Musculoskeletal ImagingEffect of Statistically Iterative Image Reconstruction on Vertebral Bone Strength Prediction Using Bone Mineral Density and Finite Element Modeling: A Preliminary StudyAnitha, D. MEng*; Subburaj, Karupppasamy PhD*; Kopp, Felix K. MSc†; Mei, Kai MSc†; Foehr, Peter MSc‡; Burgkart, Rainer MD‡; Sollmann, Nico MD, PhD§; Maegerlein, Christian MD§; Kirschke, Jan S. MD§; Noel, Peter B. PhD†; Baum, Thomas MD, PhD§ Author Information From the *Engineering Product Development Pillar, Singapore University of Technology and Design, Singapore; †Department of Radiology, ‡Department of Orthopaedic Surgery, Biomechanical Laboratory, and §Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. Received for publication May 18, 2018; accepted June 29, 2018. Correspondence to: Karupppasamy Subburaj, PhD, Engineering Product Development Pillar, Singapore University of Technology and Design, 8 Somapah Road, 487372 Singapore (e-mail: [email protected]). This work was supported by the following research grants: Deutsche Forschungsgemeinschaft BA 4906/2-1 (T.B.), Technical University of Munich Faculty of Medicine KKF grant H01 (T.B.), and Singapore University of Technology and Design Start-up Research Grant SRG EPD 2015 093 (K.S.). The authors declare no conflict of interest. Journal of Computer Assisted Tomography: 1/2 2019 - Volume 43 - Issue 1 - p 61-65 doi: 10.1097/RCT.0000000000000788 Buy Metrics Abstract Statistical iterative reconstruction (SIR) using multidetector computed tomography (MDCT) is a promising alternative to standard filtered back projection (FBP), because of lower noise generation while maintaining image quality. Hence, we investigated the feasibility of SIR in predicting MDCT-based bone mineral density (BMD) and vertebral bone strength from finite element (FE) analysis. The BMD and FE-predicted bone strength derived from MDCT images reconstructed using standard FBP (FFBP) and SIR with (FSIR) and without regularization (FSIRB0) were validated against experimental failure loads (Fexp). Statistical iterative reconstruction produced the best quality images with regard to noise, signal-to-noise ratio, and contrast-to-noise ratio. Fexp significantly correlated with FFBP, FSIR, and FSIRB0. FFBP had a significant correlation with FSIRB0 and FSIR. The BMD derived from FBP, SIRB0, and SIR were significantly correlated. Effects of regularization should be further investigated with FE and BMD analysis to allow for an optimal iterative reconstruction algorithm to be implemented in an in vivo scenario. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.