Saudi Cultural Missions Theses & Dissertations
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Item Restricted Comparative analysis of magnetic resonance imaging- and computed tomography-based finite element approaches in estimating bone strength in children(Saudi Digital Library, 2025) Alasmari, Nayef Mohammed; Li, Xinshan; Offiah, AmakaThis PhD thesis compares magnetic resonance imaging (MRI)- and computed tomography (CT)-based finite element analysis (FEA) in estimating bone strength in children. A systematic review and meta-analysis (Chapter 3) was conducted and confirmed the reliability of MRI and FEA in assessing bone material properties and strength in adults but revealed limited paediatric research, identifying only one study. As segmentation is a critical step in FEA, we then conducted a comparative study (Chapter 4) to assess the accuracy and efficiency of ITK-SNAP, 3D Slicer and Amira™ using paired paediatric CT/MRI scans. ITK-SNAP and Amira™ were the most accurate, while 3D Slicer provided comparable results with greater efficiency and was selected for this thesis. Chapter 5 outlines the methodology used to compare MRI- and CT-based FEA in estimating bone strength in children without (n = 9; Chapter 6) and with (n = 8; Chapter 7) bone disease. In children without bone disease, MRI- and CT-based FEA exhibited strong correlation for tensile (ICC = 0.83) and moderate correlation for compressive (ICC = 0.61) failure loads, with MRI-based FEA consistently underestimating the failure loads. In children with bone disease, the modalities demonstrated moderate correlation for tensile (ICC = 0.60) and fair correlation for compressive (ICC = 0.40) failure loads, with similar underestimation of failure loads by MRI-based FEA. Discrepancies between MRI- and CT-based FEA tensile and compressive estimates did not significantly differ between children without and with bone disease (p = 0.386 and p = 0.441, respectively). Chapter 8 summarises the findings, limitations and future directions. Overall, MRI-based FEA showed similar trends to CT-based FEA in estimating bone strength in children, despite underestimating failure loads, particularly in proximal femurs and under compressive loading. With continued improvements in MRI resolution and FEA modelling, MRI-based FEA holds potential as a radiation-free alternative for paediatric bone strength assessment.55 0