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Roux C, Rozes A, Reizine D, et al. Fully automated opportunistic screening of vertebral fractures and osteoporosis on more than 150,000 routine computed tomography scans. Rheumatology (Oxford). 2021;doi: 10.1093/rheumatology/keab878.
Roux, C., Rozes, A., Reizine, D., Hajage, D., Daniel, C., Maire, A., Bréant, S., Taright, N., Gordon, R., Fechtenbaum, J., Kolta, S., Feydy, A., Briot, K., & Tubach, F. (2021). Fully automated opportunistic screening of vertebral fractures and osteoporosis on more than 150,000 routine computed tomography scans. Rheumatology (Oxford, England), . https://doi.org/10.1093/rheumatology/keab878
Roux, Christian, et al. "Fully automated opportunistic screening of vertebral fractures and osteoporosis on more than 150,000 routine computed tomography scans." Rheumatology (Oxford, England) vol. (2021). doi: https://doi.org/10.1093/rheumatology/keab878
Roux C, Rozes A, Reizine D, Hajage D, Daniel C, Maire A, Bréant S, Taright N, Gordon R, Fechtenbaum J, Kolta S, Feydy A, Briot K, Tubach F. Fully automated opportunistic screening of vertebral fractures and osteoporosis on more than 150,000 routine computed tomography scans. Rheumatology (Oxford). 2021 Nov 30; doi: 10.1093/rheumatology/keab878. Epub 2021 Nov 30. PMID: 34850864.
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Rheumatology (Oxford). 2021 Nov 30; doi: 10.1093/rheumatology/keab878. Epub 2021 Nov 30.

Fully automated opportunistic screening of vertebral fractures and osteoporosis on more than 150,000 routine computed tomography scans.

Rheumatology (Oxford, England)

Christian Roux, Antoine Rozes, Daniel Reizine, David Hajage, Christel Daniel, Aurélien Maire, Stéphane Bréant, Namik Taright, Ronen Gordon, Jacques Fechtenbaum, Sami Kolta, Antoine Feydy, Karine Briot, Florence Tubach

Affiliations

  1. INSERM UMR 1153, APHP. Centre-Université de Paris, Institut de Recherche des Maladies Ostéo-Articulaires de l'Université de Paris, Hôpital Cochin, Paris, France.
  2. AP-HP. Sorbonne Université, Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, F75013, Paris, France.
  3. AP-HP, Direction des Systèmes d'Information, Paris, France.
  4. Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, F75013, Paris, France.
  5. AP-HP, Direction des Systèmes d'Information, Pôle Innovation et Données, Paris, France.
  6. INSERM UMRS 1142, France.
  7. AP-HP, Direction de la Stratégie et de la Transformation, Pôle Sciences des données et Information médicale, Paris, France.
  8. Zebra Medical Vision, Ltd, Shefayim, Israël.
  9. APHP. Centre-Université de Paris, Hôpital Cochin, Paris, France.
  10. Service de Radiologie ostéo-articulaire, Hôpital Cochin, Collégiale de Radiologie, AP-HP, France.

PMID: 34850864 DOI: 10.1093/rheumatology/keab878

Abstract

OBJECTIVE: Osteoporosis is underdiagnosed and undertreated, although severe complications of osteoporotic fractures, including vertebral fractures, are well known. This study sought to assess the feasibility and results of an opportunistic screening of vertebral fractures and osteoporosis in a large database of lumbar or abdominal CT scans.

MATERIAL AND METHODS: Data were analyzed from CT scans obtained in 35 hospitals from patients aged 60 years and more and stored in a Picture Archiving and Communication System in Assistance-Publique-Hôpitaux de Paris, from 2007 to 2013. Dedicated software analyzed the presence of at least 1 vertebral fracture (VF), and measured Hounsfield Units (HU) in lumbar vertebrae. A simulated T-score was calculated.

RESULTS: Data were analyzed from 152 268 patients (73.2 ± 9.07 years). Success rates for VF assessment and HU measurements were 82 and 87% respectively. Prevalence of VF was 24.5% and increased with age. Areas under the receiver operating characteristic curves for the detection of VF were 0.61 and 0.62 for mean HU of lumbar vertebrae and L1 HU, respectively. In patients without VF, HU decreased with age, similarly in males and females. The prevalence of osteoporosis (sT-score ≤ - 2.5) was 23.8% and 36.5% in patients without and with VFs respectively.

CONCLUSION: Opportunistic screening in patients 60 years and older having lumbar or abdominal CT scans is feasible at large scale to screen vertebral fractures and osteoporosis.

© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Keywords: administrative databases; fracture; opportunistic screening; osteoporosis; screening; vertebral fracture

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