Opportunistic Screening for Low Bone Density Using Automated Vertebral Trabecular CT Attenuation from Low-Dose CT...

Area of Science:

• Radiology
• Medical Imaging
• Bone Densitometry

Background:

• Low bone density is a significant health concern, often diagnosed using dual-energy X-ray absorptiometry (DXA).
• Routine FDG PET/CT scans offer a potential opportunity to assess bone density non-invasively.

Purpose of the Study:

• To evaluate the diagnostic performance of automated vertebral trabecular Hounsfield unit (HU) measurements from FDG PET/CT for identifying low bone density.
• To assess the correlation between HU metrics and DXA-derived bone mineral density (BMD).

Main Methods:

• Retrospective analysis of 131 women undergoing FDG PET/CT and DXA.
• Automated segmentation of lumbar vertebrae (L1-L4) using a deep learning model.
• Calculation of trabecular HU metrics and correlation with BMD; diagnostic performance assessed via ROC analysis.

Main Results:

• 35.9% of participants had low bone density.
• Automated mean HU demonstrated strong diagnostic performance (AUCs ranging from 0.845 to 0.861).
• L1 mean HU showed high correlation with BMD (r = 0.821) and independently predicted low bone density.

Conclusions:

• Automated vertebral trabecular HU assessment from routine FDG PET/CT is a reliable and efficient method for screening low bone density.
• This approach requires no additional radiation exposure or cost.
• It presents a valuable tool for opportunistic bone density screening in clinical practice.