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Osteoporosis is a chronic condition characterized by demineralization and destruction of bone tissue. Fractures
associated with the disease are becoming an increasingly relevant issue for public health institutions. Prediction
of fracture risk is a major focus research and, over the years, has been approched by various methods.
Still, bone mineral density (BMD) obtained by dual-energy X-ray absorptiometry (DXA) remains the clinical
gold-standard for diagnosis and follow-up of osteoporosis. However, DXA is restricted to specialized diagnostic
centers and there exists considerable overlap in BMD results between populations of individuals with and
without fractures. Clinically far more available than DXA is conventional x-ray imaging depicting trabecular
bone structure in great detail.
In this paper, we demonstrate that bone structure depicted by clinical radiographs can be analysed
quantitatively by parameters obtained from the Radon Transform (RT). RT is a global analysis-tool for
detection of predefined, parameterized patterns, e.g. straight lines or struts, representing suitable
approximations of trabecular bone texture.
The proposed algorithm differentiates between patients with and without fractures of the hip by application of
various texture-metrics based on the Radon-Transform to standard x-ray images of the proximal femur. We
consider three different regions-of-interest in the proximal femur (femoral head, neck, and inter-trochanteric
area), and conduct an analysis with respect to correct classification of the fracture status. Performance of the
novel approach is compared to DXA.
We draw the conclusion that performance of RT is comparable to DXA and may become a useful supplement to
densitometry for the prediction of fracture risk.
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