Detection of trabecular bone microdamage by micro-computed tomography

Microdamage is an important component of bone quality and affects bone remodeling. Improved techniques to assess microdamage without the need for histological sectioning would provide insight into the role of microdamage in trabecular bone strength by allowing the spatial distribution of damage within the trabecular microstructure to be measured. Nineteen cylindrical trabecular bone specimens were prepared and assigned to two groups. The specimens in group I were damaged to 3% compressive strain and labeled with BaSO(4). Group II was not loaded, but was labeled with BaSO(4). Micro-computed tomography (Micro-CT) images of the specimens were obtained at 10 microm resolution. The median intensity of the treated bone tissue was compared between groups. Thresholding was also used to measure the damaged area fraction in the micro-CT scans. The histologically measured damaged area fraction, the median CT intensity, and the micro-CT measured damaged area fraction were all higher in the loaded group than in the unloaded group, indicating that the micro-CT images could differentiate the damaged specimen group from the unloaded specimens. The histologically measured damaged area fraction was positively correlated with the micro-CT measured damaged area fraction and with the median CT intensity of the bone, indicating that the micro-CT images can detect microdamage in trabecular bone with sufficient accuracy to differentiate damage levels between samples. This technique provides a means to non-invasively assess the three-dimensional distribution of microdamage within trabecular bone test specimens and could be used to gain insight into the role of trabecular architecture in microdamage formation.     

Trabecular bone microdamage and microstructural stresses under uniaxial compression

The balance between local remodeling and accumulation of trabecular bone microdamage is believed to play an important role in the maintenance of skeletal integrity. However, the local mechanical parameters associated with microdamage initiation are not well understood. Using histological damage labeling, micro-CT imaging, and image-based finite element analysis, regions of trabecular bone microdamage were detected and registered to estimated microstructural von Mises effective stresses and strains, maximum principal stresses and strains, and strain energy density (SED). Bovine tibial trabecular bone cores underwent a stepwise uniaxial compression routine in which specimens were micro-CT imaged following each compression step. The results indicate that the mode of trabecular failure observed by micro-CT imaging agreed well with the polarity and distribution of stresses within an individual trabecula. Analysis of on-axis subsections within specimens provided significant positive relationships between microdamage and each estimated tissue stress, strain and SED parameter. In a more localized analysis, individual microdamaged and undamaged trabeculae were extracted from specimens loaded within the elastic region and to the apparent yield point. As expected, damaged trabeculae in both groups possessed significantly higher local stresses and strains than undamaged trabeculae. The results also indicated that microdamage initiation occurred prior to apparent yield at local principal stresses in the range of 88-121 MPa for compression and 35-43 MPa for tension and local principal strains of 0.46-0.63% in compression and 0.18-0.24% in tension. These data provide an important step towards understanding factors contributing to microdamage initiation and establishing local failure criteria for normal and diseased trabecular bone.     

3D identification of trabecular bone fracture zone using an automatic image registration scheme: A validation study

Accurate identification of the local fracture zone is an important step towards the failure assessment of trabecular bone. In previous in-vitro studies, local fracture zones were visually identified in micro-CT images by experienced observers. This is a time-consuming and observer-dependent approach and it prevents any large-scale analysis of local trabecular fracture regions. The scope of this study is the application and validation of a new registration scheme for the automatic identification of trabecular bone fracture zones. Six human trabecular specimens were extracted from different anatomical sites. Five specimens were mechanically tested and scanned using micro-CT. For each specimen pre- and post-failure micro-CT datasets were obtained. The sixth specimen was scanned twice without any mechanical compression and was used to test the accuracy of the proposed scheme. The registration scheme was applied to the acquired datasets for the automatic identification of the fracture zone. The proposed scheme comprises of a three-dimensional (3D) automatic registration method to define the differences between the two datasets, and the application of a criterion for defining slices of the pre-failure dataset as broken or unbroken. Identifications of the fracture zones were qualitatively validated against visual identification of observers. Furthermore, full 3D fracture zone identification, based on the presented scheme, was proposed. The proposed scheme proved to be more accurate and significantly faster than the currently used visual process.     

