Digitised X-ray approach could improve osteoporosis diagnosis

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A computerised approach to examining patient bone X-rays for the diagnosis of osteoporosis could side-step the subjectivity associated with visual examination.

Neelesh Kumar of the Central Scientific Instruments Organisation in Chandigarh, India, and colleagues have developed the approach founded on the digitisation of X-ray images and estimation of the bone porosity associated with osteoporosis based on computer algorithm.

According to a statement, X-rays are normally used for the diagnosis of osteoporosis when other more expensive or inconvenient tests such as dual X-ray absorptiometry are precluded.

X-ray examination usually confirms the diagnosis at the severe or late stage of development. However, a computerised system could allow much earlier diagnosis to be made and so give patients the opportunity to be treated more successfully before the disorder becomes a potentially debilitating illness.

The addition of a reference index to the X-ray image is said to be key to the success of the new computerised technique.

In conventional methods, the X-ray source quality, the film and its processing quality are possible sources of error, but in the new system these sources are all but removed by the digital index on the film, the team said.

The team has tested the system on 40 elderly Asian patients with known diagnoses. Nine out of 10 of the females had osteoporosis, and the condition was found in almost two thirds of the men.

The team, which claims the error rate is less than two per cent, has begun the compilation of a knowledge base containing validated X-ray images with which the computer algorithm compares new X-rays.

This database can be added to with new verified images once a definitive diagnosis has been made, so the system is expected to improve with use.

‘The new tool is a cost-effective solution as it uses the existing facilities available in hospitals and thus imparts no extra financial burden on healthcare providers or patients for quantitative estimation of osteoporosis,’ the researchers said.

They added that the same computerised diagnosis could be adapted to analyse bone deformity, scoliosis measurement, X-ray cracks and fractures.

A paper detailing the research appears in International Journal of Biomedical Engineering and Technology published in October.