Integrated analysis of clinical indicators and mechanical properties in cancellous bone

• HU value is recognized as a reliable microstructure indicator for cancellous bone. • Linear relationships between HU and BMD , volume fraction, mass density are established. • Positive correlations between HU, modulus, and strength are observed in the current work where weak linear correlations are observed. • Marrow-removal significantly affects CT imaging and mechanical properties. Cancellous bone plays a critical role as a shock absorber in the human skeletal system. Accurate assessment of its microstructure and mechanical properties is crucial for osteoporosis diagnosis and treatment. However, various methods with different indicators are adopted currently in the clinical and laboratory assessments which lead to confusion and inconvenience for cancellous bone analysis. In the current work, correlations among clinical indicators including CT-derived Hounsfield Unit (HU) & bone mineral density (BMD), laboratory indicators (mass density & volume fraction), and mechanical properties (modulus & strength) are explored. The results show that different indicators can be linearly linked through the HU value which can be adopted as a good microstructure indicator of cancellous bone. Additionally, the impacts of cancellous bone specimen preparation on clinical CT imaging and mechanical properties are also investigated. The results indicate common marrow-removal treatment can lead to decrease in mean HU value, deviation in HU value distribution, while it will increase the modulus and strength. The current work provides a valuable insight into the cancellous properties based on comprehensive analysis on the clinical and laboratory assessments which is critical for accurate diagnosis and personalized treatment.