Age-related differences in the morphology of microdamage propagation in trabecular bone

Microdamage density has been shown to increase with age in trabecular bone and is associated with decreased fracture toughness. Numerous studies of crack propagation in cortical bone have been conducted, but data in trabecular bone is lacking. In this study, propagation of severe, linear, and diffuse damage was examined in trabecular bone cores from the femoral head of younger (61.3±3.1 years) and older (75.0±3.9 years) men and women. Using a two-step mechanical testing protocol, damage was first initiated with static uniaxial compression to 0.8% strain then propagated at a normalized stress level of 0.005 to a strain endpoint of 0.8%. Coupling mechanical testing with a dual-fluorescent staining technique, the number and length/area of propagating cracks were quantified. It was found that the number of cycles to the test endpoint was substantially decreased in older compared to younger samples (younger: 77,372±15,984 cycles; older: 34,944±11,964 cycles, p=0.06). This corresponded with a greater number of severely damaged trabeculae expanding in area during the fatigue test in the older group. In the younger group, diffusely damaged trabeculae had a greater damage area, which illustrates an efficient energy dissipation mechanism. These results suggest that age-related differences in fatigue life of human trabecular bone may be due to differences in propagated microdamage morphology.     

Quantification of trabecular bone microdamage using the virtual internal bond model and the individual trabeculae segmentation technique

Trabecular bone microdamage significantly influences the skeletal integrity and bone remodelling process. In this paper a novel constitutive model, called the virtual internal bond model (VIB), was adopted for simulating the damage behaviour of bone tissue. A unique 3D image analysis technique, named individual trabeculae segmentation, was used to analyse the effects of microarchitectures on the damage behaviours of trabecular bone. We demonstrated that the process of initiation and accumulation of microdamage in trabecular bone samples can be captured by the VIB-embedded finite-element method simulation without a separate fracture criterion. Our simulation results showed that the microdamage can occur at as early as about 0.2–0.4% apparent strain, and a large volume of microdamage was accumulated around the apparent yield strain. In addition we found that the plate-like trabeculae, especially the longitudinal ones, take crucial roles in the microdamage behaviours of trabecular bone.     

Nonlinear behavior of trabecular bone at small strains

Study of the behavior of trabecular bone at strains below 0.40 percent is of clinical and biomechanical importance. The goal of this work was to characterize, with respect to anatomic site, loading mode, and apparent density, the subtle concave downward stress-strain nonlinearity, that has been observed recently for trabecular bone at these strains. Using protocols designed to minimize end-artifacts, 155 cylindrical cores from human vertebrae, proximal tibiae, proximal femora, and bovine proximal tibiae were mechanically tested to yield at 0.50 percent strain per second in tension or compression. The nonlinearity was quantified by the reduction in tangent modulus at 0.20 percent and 0.40 percent strain as compared to the initial modulus. For the pooled data, the mean +/- SD percentage reduction in tangent modulus at 0.20 percent strain was 9.07+/- 3.24 percent in compression and 13.8 +/- 4.79 percent in tension. At 0.40 percent strain, these values were 23.5 +/- 5.71 and 35.7+/- 7.10 percent, respectively. The magnitude of the nonlineari't depended on both anatomic site (p < 0.001) and loading mode (p < 0.001), and in tension was positively correlated with density. Calculated values of elastic modulus and yield properties depended on the strain range chosen to define modulus via a linear curve fit (p < 0.005). Mean percent differences in 0.20 percent offset yield strains were as large as 10.65 percent for some human sites. These results establish that trabecular bone exhibits nonlinearity at low strains, and that this behavior can confound intersite comparisons of mechanical properties. A nonlinear characterization of the small strain behavior of trabecular bone was introduced to characterize the initial stress-strain behavior more thoroughly.     

