Bone Strain Index

SOFTWARE FOR THE AUTOMATIC CALCULATION OF STRESS AND STRAIN OF BONE SEGMENTS

In recent years, the study of bone metabolism has required lot of efforts to take into account fundamental aspects, such as bone microarchitecture, geometry and applied loads, to obtain a correct assessment of bone strength and associated fracture risk.

The tools available today allow a determination of bone density and bone quality, but do not allow to fully analyze the mechanical characteristics of the bone segment under examination.

Bone Strain Index automatically calculates strains and stresses in a bone segment, starting from specific loading conditions for each patient. It is based on finite element calculation algorithms usually used in engineering applications, in the design and test phases of industrial mechanical equipment.

EASY TO USE
Bone Strain Index can be installed on existing DXA densitometers. It receives directly the scan performed with the densitometric examination and analyses the morphological image, the BMD and the body mass of the patient. The time required for the analysis (a few seconds) and the simplicity of use provide to the doctor a useful tool to manage patient data and diagnosis without wasting time.

EASY INTERPRETATION OF RESULTS
The software provides a fracture risk index called Bone Strain Index and a graphic representation of the deformation distribution in the analyzed bone segment. The colour map follows a ramp from blue (low strain) to green (intermediate strain), yellow, and red (high strain) indicating an increase of the risk factor proportionated to the increase of the strain. In addition, the program provides useful synthetic indicators of the achieved results, such as statistical tables and charts.

VALID DIAGNOSTIC INVESTIGATION TOOL
Resulting data and analysis are a valid tool to support traditional diagnostics and can be applied to both the lumbar and femur regions. Bone Strain Index is complementary to the data available through DXA measurements and may be used in association with the other DXA-derived bone quantity and quality variables for a better risk assessment of patients.

References

Ulivieri FM, Rinaudo L, Messina C, Aliprandi A, Sconfienza LM, Sardanelli F, Cesana BM. Bone Strain Index: preliminary distributional characteristics in a population of women with normal bone mass, osteopenia and osteoporosis. Radiol med (2022).

Cuttone S, Rinaudo L, Bignardi C, Aldieri A, Terzini M, Croce A, Messina C, Mangiavini L, Sconfienza LM, Ulivieri FM. DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty. J. Med. Biol. Eng. (2022).

Ulivieri FM, Rinaudo L. The Bone Strain Index: An Innovative Dual X-ray Absorptiometry Bone Strength Index and Its Helpfulness in Clinical Medicine. J Clin Med. 2022;11(9):2284. Published 2022 Apr 20.

Sornay-Rendu E, Duboeuf F, Ulivieri FM, Rinaudo L, Chapurlat R. The bone strain index predicts fragility fractures. The OFELY study. Bone. 2022 Feb 1;157:116348. doi: 10.1016/j.bone.2022.116348. Epub ahead of print. PMID: 35121211.

Ulivieri FM, Rinaudo L, Messina C, Piodi LP, Capra D, Lupi B, Meneguzzo C, Sconfienza LM, Sardanelli F, Giustina A, Grossi E. Bone Strain Index predicts fragility fracture in osteoporotic women: an artificial intelligence-based study. Eur Radiol Exp. 2021 Oct 19;5(1):47. doi: 10.1186/s41747-021-00242-0. PMID: 34664136.

Buccino, F., Colombo, C., Duarte, D.H.L. et al. 2D and 3D numerical models to evaluate trabecular bone damage. Med Biol Eng Comput 59, 2139–2152 (2021). https://doi.org/10.1007/s11517-021-02422-x

Tabacco G, Naciu AM, Messina C, Sanson G, Rinaudo L, Cesareo R, Falcone S, Manfrini S, Napoli N, Bilezikian JP, Ulivieri FM, Palermo A. DXA-Based Bone Strain Index: A New Tool to Evaluate Bone Quality in Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2021 Jul 13;106(8):2304-2312.
doi: 10.1210/clinem/dgab317

Ulivieri FM, Rinaudo L, Piodi LP, Messina C, Sconfienza LM, Sardanelli F, et al. Bone strain index as a predictor of further vertebral fracture in osteoporotic women: An artificial intelligence-based analysis. PLoS ONE 16(2): e0245967 (2021). https://doi.org/10.1371/journal.pone.0245967

