Project 443543

Osteoporosis is a condition where bones become fragile and more likely to break due to a decrease in bone mineral density and concurrent structural changes, leading to decreased bone strength. Unfortunately, fragility fractures, especially at the hip, are devastating for patients and place enormous burden on our healthcare system. Over a quarter of patients who suffer a hip fracture will die within a year. Assessing who is at risk of having a fracture is challenging because current clinical tools only account for bone density, not structure. Recent advances in medical imaging allow us to measure bone structure, also known as microarchitecture, in vivo, which has greatly advanced our understanding of human bone health. Our state-of-the-art imaging approach is based on high-resolution peripheral quantitative computed tomography, and we are international leaders in this technology. Through over a decade of research, we have established that there are recurring patterns of bone microarchitecture, and believe that using these patterns, we can advance our ability to develop personalized fracture risk screening tools. Current clinical tools are successful at identifying patients at high or low risk of fracture based on bone density and clinical risk factors. However, the majority of fractures occur in patients who fall between those limits. We have chosen to focus on patients whose bone density and clinical risk factors place them at moderate risk. We will develop a novel approach to quantify characteristics of bone microarchitecture that have been elusive to measure until now and use artificial intelligence techniques to classify bone phenotypes associated with fracture in the population. Our research will employ a fresh look at how we assess bone health using cutting-edge technology to establish the characteristics that underpin bone fragility. We aim to improve the stratification of fracture risk towards management and prevention of fragility fractures.