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Opportunistic screening for osteoporosis on routine computed tomography? An external validation study.
Eur Radiol. 2015 Jul; 25(7):2074-9.ER

Abstract

OBJECTIVES

Opportunistic screening for osteoporosis using computed tomography (CT) examinations that happen to visualise the spine can be used to identify patients with osteoporosis. We sought to verify the diagnostic performance of vertebral Hounsfield unit (HU) measurements on routine CT examinations for diagnosing osteoporosis in a separate, external population.

METHODS

Consecutive patients who underwent a CT examination of the chest or abdomen and had also received a dual-energy X-ray absorptiometry (DXA) test were retrospectively included. CTs were evaluated for vertebral fractures and vertebral attenuation (density) values were measured. Diagnostic performance measures and the area under the receiver operator characteristics curve (AUC) for diagnosing osteoporosis were calculated.

RESULTS

Three hundred and two patients with a mean age of 57.9 years were included, of which 82 (27%) had osteoporosis according to DXA and 65 (22%) had vertebral fractures. The diagnostic performance for vertebral HU measurements was modest, with a maximal AUC of 0.74 (0.68 - 0.80). At that optimal threshold the sensitivity was 62% (51 - 72%) and the specificity was 79% (74 - 84%).

CONCLUSIONS

We confirmed that simple trabecular vertebral density measurements on routine CT contain diagnostic information related to bone mineral density as measured by DXA, albeit with substantially lower diagnostic accuracy than previously reported.

KEY POINTS

• We externally validated the value of vertebral trabecular bone attenuation for osteoporosis • These diagnostic performance measures were, however, substantially lower than previously reported • This information might be useful when considering the implementation of opportunistic osteoporosis screening.

Authors+Show Affiliations

Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands, cfmbuckens@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

25591750

Citation

Buckens, Constantinus F., et al. "Opportunistic Screening for Osteoporosis On Routine Computed Tomography? an External Validation Study." European Radiology, vol. 25, no. 7, 2015, pp. 2074-9.
Buckens CF, Dijkhuis G, de Keizer B, et al. Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. Eur Radiol. 2015;25(7):2074-9.
Buckens, C. F., Dijkhuis, G., de Keizer, B., Verhaar, H. J., & de Jong, P. A. (2015). Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. European Radiology, 25(7), 2074-9. https://doi.org/10.1007/s00330-014-3584-0
Buckens CF, et al. Opportunistic Screening for Osteoporosis On Routine Computed Tomography? an External Validation Study. Eur Radiol. 2015;25(7):2074-9. PubMed PMID: 25591750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. AU - Buckens,Constantinus F, AU - Dijkhuis,Gawein, AU - de Keizer,Bart, AU - Verhaar,Harald J, AU - de Jong,Pim A, Y1 - 2015/01/17/ PY - 2014/06/10/received PY - 2014/12/22/accepted PY - 2014/10/23/revised PY - 2015/1/17/entrez PY - 2015/1/17/pubmed PY - 2015/12/30/medline SP - 2074 EP - 9 JF - European radiology JO - Eur Radiol VL - 25 IS - 7 N2 - OBJECTIVES: Opportunistic screening for osteoporosis using computed tomography (CT) examinations that happen to visualise the spine can be used to identify patients with osteoporosis. We sought to verify the diagnostic performance of vertebral Hounsfield unit (HU) measurements on routine CT examinations for diagnosing osteoporosis in a separate, external population. METHODS: Consecutive patients who underwent a CT examination of the chest or abdomen and had also received a dual-energy X-ray absorptiometry (DXA) test were retrospectively included. CTs were evaluated for vertebral fractures and vertebral attenuation (density) values were measured. Diagnostic performance measures and the area under the receiver operator characteristics curve (AUC) for diagnosing osteoporosis were calculated. RESULTS: Three hundred and two patients with a mean age of 57.9 years were included, of which 82 (27%) had osteoporosis according to DXA and 65 (22%) had vertebral fractures. The diagnostic performance for vertebral HU measurements was modest, with a maximal AUC of 0.74 (0.68 - 0.80). At that optimal threshold the sensitivity was 62% (51 - 72%) and the specificity was 79% (74 - 84%). CONCLUSIONS: We confirmed that simple trabecular vertebral density measurements on routine CT contain diagnostic information related to bone mineral density as measured by DXA, albeit with substantially lower diagnostic accuracy than previously reported. KEY POINTS: • We externally validated the value of vertebral trabecular bone attenuation for osteoporosis • These diagnostic performance measures were, however, substantially lower than previously reported • This information might be useful when considering the implementation of opportunistic osteoporosis screening. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/25591750/Opportunistic_screening_for_osteoporosis_on_routine_computed_tomography_An_external_validation_study_ L2 - https://dx.doi.org/10.1007/s00330-014-3584-0 DB - PRIME DP - Unbound Medicine ER -