Classical computational biomechanical approaches are costly and require a high level of expertise, often limiting their clinical application. A data-driven Machine Learning (ML) framework can serve as an effective alternative for disease diagnosis and prediction. This study aimed to develop an ML-based modeling approach integrating Quantitative Computed Tomography-based Finite Element Analysis (QCT-based FEA) to assess fall-induced hip fracture probability and probable facture locations in an elderly individual. Specifically, this study focused on predicting patient-specific hip fracture risk using fracture risk index (FRI), calculated on the basis of 1st and 3rd principal strains, and visualizing strain distributions in the proximal femur by generating surrogate FE models via supervised CatBoost model. The training dataset, comprising clinical, anatomical, and mechanical (loading) features, was obtained from QCT image data and QCT-based FEA, which also provided the FRI and strain distributions as targets. The optimized CatBoost model demonstrated 76% accuracy with an AUROC of 0.81 in fracture risk prediction, as well as correlation coefficients of 0.73 for the 1st principal strain and 0.76 for the 3rd principal strain in the surrogate FE models for visualization. Although trained on a limited dataset, this study highlights the efficacy of ML-based surrogate modeling in the QCT-based FEA process for predicting hip fracture risk and visually identifying fracture locations.
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