Mechanisms of uniformity of yield strains for trabecular bone

Variations in yield strains for trabecular bone within a specific anatomic site are only a small fraction of the substantial variations that exist for elastic modulus and strength, and yet the source of this uniformity is not known. Our goal was to investigate the underlying mechanisms by using high-resolution, materially nonlinear finite element models of 12 human femoral neck trabecular bone specimens. The finite element models, used to obtain apparent yield strains in both tension and compression, assumed that the tissue-level yield strains were the same across all specimens. Comparison of the model predictions with the experimental data therefore enabled us to isolate the combined roles of volume fraction and architecture from the role of tissue material properties. Results indicated that, for both tensile and compressive loading, natural variations in volume fraction and architecture produced a negligible coefficient of variation (less than 3%) in apparent yield strains. Analysis of tissue-level strains showed that while bending of individual trabeculae played only a minor role in the apparent elastic behavior, the combined effects of this bending and tissue-level strength asymmetry produced apparent-level failure strains in compression that were 14% lower than those at the tissue level. By contrast, tissue and apparent-level yield strains were equivalent for tensile loading. We conclude that the uniformity of apparent yield strains is primarily the result of the highly oriented architecture that minimizes bending. Most of the variation that does occur is the result of the non-uniformity of the tissue-level yield strains.     

Microdistribution and local dosimetry of 226Ra in trabecular bone of the beagle

Sections of lumbar vertebral bodies of young adult beagle dogs have been analyzed autoradiographically to characterize and quantify the local distribution of 226Ra by means of a scanning microscope photometer. The animals received a single injection of 355 kBq/kg body weight and were serially sacrificed at 5 to 1381 days postinjection. Hotspot concentrations decreased from about 51 kBq/g bone at 5 days to 20 kBq/g at 1381 days postinjection. The diffuse concentration changed from 8.3 to 1.9 kBq/g. The mean 226Ra concentration in the trabecular areas scanned was initially higher and at the end of the observation period lower than the average calculated for the whole lumbar vertebral column. Density and area of, and fraction of bone activity in, hotspots virtually remained constant. With time hotspots tended to become translocated into bone volume. Mean dose rates to lining cells from both hotspots and diffuse labels decreased from about 210 mGy/d at early postinjection times to 105 mGy/d. This corresponds to 2.5 to 1.1 times the average skeletal dose rate. A discussion of the level of irradiation in terms of hit frequencies shows that osteoblasts in the initial phase of hotspot formation receive about 60 hits to their nucleus for the duration of bone formation. After about 6 months, however, the 226Ra concentration in new bone and the corresponding hit frequency appears to be low enough that interference with bone formation is unlikely. Morphometric measurements showed that abnormal bone accretion and thickening of trabeculae occurred. This was interpreted as an imbalance between bone formation and resorption. Both formation and resorption seem to be substantially lowered compared to control animals.     

Medical image registration using Edgeworth-based approximation of Mutual Information

We propose a new similarity measure for iconic medical image registration, an Edgeworth-based third order approximation of Mutual Information (MI) and named 3-EMI. Contrary to classical Edgeworth-based MI approximations, such as those proposed for independent component analysis, the 3-EMI measure is able to deal with potentially correlated variables. The performance of 3-EMI is then evaluated and compared with the Gaussian and B-Spline kernel-based estimates of MI, and the validation is leaded in three steps. First, we compare the intrinsic behavior of the measures as a function of the number of samples and the variance of an additive Gaussian noise. Then, they are evaluated in the context of multimodal rigid registration, using the RIRE data. We finally validate the use of our measure in the context of thoracic monomodal non-rigid registration, using the database proposed during the MICCAI EMPIRE10 challenge. The results show the wide range of clinical applications for which our measure can perform, including non-rigid registration which remains a challenging problem. They also demonstrate that 3-EMI outperforms classical estimates of MI for a low number of samples or a strong additive Gaussian noise. More generally, our measure gives competitive registration results, with a much lower numerical complexity compared to classical estimators such as the reference B-Spline kernel estimator, which makes 3-EMI a good candidate for fast and accurate registration tasks.     

