Hip fracture has been identified as one of the main health problems in the elderly. To improve the accuracy in assessing subject-specific hip fracture risk, this study proposed normalized cortical bone thickness (NCBT) estimated from patient’s hip DXA as an alternative predictor of hip fracture risk. Hip fracture risk index (HFRI) derived from DXA-based finite element model was utilized as a baseline for evaluating the effectiveness of NCBT in predicting hip fracture risk. It was found that NCBT at the lateral side of the narrowest femoral neck had the strongest correlation with femoral neck HFRI among the six locations of the proximal femur. This study suggests that it is possible to use NCBT as a surrogate for a quick evaluation of hip fracture risk. Yet its clinical performances such as sensitivity to therapy effectiveness and the ability to discriminate clinical fracture cases will be investigated in a future study.

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The goal of this thesis is to get acquainted with methods of determining bone mineral density from appropriate tissue types in diagnostic CT data and possibly modifying or extending them in order to make the bone quality diagnosis more reliable. The thesis begins by introducing the issue of determining bone quality. Next, a method that takes cortical bone deformations into account as well as bone mineral density is introduced. Accuracy assessment based on opinion of a medical expert suggests positive outcome of future objective accuracy assessment utilizing so far unavailable base of calibrated CT data, that is needed before deployment into clinical practice. If the accuracy of the suggested method is confirmed this way, this work provides a so far absent tool for fully automatic preventive diagnostics of osteoporosis.