Automated image analysis for bone density measurements using computed tomography

Quantitative trabecular bone density (TBD) measurements in the appendicular skeleton, using computer tomography, are described. Pixel-value frequency histograms are generated, to determine the spatial coordinates of the centers of mass distribution for both bones in the image field. A line joining these centers is used as an axis for subsequent enhancement of horizontal image features, and for radial fan searches, to separate bone images in the analysis field. One bone image is then deleted and the outer contour of the remaining bone is determined using cross-correlation and mathematical morphology operators. This contour is then used as a template to calculate average linear attenuation coefficients (LACs) over 1-pixel-wide annuli for TBD calculation. Data from 33 individual subjects (1251 images) have been processed using both automatic and manual analysis methods. Both methods give the same numerical values for TBD, but the automatic method has slightly better precision. The analysis method is general and is adaptable to other imaging situations.