Ulivieri FM, Rinaudo L. Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index, Frontiers in Medicine (2021). https://doi.org/10.3389/fmed.2020.590139

Messina C, Acquasanta M, Rinaudo L, Tortora S, Arena G, Albano D, Sconfienza LM, Ulivieri FM Short-Term Precision Error of Bone Strain Index, a New DXA-Based Finite Element Analysis Software for Assessing Hip Strength, Journal of Clinical Densitometry (2020). https://doi.org/10.1016/j.jocd.2020.10.013

Messina, C., Rinaudo, L., Cesana, B.M. et al. Prediction of osteoporotic fragility re-fracture with lumbar spine DXA-based derived bone strain index: a multicenter validation study. Osteoporos Int (2020). https://doi.org/10.1007/s00198-020-05620-9

Ulivieri, F.M., Rinaudo, L., Piodi, L.P. et al. Usefulness of Dual X-ray Absorptiometry-Derived Bone Geometry and Structural Indexes in Mastocytosis. Calcif Tissue Int (2020). https://doi.org/10.1007/s00223-020-00749-5

Ulivieri, F.M., Piodi, L.P., Rinaudo, L. et al. Bone Strain Index In The Prediction Of Vertebral Fragility RefractureEur Radiol Exp 4, 23 (2020) doi:10.1186/s41747-020-00151-8

Messina C, Piodi LP et al. (2020) Artificial neural network analysis of bone quality DXA parameters response to teriparatide in fractured osteoporotic patients. PLoS One. doi: https://doi.org/10.1371/journal.pone.0229820

Messina C, Piodi LP, Rinaudo L, Buonenna C, Sconfienza LM, Vergani L, Ulivieri FM (2020) Reproducibility of DXA-based bone strain index and the influence of body mass: an in vivo study. Radiol med 125, 313-318 https://doi.org/10.1007/s11547-019-01118-5

Messina C, Piodi LP, Rinaudo L, Emili I, Porro F, Buonenna C, Sconfienza LM, Vergani L, Ulivieri FM (2019) Bone strain index reproducibility and soft tissue thickness influence: a dual x-ray photon absorptiometry phantom study. European Radiology Experimental 3:33 doi:10.1186/s41747-019-0110-9

Terzini M, Aldieri A, Rinaudo L, Osella G, Audenino AL and Bignardi C (2019) Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models. Front. Bioeng. Biotechnol. 7:220. doi: 10.3389/fbioe.2019.00220

Colombo C, Libonati F, Rinaudo L, Bellazzi M, Ulivieri FM, Vergani L (2019) A new finite element based parameter to predict bone fracture. PLoS ONE 14(12): e0225905. doi:10.1371/journal.pone.0225905

Rodari G, Scuvera G, Ulivieri FM, et al (2018) Progressive bone impairment with age and pubertal development in neurofibromatosis type I. Arch Osteoporos 13:93. https://doi.org/10.1007/s11657-018-0507-8

Ulivieri FM, Rebagliati GAA, Piodi LP, et al (2018) Usefulness of bone microarchitectural and geometric DXA-derived parameters in haemophilic patients. Haemophilia.

Ulivieri FM, Piodi LP, Grossi E, et al (2018) The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study. PLoS One 13:e0190477. 

1.bone-strain-index-logo

SOFTWARE FOR THE AUTOMATIC CALCULATION OF STRESS AND STRAIN OF BONE SEGMENTS

In recent years, the study of bone metabolism has required lot of efforts to take into account fundamental aspects, such as bone microarchitecture, geometry and applied loads, to obtain a correct assessment of bone strength and associated fracture risk.

The tools available today allow a determination of bone density and bone quality, but do not allow to fully analyze the mechanical characteristics of the bone segment under examination.

Bone Strain Index automatically calculates strains and stresses in a bone segment, starting from specific loading conditions for each patient. It is based on finite element calculation algorithms usually used in engineering applications, in the design and test phases of industrial mechanical equipment.

