To evaluate the value of L1 cortical bone quantitative CT parameters in predicting osteoporosis

To explore the changing trends of cortical bone of the first lumbarvertebral body (L1_{cortical bone}) measured by the CT spinal bone quantitative system with age, sex, and volume bone mineral density(vBMD), as well as their predictive value in osteoporosis.

A retrospective analysis was conducted on 169 participants who underwent simultaneous chest-abdominal or lumbar spine computed tomography (CT) and quantitative computed tomography (QCT) scans. All participants were stratified by sex (male and female) and further divided into three age groups: 50-59 years, 60-69 years, and ≥ 70 years. Based on QCT results, participants were categorized into two groups: non-osteoporosis (including normal bone mass and osteopenia) and osteoporosis. The average density, average thickness, average area and the total volume of L1_{cortical bone} were measured using a CT spinal bone quantification system. A one-way analysis of variance (ANOVA) was employed to compare differences in the aforementioned parameters among different age and vBMD groups, while receiver operating characteristic (ROC) curve analysis was used to evaluate their efficacy in predicting osteoporosis.

For all participants and the female subgroup, there were statistically significant differences in the average thickness, average area, and total volume of L1_{cortical bone} among the 50-59, 60-69, and ≥ 70 year age groups, with all parameters showing a decreasing trend with increasing age. Additionally, statistically significant differences were observed in the average thickness, average area, and total volume of L1_{cortical bone} among the normal, osteopenia, and osteoporosis groups, and these parameters exhibited a decreasing trend with decreasing vBMD. In the male subgroup, the area under the ROC curve (AUC) values of the three parameters (average thickness, average area, and total volume) for detecting osteoporosis were 0.77, 0.83, and 0.84, respectively. The average thickness of L1_{cortical bone} demonstrated the highest sensitivity (82.89%), whereas the average area showed the highest specificity (90.00%). A similar trend was observed in the female participants.

The quantitative parameters including the average thickness, average area, and total volume of L1_{cortical bone} measured by the CT spinal bone quantitative system appear to show a downward trend with increasing age and decreasing vBMD, and may potentially help in detecting osteoporosis.