Contribution of inter-site variations in architecture to trabecular bone apparent yield strains

Apparent yield strains for trabecular bone are uniform within an anatomic site but can vary across site. The overall goal of this study was to characterize the contribution of inter-site differences in trabecular architecture to corresponding variations in apparent yield strains. High-resolution, small deformation finite element analyses were used to compute apparent compressive and tensile yield strains in four sites (n = 7 specimens per site): human proximal tibia, greater trochanter, femoral neck, and bovine proximal tibia. These sites display differences in compressive, but not tensile, apparent yield strains. Inter-site differences in architecture were captured implicitly in the model geometries, and these differences were isolated as the sole source of variability across sites by using identical tissue properties in all models. Thus, the effects inter-site variations in architecture on yield strain could be assessed by comparing computed yield strains across site. No inter-site differences in computed yield strains were found for either loading mode (p > 0.19), indicating that, within the context of small deformations, inter-site variations in architecture do not affect apparent yield strains. However, results of ancillary analyses designed to test the validity of the small deformation assumption strongly suggested that the propensity to undergo large deformations constitutes an important contribution of architecture to inter-site variations in apparent compressive yield strains. Large deformations substantially reduced apparent compressive, but not tensile, yield strains. These findings indicate the importance of incorporating large deformation capabilities in computational analyses of trabecular bone. This may be critical when investigating the biomechanical consequences of trabecular thinning and loss.     

Accuracy and precision of digital volume correlation in quantifying displacements and strains in trabecular bone

Strain measurement is an essential tool in the study of trabecular bone structure-function relationships. Digital volume correlation (DVC) is a measurement technique that quantifies strains throughout the interior of a specimen, rather than simply those on the surface. DVC relies on tracking the movement of microstructural features, and as such, the accuracy and precision of this technique may depend on trabecular structure. This study quantified displacement and strain measurement errors in six types of trabecular bone that spanned a wide range of volume fraction and trabecular architecture. Accuracy and precision were compared across bone type and also across three DVC methods. Both simulated and real displacement fields were analyzed using micro-computed tomography images of specimens from the bovine distal femur, bovine proximal tibia, rabbit distal femur, rabbit proximal tibia, rabbit vertebra, and human vertebra. Differences as large as three-fold in accuracy and precision of the displacements and strains were found among DVC methods and among bone types. The displacement precision and the strain accuracy and precision were correlated with measures of trabecular structure such as structural model index. These results demonstrate that the performance of the DVC technique can depend on trabecular structure. Across all bone types, the displacement and strain errors ranged 1.86-3.39 microm and 345-794 microepsilon, respectively. For specimens from the human vertebra and bovine distal femur, the measurement errors were approximately 20 times smaller than the yield strain. In these cases, DVC is a viable technique for measuring pre- and post-yield strains throughout trabecular bone specimens and the trabecular compartment of whole bones.     

Two-dimensional gel electrophoresis image registration using block-matching techniques and deformation models

Block-matching techniques have been widely used in the task of estimating displacement in medical images, and they represent the best approach in scenes with deformable structures such as tissues, fluids, and gels. In this article, a new iterative block-matching technique—based on successive deformation, search, fitting, filtering, and interpolation stages—is proposed to measure elastic displacements in two-dimensional polyacrylamide gel electrophoresis (2D–PAGE) images. The proposed technique uses different deformation models in the task of correlating proteins in real 2D electrophoresis gel images, obtaining an accuracy of 96.6% and improving the results obtained with other techniques. This technique represents a general solution, being easy to adapt to different 2D deformable cases and providing an experimental reference for block-matching algorithms.     

