Abstract About 1.8 million new cancer cases are estimated in the US in 2019 from which 50–85% might metastasize to the thoracic and lumbar spines. Subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) is a promising used tool to predict vertebral fracture properties. The aims of this study were twofold: First, to develop an optimized equation for the elastic modulus accounting for all input parameters in FE modeling of fracture properties. Second, to assess the effect of lesion size and location on the predicted fracture loads. An inverse QCT/FEA method was implemented to determine optimal coefficients for the modulus equation as a function of ash density. Lesions of 16 and 20 mm were then virtually located at the center, off-centered, anterior, and posterior regions of the vertebrae. A total of 6426 QCT/FEA models were run to optimize the coefficients and evaluate the effect of lesions on fracture properties. QCT/FEA predicted stiffness showed high correlations (50%) with the experimentally measured values. Compared to a 16 mm lesion size, a 20 mm lesion had a reduction in failure load of 55%, 57%, 52%, and 44% at the center, off-centered, anterior cortex, and pedicle, respectively (p < 0.001). Lesions affecting mostly trabecular bone showed the largest reduction in predicted failure loads (about 55%), and females presented weaker outcomes than males. An optimal elastic modulus equation resulted in accurate vertebral stiffness predictions. A deterioration of the trabecular bone due to the presence of a lesion highly affected the predicted fracture loads, and this reduction was significantly higher in females compared to males.

中文翻译：

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使用优化的灰密度-模量方程，转移病灶大小和位置对椎骨承载能力的影响

摘要 2019 年美国估计约有 180 万新癌症病例，其中 50-85% 可能转移到胸椎和腰椎。基于特定对象的定量计算机断层扫描有限元分析 (QCT/FEA) 是一种很有前途的用于预测椎骨骨折特性的工具。这项研究的目的有两个：首先，开发一个优化的弹性模量方程，考虑到断裂特性有限元建模中的所有输入参数。其次，评估病变大小和位置对预测骨折负荷的影响。实施逆 QCT/FEA 方法来确定作为灰分密度函数的模量方程的最佳系数。16 和 20 毫米的病变实际上位于椎骨的中心、偏心、前部和后部区域。共运行 6426 个 QCT/FEA 模型以优化系数并评估损伤对断裂特性的影响。QCT/FEA 预测刚度显示出与实验测量值的高度相关性 (50%)。与 16 mm 病灶大小相比，20 mm 病灶在中心、偏心、前皮质和椎弓根处的失效载荷分别降低了 55%、57%、52% 和 44%（p < 0.001 ）。主要影响小梁骨的病变显示预测失败负荷的最大减少（约 55%），女性的结果比男性弱。最佳弹性模量方程导致准确的椎体刚度预测。由于病变的存在而导致的骨小梁退化极大地影响了预测的骨折负荷，