: By analyzing other clinical data such as medical images, it is known when making comparisons between two groups, there were no significant difference in terms of stone size, stone site, and success rate of operation (97.8%, 87/89 for group A; 100%, 114/144 for group B). In further, the operation time of group A was longer than that of group B (65.46 ± 10.17 min vs. 59.58 ± 9.25 min, P < 0 05), and the hospitalization time in group A was much shorter (6.53 ± 0.89 d vs. 10.16 ± 1.50 d, P < 0.01). The clearance rate of stone at 3-day post-surgery in group A was much lower than that of group B (36%, 32/89 vs. 51.7%, 59/114, P < 0.05). In addition, the clearance rate of stone at 1-month post-surgery (84.3%, 75/89 in group A vs. 85.1%, 97/114 in group B), and the occurrence rate of complications (21.3%, 19/89 in group A vs. 20.1%, 23/114 in group B) showed no significantly difference (P > 0.05). Besides, the probabilities of a second operation in group A and B were 14.6% (19/89) and 20.1% (23/114), respectively. And no significantly difference could be drawn according to statistical analysis. Conclusion: The application of flexible ureteroscope applied in treatment of upper urinary calculi without preoperative ureteral stent was economical, safe and effective.

A CT metal artifact reduction algorithm based on sinogram surgery.

Streak artifacts in computed tomography (CT) images caused by metallic objects limit the wider use of CT imaging technologies. There have been various attempts to improve CT images containing streak artifacts; however, most of them generate additional artifacts or do not completely eradicate existing artifacts. In this paper, we propose a novel algorithm which reduces streak artifacts in CT images. Using CT numbers reconstructed from a given sinogram, we extract the metal part M and the surrounding area C with similar CT numbers. By filling in the area C∪M with the evaluated average CT number of C, we obtain a modified CT image. Using forward projection of the modified CT image, we generate a sinogram containing information about the anatomical structure. We undertake sinogram surgery to remove the metallic effects from the sinogram, after which we repeat the procedure. We perform numerical experiments using various simulated phantoms and patient images. For a quantitative analysis, we use the relative l∞ error and the relative l2 error. In simulated phantom experiments, all l∞ errors and l2 errors approach 10% and 1% of the initial errors, respectively. Moreover, for the patient image simulations, all l∞ errors are decreased by a factor of 20 while the l2 errors are decreased less than 5%. We observe that the proposed algorithm effectively reduces the metal artifacts. In this paper, we propose a metal artifact reduction algorithm based on sinogram surgery to reduce metal artifacts without additional artifacts. We also provide empirical convergence of our algorithm.

A comprehensive review of denoising techniques for abdominal CT images

Computed Tomography (CT) is one of the effective imaging modality in medical sciences that assist in diagnosing various pathologies inside the human body. Despite considerable advancement in acquisition speed, signal to noise ratio and image resolution of computed tomography imaging technology, CT images are still affected by noise and artifacts. A tradeoff between the amount of noise reduced and conservation of genuine image details has to be made in such a way that it enhances the clinically relevant image content. Therefore, noise reduction in medical images is an important and challenging task, as it helps to improve the performance of other image processing procedures such as segmentation or classification to perform better diagnosis by clinicians. Different techniques have been suggested in the literature on denoising of CT images, and each technique has its own presumptions, benefits, and drawbacks. To the best of our knowledge, no survey paper was found in the literature that compares the performance of various denoising techniques for CT images. This study aims to compare the capabilities of several notable and contemporary denoising techniques in the presence of different types of noise present in abdominal CT images. This comparative analysis helps to determine the most suitable denoising technique for practitioners and researchers that can be used in real life scenarios. Furthermore, the advantages and disadvantages of considered denoising methods have also been discussed along with some recommendations for further research in this area.

Influence of CT parameters on STL model accuracy

PurposeAdditive manufactured (AM) skull models are increasingly used to plan complex surgical cases and design custom implants. The accuracy of such constructs depends on the standard tessellation language (STL) model, which is commonly obtained from computed tomography (CT) data. The aims of this study were to assess the image quality and the accuracy of STL models acquired using different CT scanners and acquisition parameters.Design/methodology/approachImages of three dry human skulls were acquired using two multi-detector row computed tomography (MDCT) scanners, a dual energy computed tomography (DECT) scanner and one cone beam computed tomography (CBCT) scanner. Different scanning protocols were used on each scanner. All images were ranked according to their image quality and converted into STL models. The STL models were compared to gold standard models.FindingsImage quality differed between the MDCT, DECT and CBCT scanners. Images acquired using low-dose MDCT protocols were preferred over images acquired using routine protocols. All CT-based STL models demonstrated non-uniform geometrical deviations of up to +0.9 mm. The largest deviations were observed in CBCT-derived STL models.Practical implicationsWhile patient-specific AM constructs can be fabricated with great accuracy using AM technologies, their design is more challenging because it is dictated by the correctness of the STL model. Inaccurate STL models can lead to ill-fitting implants that can cause complications after surgery.Originality/valueThis paper suggests that CT imaging technologies and their acquisition parameters affect the accuracy of medical AM constructs.

Vertebral Body Compressive Strength Evaluated by Dual-Energy X-Ray Absorptiometry and Hounsfield Units In Vitro

Dual-energy X-ray absorptiometry (DXA) and Hounsfield unit (HU) are 2 technologies used in vivo to assess bone mineral density and to predict fracture risk. However, few in vitro studies focus on the difference between the 2 technologies in the ability to determine vertebral body compressive strength. Forty-two lumbar vertebrates were harvested from 7 mature goats. All the vertebrae were imaged using clinical computed tomography and assessed by DXA subsequently. The individual vertebral body was then mechanically tested to failure in compression, to determine ultimate load and stress. HU has a moderate correlation with DXA (r = 0.64). DXA has significant associations with ultimate load and stress (r = 0.59 and 0.69, respectively). Significant positive linear correlations were also found between HU and ultimate load (r = 0.65) and stress (r = 0.81). There was no significant difference between HU and DXA to predict the ultimate load (t = 0.56, p = 0.577) or the ultimate stress (t = 1.62, p = 0.112). HU has an equal predictive value as the DXA for whole vertebral body compressive strength. This work supports the application of the HU measurement using clinical computed tomography imaging technology to assess bone strength and fracture risk.