Novel strategies for the characterization of cancellous bone morphology: Virtual isolation and analysis

Objectives: The advent of micro-computed tomography (μCT) made cancellous bone more accessible than ever before. Nevertheless, the characterization of cancellous bone is made difficult by its inherent complexity and the difficulties in defining homology across datasets. Here we propose novel virtual methodological approaches to overcome those issues and complement existing methods. Materials and methods: We present a protocol for the isolation of the whole cancellous region within a μCT scanned bone. This method overcomes the subsampling issues and allows studying cancellous bone as a single unit. We test the protocol on a set of primate bones. In addition, we describe a set of morphological indices calculated on the topological skeleton of the cancellous bone: node density, node connectivity, trabecular angle, trabecular tortuosity, and fractal dimension. The usage of the indices is shown on a small comparative sample of primate femoral heads. Results: The isolation protocol proves reliable in isolating cancellous structures from several different bones, regardless of their shape. The indices seem to detect some functional differences, although further testing on comparative samples is needed to clarify their potential for the study of cancellous architecture. Conclusions: The approaches presented overcome some of the difficulties of trabecular bone studies. The methods presented here represent an alternative or supporting method to the existing tools available to address the biomechanics of cancellous bone.