EASY TO USE
Bone Strain Index can be installed on existing DXA densitometers. It receives directly the scan performed with the densitometric examination and analyses the morphological image, the BMD and the body mass of the patient. The time required for the analysis (a few seconds) and the simplicity of use provide to the doctor a useful tool to manage patient data and diagnosis without wasting time.

pc-bs-newi

EASY INTERPRETATION OF RESULTS
The software provides a fracture risk index called Bone Strain Index (BSI) and a graphic representation of the deformation distribution in the analyzed bone segment. The colour map follows a ramp from blue (low strain) to green (intermediate strain), yellow, and red (high strain) indicating an increase of the risk factor proportionated to the increase of the strain. In addition, the program provides useful synthetic indicators of the achieved results, such as statistical tables and charts.

VALID DIAGNOSTIC INVESTIGATION TOOL
Resulting data and analysis are a valid tool to support traditional diagnostics and can be applied to both the lumbar and femur regions. BSI is complementary to the data available through DXA measurements and may be used in association with the other DXA-derived bone quantity and quality variables for a better risk assessment of patients.

References

Ulivieri FM, Rinaudo L, Messina C, Aliprandi A, Sconfienza LM, Sardanelli F, Cesana BM. Bone Strain Index: preliminary distributional characteristics in a population of women with normal bone mass, osteopenia and osteoporosis. Radiol med (2022).

Cuttone S, Rinaudo L, Bignardi C, Aldieri A, Terzini M, Croce A, Messina C, Mangiavini L, Sconfienza LM, Ulivieri FM. DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty. J. Med. Biol. Eng. (2022).

Ulivieri FM, Rinaudo L. The Bone Strain Index: An Innovative Dual X-ray Absorptiometry Bone Strength Index and Its Helpfulness in Clinical Medicine. J Clin Med. 2022;11(9):2284. Published 2022 Apr 20.

Tabacco G, Naciu AM, Messina C, Sanson G, Rinaudo L, Cesareo R, Falcone S, Manfrini S, Napoli N, Bilezikian JP, Ulivieri FM, Palermo A. DXA-Based Bone Strain Index: A New Tool to Evaluate Bone Quality in Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2021 May 8:dgab317. doi: 10.1210/clinem/dgab317

Ulivieri FM, Piodi LP, Grossi E, et al (2018) The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study. PLoS One 13:e0190477. 

Ulivieri FM, Rebagliati GAA, Piodi LP, et al (2018) Usefulness of bone microarchitectural and geometric DXA-derived parameters in haemophilic patients. Haemophilia.

Rodari G, Scuvera G, Ulivieri FM, et al (2018) Progressive bone impairment with age and pubertal development in neurofibromatosis type I. Arch Osteoporos 13:93. https://doi.org/10.1007/s11657-018-0507-8

Colombo C, Libonati F, Rinaudo L, Bellazzi M, Ulivieri FM, Vergani L (2019) A new finite element based parameter to predict bone fracture. PLoS ONE 14(12): e0225905. doi:10.1371/journal.pone.0225905

Terzini M, Aldieri A, Rinaudo L, Osella G, Audenino AL and Bignardi C (2019) Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models. Front. Bioeng. Biotechnol. 7:220. doi: 10.3389/fbioe.2019.00220

Messina C, Piodi LP, Rinaudo L, Emili I, Porro F, Buonenna C, Sconfienza LM, Vergani L, Ulivieri FM (2019) Bone strain index reproducibility and soft tissue thickness influence: a dual x-ray photon absorptiometry phantom study. European Radiology Experimental 3:33 doi:10.1186/s41747-019-0110-9

Messina C, Piodi LP, Rinaudo L, Buonenna C, Sconfienza LM, Vergani L, Ulivieri FM (2020) Reproducibility of DXA-based bone strain index and the influence of body mass: an in vivo study. Radiol med 125, 313-318 https://doi.org/10.1007/s11547-019-01118-5

Messina C, Piodi LP et al. (2020) Artificial neural network analysis of bone quality DXA parameters response to teriparatide in fractured osteoporotic patients. PLoS One. doi: https://doi.org/10.1371/journal.pone.0229820

Ulivieri, F.M., Piodi, L.P., Rinaudo, L., Scanagatta, P. & Cesana, B.M. (2020) Bone Strain Index In The Prediction Of Vertebral Fragility RefractureEuropean Radiology Experimental 4:23 doi:10.1186/s41747-020-00151-8

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