Division of Biomedical Engineering

Osteoporosis is defined as low bone mass, and results in a markedly increased risk of skeletal fractures. Development of new drugs to reduce bone loss or increase bone mass is promising. However, it requires that the individuals at risk can be accurately identified. In today’s clinical practice, the risk of fracture is estimated by measuring bone density from a 2D x-ray image called DXA. However, this method suffers from low sensitivity, with over 40 % of the subjects who actually fracture who were not classified as being at risk.

We have therefore developed DXA2FEM. DXA2FEM is a tool that calculates the actual strength of the bone for each individual using functional imaging and numerical simulations. It reconstructs the 3D anatomy of the patient’s thigh bone from the 2D DXA image using a so-called statistical shape and appearance model, and then calculates femoral strength for a fall to the side using structural analysis with finite element models.

Our team has developed and validated our technology over the years against relevant clinical images, in vitro mechanical tests, and is now in the phase of validation against relevant prospective clinical cohorts. The method showed already its clinical potential against a clinical cohort of men from Sweden (see publications in the box below) and testing is ongoing on clinical cohorts of women. Interested in DXA2FEM? Contact our team! This project is a collaboration between Lund University and University of Eastern Finland.

External link:

Recent publications (external links):

Grassi, Väänänen, Jehpsson, Ljunggren, Rosengren, Karlsson, Isaksson. 3d Finite Element Models Reconstructed from 2d Dxa Images Improve Hip Fracture Prediction Compared to Areal Bmd in Mros Sweden Cohort.  Journal of Bone and Mineral Research 38:9, 1258-1267, 2023 https://doi.org/10.1002/jbmr.4878.

Grassi, Väänänen, Isaksson. Statistical shape and appearance models: development towards improved osteoporosis care. Current Osteoporosis Reports 19, 676–687, 2021 https://doi.org/10.1007/s11914-021-00711-w

Grassi, Fleps, Sahlstedt, Väänänen, Ferguson, Isaksson, Helgason: Validation of 3D finite element models from simulated DXA images for biofidelic simulations of sideways fall impact to the hip, Bone, 2021 doi.org/10.1016/j.bone.2020.115678