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Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment.
Osteoporos Int. 2017 01; 28(1):329-338.OI

Abstract

This study evaluated the use of low-dose chest computed tomography (LDCT) for detecting bone fragility. LDCT-measured vertebral bone attenuation by volumetric methods showed good correlation with bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DXA, and good diagnostic performance for identifying osteoporosis and compression fractures. The results of this study suggest the feasibility of obtaining comprehensive information on bone health in subjects undergoing LDCT.

INTRODUCTION

Osteoporosis is a prevalent but underdiagnosed disease that increases fracture risk. This study evaluated the utility of vertebral attenuation derived from low-dose chest computed tomography (LDCT) compared to dual-energy x-ray absorptiometry (DXA) for detecting bone fragility.

METHODS

A total of 232 subjects (78 men and 154 women) aged above 50 years who underwent both LDCT and DXA within 30 days were evaluated. LDCT-measured bone attenuation in Hounsfield units (HU) of four vertebrae (T4, T7, T10, and L1) was evaluated using volumetric methods for correlation with DXA-measured bone mineral density (BMD) and for the diagnosis of compression fractures, osteoporosis, and low BMD (osteoporosis or osteopenia) in men and women, with DXA measurements as the reference standard.

RESULTS

The average attenuation of the four vertebrae showed strong correlation with DXA-measured BMD of the lumbar spine (r = 0.726, p < 0.05). In receiver-operating characteristic (ROC) analyses, the area under the curve (AUC) across LDCT-measured thresholds of the average attenuation to distinguish compression fractures was 0.827, and a threshold of 129.5 HU yielded 90.9 % sensitivity and 64.4 % specificity. Similarly, average attenuation showed high AUCs and good diagnostic performance for detecting osteoporosis and low BMD in both men and women. Among 44 subjects with compression fractures, the average bone attenuation showed strong negative correlation with both the worst fracture grade (r = -0.525, p < 0.05) and cumulative fracture grade score (r = -0.633, p < 0.05).

CONCLUSION

LDCT-measured bone attenuation by volumetric methods showed good correlation with BMD measured by DXA and good diagnostic performance for identifying bone fragility.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.Department of Radiology, Institute of Radiation Medicine, Seoul National University Medical Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea.Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea. mdyspark@gmail.com.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27480628

Citation

Kim, Y W., et al. "Vertebral Bone Attenuation On Low-dose Chest CT: Quantitative Volumetric Analysis for Bone Fragility Assessment." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 28, no. 1, 2017, pp. 329-338.
Kim YW, Kim JH, Yoon SH, et al. Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment. Osteoporos Int. 2017;28(1):329-338.
Kim, Y. W., Kim, J. H., Yoon, S. H., Lee, J. H., Lee, C. H., Shin, C. S., & Park, Y. S. (2017). Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(1), 329-338. https://doi.org/10.1007/s00198-016-3724-2
Kim YW, et al. Vertebral Bone Attenuation On Low-dose Chest CT: Quantitative Volumetric Analysis for Bone Fragility Assessment. Osteoporos Int. 2017;28(1):329-338. PubMed PMID: 27480628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment. AU - Kim,Y W, AU - Kim,J H, AU - Yoon,S H, AU - Lee,J H, AU - Lee,C-H, AU - Shin,C S, AU - Park,Y S, Y1 - 2016/08/01/ PY - 2015/12/11/received PY - 2016/07/26/accepted PY - 2016/8/3/pubmed PY - 2018/4/25/medline PY - 2016/8/3/entrez KW - Bone mineral density KW - Compression fracture KW - Low-dose chest CT KW - Osteoporosis KW - Volumetric analysis SP - 329 EP - 338 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 28 IS - 1 N2 - : This study evaluated the use of low-dose chest computed tomography (LDCT) for detecting bone fragility. LDCT-measured vertebral bone attenuation by volumetric methods showed good correlation with bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DXA, and good diagnostic performance for identifying osteoporosis and compression fractures. The results of this study suggest the feasibility of obtaining comprehensive information on bone health in subjects undergoing LDCT. INTRODUCTION: Osteoporosis is a prevalent but underdiagnosed disease that increases fracture risk. This study evaluated the utility of vertebral attenuation derived from low-dose chest computed tomography (LDCT) compared to dual-energy x-ray absorptiometry (DXA) for detecting bone fragility. METHODS: A total of 232 subjects (78 men and 154 women) aged above 50 years who underwent both LDCT and DXA within 30 days were evaluated. LDCT-measured bone attenuation in Hounsfield units (HU) of four vertebrae (T4, T7, T10, and L1) was evaluated using volumetric methods for correlation with DXA-measured bone mineral density (BMD) and for the diagnosis of compression fractures, osteoporosis, and low BMD (osteoporosis or osteopenia) in men and women, with DXA measurements as the reference standard. RESULTS: The average attenuation of the four vertebrae showed strong correlation with DXA-measured BMD of the lumbar spine (r = 0.726, p < 0.05). In receiver-operating characteristic (ROC) analyses, the area under the curve (AUC) across LDCT-measured thresholds of the average attenuation to distinguish compression fractures was 0.827, and a threshold of 129.5 HU yielded 90.9 % sensitivity and 64.4 % specificity. Similarly, average attenuation showed high AUCs and good diagnostic performance for detecting osteoporosis and low BMD in both men and women. Among 44 subjects with compression fractures, the average bone attenuation showed strong negative correlation with both the worst fracture grade (r = -0.525, p < 0.05) and cumulative fracture grade score (r = -0.633, p < 0.05). CONCLUSION: LDCT-measured bone attenuation by volumetric methods showed good correlation with BMD measured by DXA and good diagnostic performance for identifying bone fragility. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/27480628/Vertebral_bone_attenuation_on_low_dose_chest_CT:_quantitative_volumetric_analysis_for_bone_fragility_assessment_ L2 - https://doi.org/10.1007/s00198-016-3724-2 DB - PRIME DP - Unbound Medicine ER -