Interrelationship of trabecular mechanical and microstructural properties in sheep trabecular bone

The ability to evaluate fracture risk at an early time point is essential for improved prognostics as well as enhanced treatment in cases of bone loss such as from osteoporosis. Improving the diagnostic ability is inherent upon both high-resolution non-invasive imaging, and a thorough understanding of how the derived indices of structure and density relate to its true mechanical behavior. Using sheep femoral trabecular bone with a range of strength, the interrelationship of mechanical and microstructural parameters was analyzed using multi-directional mechanical testing and micro-computed tomography. Forty-five cubic trabecular bone samples were harvested from 23 adult female sheep, some of whom had received hind-limb vibratory stimuli over the course of 2 years with consequently enhanced mechanical properties. These samples were pooled into a low, medium, or high strength group for further analysis. The findings show that microCT indices that are structural in nature, e.g., structural model index (SMI) (r2=0.85, p<0.0001) is as good as more density oriented indices like bone volume/total volume (BV/TV) (r2=0.81, p<0.0001) in predicting the ultimate strength of a region of trabecular bone. Additionally, those indices more related to global changes in trabecular structure such as connectivity density (ConnD) or degree of anisotropy (DA) are less able to predict the mechanical properties of bone. Interrelationships of trabecular indices such as trabecular number (TbN), thickness (TbTh), and spacing (TbSp) provide clues as to how the trabecular bone will remodel to ultimately achieve differences in the apparent mechanical properties. For instance, the analysis showed that a loss of bone primarily affects the connectedness and overall number of trabeculae, while increased strength results in an increase of the overall thickness of trabeculae while not improving the connectedness. Certainly, the microCT indices studied are able to predict the bulk mechanical properties of a trabecular ROI well, leaving unaccounted only about 15-20% of its inherent variability. Diagnostically, this implies that future work on the early prediction of fracture risk should continue to explore the role of bone quality as the key factors or as an adjuvant to bone quantity (e.g., apparent density).     

Simulation of vertebral trabecular bone loss using voxel finite element analysis

Trabecular bone loss in human vertebral bone is characterised by thinning and eventual perforation of the horizontal trabeculae. Concurrently, vertical trabeculae are completely lost with no histological evidence of significant thinning. Such bone loss results in deterioration in apparent modulus and strength of the trabecular core. In this study, a voxel-based finite element program was used to model bone loss in three specimens of human vertebral trabecular bone. Three sets of analyses were completed. In Set 1, strain adaptive resorption was modelled, whereby elements which were subject to the lowest mechanical stimulus (principal strain) were removed. In Set 2, both strain adaptive and microdamage mechanisms of bone resorption were included. Perforation of vertical trabeculae occurred due to microdamage resorption of elements with strains that exceeded a damage threshold. This resulted in collapse of the trabecular network under compression loading for two of the specimens tested. In Set 3, the damage threshold strain was gradually increased as bone loss progressed, resulting in reduced levels of microdamage resorption. This mechanism resulted in trabecular architectures in which vertical trabeculae had been perforated and which exhibited similar apparent modulus properties compared to experimental values reported in the literature. Our results indicate that strain adaptive remodelling alone does not explain the deterioration in mechanical properties that have been observed experimentally. Our results also support the hypothesis that horizontal trabeculae are lost principally by strain adaptive resorption, while vertical trabeculae may be lost due to perforation from microdamage resorption followed by rapid strain adaptive resorption of the remaining unloaded trabeculae.     

