Detection of abdominal aortic calcification with lateral spine imaging using DXA

Area of Science:

• Gerontology
• Radiology
• Cardiology

Background:

• Abdominal aortic calcification (AAC) is a predictor of cardiovascular disease (CVD) and mortality.
• Lateral spine imaging with dual-energy X-ray absorptiometry (DXA) is established for vertebral fracture assessment.
• The utility of lateral DXA for detecting AAC has not been previously explored.

Purpose of the Study:

• To investigate the efficacy of lateral DXA imaging in detecting abdominal aortic calcification (AAC).
• To compare the agreement between lateral DXA and standard radiography for AAC assessment.

Main Methods:

• Fifty-seven women aged 65+ with technically adequate lateral DXA and radiographic images were analyzed.
• Two blinded readers scored AAC on both radiographic and lateral DXA images using a validated 24-point scale.
• Intra-class correlation coefficients (ICCs) were calculated to assess inter-reader and inter-technology agreement.

Main Results:

• Very good agreement was observed between radiograph and lateral DXA AAC scores (ICC: 0.81-0.82).
• High inter-reader agreement was found for both radiography (ICC: 0.92) and lateral DXA (ICC: 0.89).
• Lateral DXA demonstrated high reliability for AAC assessment.

Conclusions:

• Lateral spine imaging using DXA is a reliable method for detecting abdominal aortic calcification (AAC).
• This technology offers potential for simultaneous assessment of vertebral fractures and AAC, a CVD risk factor.
• Lateral DXA presents a promising tool for integrated screening in older adults.