Distribution and variability study of the femur cortical thickness from computer tomography

In the context of patient-specific 3D bone reconstruction, enhancing the surface with cortical thickness (COT) opens a large field of applications for research and medicine. This functionality calls for database analysis for better knowledge of COT. Our study provides a new approach to reconstruct 3D internal and external cortical surfaces from computer tomography (CT) scans and analyses COT distribution and variability on a set of asymptomatic femurs. The reconstruction method relies on a short (∼5 min) initialisation phase based on 3D reconstruction from biplanar CT-based virtual X-rays and an automatic optimisation phase based on intensity-based cortical structure detection in the CT volume, the COT being the distance between internal and external cortical surfaces. Surfaces and COT show root mean square reconstruction errors below 1 and 1.3 mm. Descriptions of the COT distributions by anatomical regions are provided and principal component analysis has been applied. The first mode, 16–50% of the variance, corresponds to the variation of the mean COT around its averaged shape; the second mode, 9–28%, corresponds to a fine variation of its shape. A femur COT model can, therefore, be described as the averaged COT distribution in which the first parameter adjusts its mean value and a second parameter adjusts its shape.