The Suitable Population for Opportunistic Low Bone Mineral Density Screening Using Computed Tomography.

Area of Science:

• Radiology
• Osteoporosis Research
• Medical Imaging Analysis

Background:

• Low bone mineral density (low-BMD) is a significant risk factor for fractures.
• Dual-energy X-ray absorptiometry (DXA) is the standard for BMD assessment, but computed tomography (CT) may offer an alternative.
• Trabecular bone density on CT scans can potentially indicate systemic bone health.

Purpose of the Study:

• To determine the optimal CT attenuation values for predicting low bone mineral density (low-BMD).
• To identify specific patient populations where CT-based BMD prediction is most effective.

Main Methods:

• Retrospective analysis of 1268 patients with concurrent chest CT and DXA scans.
• Measurement of CT attenuation values in the trabecular bone of the thoracic vertebra 7 (T7).
• Utilized Receiver Operating Characteristic (ROC) curves to assess diagnostic performance for low-BMD.

Main Results:

• Area Under the Curve (AUC) for low-BMD prediction was significantly higher in females (0.894) than males (0.744).
• Predictive ability improved with age but decreased with increasing height and weight.
• A CT threshold of 140.25 HU in females and 126.31 HU in individuals aged 70+ demonstrated high sensitivity (69.3% and 76.1%, respectively) at ~90% specificity.

Conclusions:

• CT attenuation values are a viable tool for predicting low-BMD, particularly in specific demographic groups.
• The findings suggest CT-based assessment is more effective for predicting low-BMD in females, the elderly, and individuals with lower height and weight.