Osteoporosis screening using QCT-based cutoff value of Hounsfield units in patients with degenerative lumbar diseases
Da Zou1,2, Xuan He1,2, Zesen Shang1
1Orthopaedics Department, Peking University Third Hospital, Haidian, Beijing, China.
Insights
This study establishes Hounsfield unit (HU) cutoff values for osteoporosis screening using computed tomography (CT) in patients with degenerative lumbar disease. A 110 HU cutoff identifies osteoporosis, and 160 HU identifies osteopenia, aiding in bone density assessment.
Area of Science:
- Radiology
- Orthopedics
- Osteoporosis Research
Background:
- Degenerative lumbar diseases often coexist with osteoporosis.
- Accurate osteoporosis screening is crucial for fracture prevention in this population.
- Quantitative computed tomography (QCT) provides reliable bone mineral density (BMD) measurements.
Purpose of the Study:
- To determine Hounsfield unit (HU) cutoff values for osteoporosis screening in patients with degenerative lumbar diseases.
- To establish the relationship between computed tomography (CT) HU values and QCT-measured bone mineral density (BMD).
Main Methods:
- Retrospective analysis of 136 patients (≥50 years) with degenerative lumbar diseases.
- Measurement of L1-2 QCT-BMD and CT values from the same imaging data.
- Linear regression analysis to correlate CT values with QCT-BMD and establish cutoff points.
Main Results:
- Prevalence of osteoporosis, osteopenia, and normal BMD was 33.8%, 51.5%, and 14.7%, respectively.
- A strong correlation (r > 0.9) was found between CT values and QCT-BMD.
- Established cutoff values: 110 HU for osteoporosis and 160 HU for osteopenia, with high sensitivity and specificity.
Conclusions:
- CT-derived Hounsfield units are effective for osteoporosis screening in degenerative lumbar disease patients.
- QCT-based cutoff values of 110 HU (osteoporosis) and 160 HU (osteopenia) are proposed.
- These findings facilitate non-BMD-specific CT scans for osteoporosis assessment.
Purpose:
In patients with degenerative lumbar diseases, we aimed to establish the cutoff value of Hounsfield units (HU) for osteoporosis screening on the basis of the relationship between computed tomography (CT) HU value and volume bone mineral density (BMD) measured by quantitative computed tomography (QCT).
Methods:
A total of 136 patients aged ≥ 50 years with degenerative lumbar diseases were retrospectively included. Their QCT-BMD of L1-2 were recorded, and the CT values of L1-2 were measured with the same CT images of QCT. The degree of bone loss was evaluated with the criteria based on QCT-BMD: cutoff value of 80 mg/cm3 for osteoporosis and cutoff value of 120 mg/cm3 for osteopenia. The cutoff of CT value was acquired according to the linear regression equation between CT value and QCT-BMD.
Results:
The rate of osteoporosis, osteopenia, normal BMD was 33.8% (46/136), 51.5% (70/136), and 14.7% (20/136), respectively. The Pearson correlation coefficients between CT value and QCT-BMD were over 0.9 (P < 0.05). The cutoff of average CT value of L1-2 was calculated and adjusted to 110HU for osteoporosis and 160HU for osteopenia according the equation: average QCT-BMD of L1-2 = 0.76 ✕ average CT value of L1-2-0.46 (R2 = 0.931, P < 0.001). Cutoff value of 110HU was 91.2% (42/46) sensitive and 88.9% (80/90) specific for identifying osteoporosis. The cutoff value of 160HU was 95.0% (19/20) sensitive and 96.6% (112/116) specific for distinguishing normal BMD from abnormal BMD (osteoporosis and osteopenia).
Conclusion:
The CT value is effective in osteoporosis screening, and the QCT-based cutoff value is 110 HU for osteoporosis and 160 HU for osteopenia in the patients with degenerative lumbar disease.
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