Comparison of anatomic coordinate systems with rigid multi-resolution 3D registration for the reproducible positioning of analysis volumes of interest in QCT

In this study we compared two approaches that have recently been used to minimize precision errors in 3D quantitative computed tomography (QCT) images of the hip and the spine in order to optimize the detection of longitudinal changes in bone mineral density (BMD). In 30 subjects we obtained baseline and 1 year follow-up 3D CT scans of the proximal femur and the spine. QCT analysis was applied to a variety of volumes of interest (VOIs) automatically positioned relative to anatomic coordinate systems (ACS). In the first approach (A1) baseline and follow-up scans were analyzed independently. In the second approach (A2) a 3D versor-based rigid intensity registration method was applied to match baseline and follow-up images, and the baseline ACS was mapped on the follow-up image using the registration transformation. Afterwards, the analysis VOIs were again independently calculated for baseline and follow-up images. There were no significant differences of percent BMD changes between baseline and follow-up images between A1 and A2 for any of the VOIs investigated. With advanced image processing methods a time-consuming 3D registration between baseline and follow-up images before the analysis does not improve analysis precision compared to the use of anatomical coordinate systems.