CT2S - Computer Tomography to Strength

Digital Twin Application for patient treatment & BoneStrength: In Silico Trials solution

 A Use Case by

Short description

The CT2S (Computer Tomography to Strength) application was designed to predict the risk of hip fracture at the time of a CT scan, creating a patient-specific finite-element model of the femur. The CT2S pipeline comprises femur geometry segmentation, high-quality 3D mesh generation, element-wise material property mapping, and eventually finite-element model simulation. By using a disease progression model, this is now being extended to assess the Absolute Risk of Fracture up to 10 years (ARF10). In parallel with this, a solution known as BoneStrength is being developed (based on algorithms in CT2S and ARF10) to build an in silico trial application for bone-related drugs and treatments. Currently, the BoneStrength pipeline is being used on a cohort of 1000 digital patients to simulate the effect of an osteoporosis drug.

Results & Achievements

  • M. Taylor, M. Viceconti, P. Bhattacharya, X. Li 2021. “Finite element analysis informed var-iable selection for femoral fracture risk predic-tion”, Journal of the Mechanical Behavior of Biomedical Materials, in press.
  • C. Winsor, X. Li, M. Qasim, C.R. Henak, P.J. Pickhardt, H. Ploeg, M. Viceconti 2021. “Eval-uation of patient tissue selection methods for deriving equivalent density calibration for femo-ral bone quantitative CT analyses”, Bone, 143, 115759.
  • Z. Altai, E. Montefiori, B. van Veen, M. A. Paggiosi, E. V. McCloskey, M. Viceconti, C. Mazzà, X. Li 2021. “Femoral neck strain pre-diction during level walking using a combined musculoskeletal and finite element model ap-proach”, PLoS ONE, 68. https://doi.org/10.1371/journal.pone.0245121

The codes are currently running on three HPC clusters, namely, ShARC (Tier-3, hosted by University of Sheffield, England), Cartesius (Tier-1, hosted by SURF, The Netherlands), and Galileo (Tier-1, hosted by CINECA, Italy).

Objectives

  • To develop an efficient digital twin solution for the estimation of long bone fracture risk in elderly patients (CT2S solution)
  • To not only be able to evaluate the bone strength at present, but also predict the changes in the next 10 years (ARF10 solution)
  • To extend the digital twin solution to predict other types of fracture, such as the vertebral
  • To enable the running of large scale in silico clinical trials (BoneStrength solution, with a current target for bone treatments)
  • To port these solutions on multiple HPC platforms across Europe and solve potential scalability issues

Technologies

CT2S
ARF10
BoneStrength

Use Case Owner

Marco Viceconti
University of Bologna

Collaborating Institutions

University of Bologna
University of Sheffield