Three-dimensional methods for quantification of cancellous bone architecture

Recent development in three-dimensional (3-D) imaging of cancellous bone has made possible true 3-D quantification of trabecular architecture. This provides a significant improvement of the tools available for studying and understanding the mechanical functions of cancellous bone. This article reviews the different techniques for 3-D imaging, which include serial sectioning, X-ray tomographic methods, and NMR scanning. Basic architectural features of cancellous bone are discussed, and it is argued that connectivity and architectural anisotropy (fabric) are of special interest in mechanics-architecture relations. A full characterization of elastic mechanical properties is, with traditional mechanical testing, virtually impossible, but 3-D reconstruction in combination with newly developed methods for large-scale finite element analysis allow calculations of all elastic properties at the cancellous bone continuum level. Connectivity has traditionally been approached by various 2-D methods, but none of these methods have any known relation to 3-D connectivity. A topological approach allows unbiased quantification of connectivity, and this further allows expressions of the mean size of individual trabeculae, which has previously also been approached by a number of uncertain 2-D methods. Anisotropy may be quantified by fundamentally different methods. The well-known mean intercept length method is an interface-based method, whereas the volume orientation method is representative of volume-based methods. Recent studies indicate that volume-based methods are at least as good as interface-based methods in predicting mechanical anisotropy. Any other architectural property may be quantified from 3-D reconstructions of cancellous bone specimens as long as an explicit definition of the property can be given. This challenges intuitive and vaguely defined architectural properties and forces bone scientists toward 3-D thinking.