Cortical thickness estimation of the proximal femur from multi-view Dual-Energy X-ray Absorptiometry (DXA)

Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 ± 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 ± 0:79 mm. © 2013 SPIE.

Sensitivity analysis and optimization of the nuclear fuel cycle

A sensitivity study has been conducted to assess the robustness of the conclusions presented in the MIT Fuel Cycle Study. The Once Through Cycle (OTC) is considered as the base-line case, while advanced technologies with fuel recycling characterize the alternative fuel cycles. The options include limited recycling in LWRs and full recycling in fast reactors and in high conversion LWRs. Fast reactor technologies studied include both oxide and metal fueled reactors. The analysis allowed optimization of the fast reactor conversion ratio with respect to desired fuel cycle performance characteristics. The following parameters were found to significantly affect the performance of recycling technologies and their penetration over time: Capacity Factors of the fuel cycle facilities, Spent Fuel Cooling Time, Thermal Reprocessing Introduction Date, and incore and Out-of-core TRU Inventory Requirements for recycling technology. An optimization scheme of the nuclear fuel cycle is proposed. Optimization criteria and metrics of interest for different stakeholders in the fuel cycle (economics, waste management, environmental impact, etc.) are utilized for two different optimization techniques (linear and stochastic). Preliminary results covering single and multi-variable and single and multi-objective optimization demonstrate the viability of the optimization scheme.