Prediction of trabecular bone principal structural orientation using quantitative ultrasound scanning

Bone has the ability to adapt its structure in response to the mechanical environment as defined as Wolff's Law. The alignment of trabecular structure is intended to adapt to the particular mechanical milieu applied to it. Due to the absence of normal mechanical loading, it will be extremely important to assess the anisotropic deterioration of bone during the extreme conditions, i.e., long term space mission and disease orientated disuse, to predict risk of fractures. The propagation of ultrasound wave in trabecular bone is substantially influenced by the anisotropy of the trabecular structure. Previous studies have shown that both ultrasound velocity and amplitude is dependent on the incident angle of the ultrasound signal into the bone sample. In this work, seven bovine trabecular bone balls were used for rotational ultrasound measurement around three anatomical axes to elucidate the ability of ultrasound to identify trabecular orientation. Both ultrasound attenuation (ATT) and fast wave velocity (UV) were used to calculate the principal orientation of the trabecular bone. By comparing to the mean intercept length (MIL) tensor obtained from μCT, the angle difference of the prediction by UV was 4.45°, while it resulted in 11.67° angle difference between direction predicted by μCT and the prediction by ATT. This result demonstrates the ability of ultrasound as a non-invasive measurement tool for the principal structural orientation of the trabecular bone.     

Head and neck lymph node region delineation with image registration

Background  

The success of radiation therapy depends critically on accurately delineating the target volume, which is the region of known or suspected disease in a patient. Methods that can compute a contour set defining a target volume on a set of patient images will contribute greatly to the success of radiation therapy and dramatically reduce the workload of radiation oncologists, who currently draw the target by hand on the images using simple computer drawing tools. The most challenging part of this process is to estimate where there is microscopic spread of disease.     

Testing two predictions for fracture load using computer models of trabecular bone

Aging induces several types of architectural changes in trabecular bone including thinning, increased levels of anisotropy, and perforation. It has been determined, on the basis of analysis of mathematical models, that reduction in fracture load caused by perforation is significantly higher than those due to equivalent levels of thinning or anisotropy. The analysis has also provided an expression which relates the fractional reduction of strength tau to the fraction of elements nu that have been removed from a network. Further, it was proposed that the ratio Gamma of the elastic constant of a sample and its linear response at resonance can be used as a surrogate for tau. Experimental validation of these predictions requires following architectural changes in a given sample of trabecular bone; techniques to study such changes using microcomputed tomography are only beginning to be available. In the present study, we use anatomically accurate computer models constructed from digitized images of bone samples for the purpose. Images of healthy bone are subjected to successive levels of synthetic degradation via surface erosion. Computer models constructed from these images are used to calculate their fracture load and other mechanical properties. Results from these computations are shown to be consistent with predictions derived from the analysis of mathematical models. Although the form of tau(nu) is known, parameters in the expression are expected to be sample-specific, and hence nu is not a reliable predictor of strength. We provide an example to demonstrate this. In contrast, analysis of model networks shows that the linear part of tau(Gamma) depends only on the structure of trabecular bone. Computations on models constructed from samples of iliac crest trabecular bone are shown to be in agreement with this assertion. Since Gamma can be computed from a vibrational assessment of bone, we argue that the latter can be used to introduce new surrogates for bone strength and hence diagnostic tools for osteoporosis.     

Measurement of structural anisotropy in femoral trabecular bone using clinical-resolution CT images

Discrepancies in finite-element model predictions of bone strength may be attributed to the simplified modeling of bone as an isotropic structure due to the resolution limitations of clinical-level Computed Tomography (CT) data. The aim of this study is to calculate the preferential orientations of bone (the principal directions) and the extent to which bone is deposited more in one direction compared to another (degree of anisotropy). Using 100 femoral trabecular samples, the principal directions and degree of anisotropy were calculated with a Gradient Structure Tensor (GST) and a Sobel Structure Tensor (SST) using clinical-level CT. The results were compared against those calculated with the gold standard Mean-Intercept-Length (MIL) fabric tensor using micro-CT. There was no significant difference between the GST and SST in the calculation of the main principal direction (median error=28°), and the error was inversely correlated to the degree of transverse isotropy (r=−0.34, p<0.01). The degree of anisotropy measured using the structure tensors was weakly correlated with the MIL-based measurements (r=0.2, p<0.001). Combining the principal directions with the degree of anisotropy resulted in a significant increase in the correlation of the tensor distributions (r=0.79, p<0.001). Both structure tensors were robust against simulated noise, kernel sizes, and bone volume fraction. We recommend the use of the GST because of its computational efficiency and ease of implementation. This methodology has the promise to predict the structural anisotropy of bone in areas with a high degree of anisotropy, and may improve the in vivo characterization of bone.     

