Quantitative computed tomography of bone

Computed tomography (CT) is well accepted as an imaging procedure, but comparatively little effort has been made to utilize the potential capability of CT to quantify tissue densities and composition. There are two reasons for this. First, precision and accuracy of quantification are limited by nonlinear effects. These effects are nonlocal and are object and scanner dependent. Second, intraindividual and interindividual variations of tissue compositions are considerable. Single energy measurements require restrictive assumptions on tissue compositions. The diagnosis and treatment monitoring of osteopenic bone diseases with low-dose CT is given as an example of a successful application of quantitative CT. With a special-purpose CT system and an analytic procedure for the quantification of bone at peripheral measuring sites, longitudinal examinations were performed. Low-dose quantitative CT permitted quantification, on an individual basis, of the bone loss of immobilization osteoporosis on a week-by-week basis. Changes due to postmenopausal osteoporosis are less drastic, and so measurement at intervals of months is adequate. In women after menopause, 3-month intervals were used in evaluating the natural course of osteoporosis and in quantifying the effects of sodium fluoride treatment on trabecular bone. Low-dose quantitative CT has proved to be a sensitive and highly reproducible procedure for the noninvasive evaluation of bone loss or bone accretion. During a disease or therapy, each patient can be evaluated individually.