Advanced Image Analysis Techniques of New High-Resolution Images of teh Proximal Femur in the Presence of Red and Yellow Bone Marrow using Local Bone Enhancement Fuzzy Clustering

Introduction Osteoporotic fractures of the proximal femur are very common and often result in high rates of morbidity and mortality. Most osteoporotic fractures occur at locations that are rich in trabecular bone and there is increasing evidence that the trabecular and cortical bone architecture contributes significantly to bone strength. MRI has emerged as one of the leading in vivo methods for non-invasive imaging of the trabecular bone microstructure at peripheral sites. However, in vivo high resolution imaging of deeper sited regions like the proximal femur is more challenging. Thus, images of the proximal femur with high spatial resolution (in particular slice thickness) have previously not been acquired in a clinically reasonable scan time with sufficient signal-tonoise ratio (SNR). Furthermore, the presence of red and yellow bone marrow (Figure 1) is unique to the femur and requires enhanced image processing methods in order to separate both marrow phases from the bone. The goal of this abstract was two-fold; firstly, to acquire in vivo images of the proximal femur with high spatial resolution and SNR in a clinically feasible scan time as previously only accomplished at peripheral sites using recent enhancements in scanner and coil technology. Secondly, to evaluate the feasibility of trabecular bone analysis in the presence of red and yellow marrow in the deep seated femoral head using a novel approach to trabecular bone segmentation termed bone enhancement fuzzy clustering (BE-FCM).