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Burke CJ, Didolkar MM, Barnhart HX, et al. The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis. Clin Cases Miner Bone Metab. 2016;13(2):135-140doi: 10.11138/ccmbm/2016.13.2.135.
Burke, C. J., Didolkar, M. M., Barnhart, H. X., & Vinson, E. N. (2016). The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 13(2), 135-140. https://doi.org/10.11138/ccmbm/2016.13.2.135
Burke, Christopher John, et al. "The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis." Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases vol. 13,2 (2016): 135-140. doi: https://doi.org/10.11138/ccmbm/2016.13.2.135
Burke CJ, Didolkar MM, Barnhart HX, Vinson EN. The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis. Clin Cases Miner Bone Metab. 2016 May-Aug;13(2):135-140. doi: 10.11138/ccmbm/2016.13.2.135. Epub 2016 Oct 05. PMID: 27920811; PMCID: PMC5119712.
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Clin Cases Miner Bone Metab. 2016 May-Aug;13(2):135-140. doi: 10.11138/ccmbm/2016.13.2.135. Epub 2016 Oct 05.

The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis.

Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases

Christopher John Burke, Manjiri M Didolkar, Huiman X Barnhart, Emily N Vinson

Affiliations

  1. Hospital for Joint Diseases, NYU Langone Medical Center, Department of Radiology, Division of Musculoskeletal Radiology, NY, NY, USA.
  2. Duke University Medical Center, Department of Radiology, Division of Musculoskeletal Radiology, Durham, NC, USA.
  3. Duke University, Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, NC, USA.

PMID: 27920811 PMCID: PMC5119712 DOI: 10.11138/ccmbm/2016.13.2.135

Abstract

OBJECTIVES: To evaluate whether lumbar vertebral body density CT attenuation values measured in Hounsfield Units (HUs) on routine Computed Tomography (CT) examinations can be reliably measured with limited variability, and to evaluate for a correlation between HUs and bone mineral density as measured by dual energy X-ray absorptiometry (DXA) scan.

METHODS: Retrospective review of a total of 249 routine MDCT examinations, performed to measure HUs at the first non-rib bearing lumbar vertebral body on axial images, cross-referenced to the lateral scout image.

RESULTS: The overall ICC and RC for intra-reader variability on CT HU were 0.987 (95% CI 0.973 - 0.999) and 15.664 (95% CI 11.66-16.97). The overall ICC and RDC for inter-reader variability on CT HU were 0.952 (95% CI 0.892 - 0.999) and 30.20 (95% CI 23.73 - 34.48). The ICC and RC for interscanner variability were 0.98 (95% CI 0.95 - 0.99) and 16.67 (95% CI 13.13 - 22.85). The correlation between the L1 HUs and L1 BMD, L1 t-score, and overall t-score was 0.437, 0.392, and 0.400, respectively.

CONCLUSIONS: CT attenuation values of the first lumbar vertebra can be measured on routine abdomen CTs with limited variability despite multiple readers and scanners. Correlation between HU and BMD as measured by DXA scan was only weakly positive, and by this method measuring the density of a lumbar vertebral body from a routine MDCT scan does not provide the sensitivity or specificity necessary for a screening test. However above a certain measured value (180 HU), patients have a low chance of osteoporosis and therefore may not need additional screening, potentially limiting radiation exposure and cost.

Keywords: bone mineral density; computed tomography; dual-energy X-ray absorptiometry; osteoporosis

Conflict of interest statement

No conflict of interest.

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