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Revealing the cortical thickness from DXA

3D-DXA is a software solution that reconstructs bony structures in 3D from Dual-energy X-ray Absorptiometry (DXA) [1]. It allows clinicians to assess the cortical bone and trabecular macrostructure in routine clinical practice.


3D-DXA incorporates a statistical model built from a database of quantitative computed tomography scans. The shape and density variations in the first three principal directions are shown [1].
3D-DXA registers the statistical model onto the DXA projection of the patient. The algorithm maximizes the similarity between the projection of the model and the DXA image [1].
2D-3D.gif3D-DXA estimates the cortical thickness and density by the fitting a mathematical function onto the density profiles measured along the normal vector at each vertex of the femoral shape [2].


3D-DXA calculates: the cortical volumetric density, the cortical thickness, the trabecular volumetric density (at specific regions of interest [1]).
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3D Patient-Specific Model

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As a result of the registration, we get a 3D patient-specific model of the femoral shape and bone density.

Cortical Thickness Distribution

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The cortical thickness distribution is automatically calculated.

3D-DXA features:
  • Available for most DXA scanners
  • Integrated into routine DXA workflow
  • Automatic generation and printing of 3D-DXA report
  • Clinical module to monitor patients’ 3D-DXA measurements
  • Automated analysis of retrospective data


3D-DXA has been evaluated in several peer-reviewed publications worldwide. A multicentre clinical comparing 3D-DXA with Computed Tomography (CT) [1] showed that:

  • 3D-DXA Femoral shape accuracy was 0.9 mm
  • 3D-DXA Cortical thickness accuracy was 0.3 mm
  • Correlation coefficients between 3D-DXA and CT measurements at the total femur were 0.91 for the cortical thickness, 0.94 for the cortical density, 0.85 for the trabecular density, and 0.95 for the integral density

Clinical studies using 3D-DXA have evaluated subjects with pathologies such as osteoporosis, diabetes, HIV or cancer. Some studies have included subjects under pharmacological treatments or athletes. Details on those studies can be found here.

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[1] Humbert L, Martelli Y, Fonolla R, et al 2017 3D-DXA: Assessing the Femoral Shape, the Trabecular Macrostructure and the Cortex in 3D from DXA images. IEEE Trans Med Imaging 36:27–39.

[2] Humbert L, Hazrati Marangalou J, del Río Barquero LM, et al 2016 Technical Note: Cortical thickness and density estimation from clinical CT using a prior thickness-density relationship. Med Phys 43:1945–1954.

See the full list: 3D-DXA Publications.

Disclaimer & Regulatory Information

3D-DXA must be used by trained medical professionals or technicians who are qualified to perform clinical analyses.
3D-DXA is intended for research use and should not be used for diagnosis or treatment planning.
3D-DXA is currently under CE marking process.