Incorporating tissue anisotropy and heterogeneity in finite element models of trabecular bone altered predicted local stress distributions

Trabecular bone is composed of organized mineralized collagen fibrils, which results in heterogeneous and anisotropic mechanical properties at the tissue level. Recently, biomechanical models computing stresses and strains in trabecular bone have indicated a significant effect of tissue heterogeneity on predicted stresses and strains. However, the effect of the tissue-level mechanical anisotropy on the trabecular bone biomechanical response is unknown. Here, a computational method was established to automatically impose physiologically relevant orientation inherent in trabecular bone tissue on a trabecular bone microscale finite element model. Spatially varying tissue-level anisotropic elastic properties were then applied according to the bone mineral density and the local tissue orientation. The model was used to test the hypothesis that anisotropy in both homogeneous and heterogeneous models alters the predicted distribution of stress invariants. Linear elastic finite element computations were performed on a 3 mm cube model isolated from a microcomputed tomography scan of human trabecular bone from the distal femur. Hydrostatic stress and von Mises equivalent stress were recorded at every element, and the distributions of these values were analyzed. Anisotropy reduced the range of hydrostatic stress in both tension and compression more strongly than the associated increase in von Mises equivalent stress. The effect of anisotropy was independent of the spatial redistribution high compressive stresses due to tissue elastic heterogeneity. Tissue anisotropy and heterogeneity are likely important mechanisms to protect bone from failure and should be included for stress analyses in trabecular bone.     

Comparison of trabecular bone behavior in core and whole bone samples using high-resolution modeling of a vertebral body

Computational analysis of trabecular bone normally involves the modeling of (experimental tests of) cored samples. However, the lack of constraint on the sides of the extracted trabecular bone samples limits the information that can be inferred regarding true in situ behavior. Here, the element-by-element voxel-based finite element method was applied via, a custom-written software suite (FEEBE), to a 72 μm resolution model of an ovine vertebra. The difference between the apparent modulus of eight concentric core cylinders when modeled as part of the whole bone (containing 84 × 10⁶ degrees of freedom) and independent of the whole bone was investigated. The results showed that cored trabecular bone apparent modulus depended significantly on the core diameter when modeled as an extracted core (r ² = 0.975) and as part of a whole bone (r ² = 0.986). The cause of this result was separated into the side-artifact effect and bone volume fraction (BV/TV) effect. For the independently modeled cores, the apparent modulus of an inner core region of interest varied with increasing thickness of the outer annulus. This was attributed to the side-artifact effect, given that the BV/TV of the core region was constant. Within the whole trabecular structure, the side artifact was eliminated as the entire bone structure was modeled. However, a BV/TV effect influenced the apparent modulus depending on the size of the core selected for determining apparent modulus. Changing the size of the core varied the overall BV/TV of the core, and this significantly (r ² = 0.999) influences the apparent modulus. Therefore, determining a ‘true’ apparent modulus for trabecular bone was not achievable. The independently modeled cores consistently under-predict the in vivo apparent modulus. It is recommended that if a ‘true’ apparent modulus is required, the BV/TV at which it is required needs to be first determined. Apparent modeling of entire bones at microscale resolution allowed regions of low and high tissue strains to be identified, consistent with patterns of trabecular bone remodeling and resorption reported in literature. The basivertebral vein cavity underwent the highest strains within the entire vertebral body, suggesting that failure might initiate here, despite containing visibly thicker struts and plate trabeculae. Although computationally expensive, analysis of the entire vertebral body provided a full picture of in situ trabecular bone deformation.