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Opportunistic Screening for Osteoporosis by CT as Compared with DXA
Molaya Chaisen1,2, Chanika Sritara1, Niyata Chitrapazt3
1Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Diagnostics (Basel, Switzerland)
|January 8, 2025
Summary
Non-contrast computed tomography (CT) scans can opportunistically screen for osteoporosis. Specific Hounsfield unit (HU) thresholds in L1-L4 vertebrae show high sensitivity for detecting low bone mineral density (BMD).
Area of Science:
- Radiology
- Osteoporosis Research
- Medical Imaging Analysis
Background:
- Osteoporosis diagnosis commonly relies on dual-energy X-ray absorptiometry (DXA).
- Non-contrast computed tomography (CT) offers potential for opportunistic osteoporosis screening.
- Evaluating CT attenuation values for osteoporosis assessment is an area of interest.
Purpose of the Study:
- To assess screening thresholds for osteoporosis using CT attenuation values (Hounsfield units, HU).
- To compare CT-based HU measurements of L1-L4 vertebrae with DXA assessments of bone mineral density (BMD).
Main Methods:
- Retrospective analysis of 109 patients with both CT and DXA scans within 12 months.
- Exclusion of patients with metal artifacts impacting vertebral analysis.
- Measurement of CT attenuation values in the trabecular region of L1-L4 vertebrae and comparison with DXA T-scores.
Main Results:
- Moderate correlation (r=0.542) observed between L1-L4 vertebral HU values and lowest DXA T-score.
- A threshold of ≤142 HU at L1 showed 91.9% sensitivity and 48.4% specificity for osteoporosis screening.
- A threshold of ≤160 HU at L1 demonstrated 97.3% sensitivity and 31.3% specificity.
Conclusions:
- Non-contrast CT is supported as an opportunistic tool for osteoporosis assessment.
- Specific Hounsfield unit thresholds can aid in opportunistic osteoporosis screening via CT scans.
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