Ayşegül CANSU
(Karadeniz Teknik Üniversitesi)
(Sivas Numune Hastanesi)
(Karadeniz Teknik Üniversitesi)
(Karadeniz Teknik Üniversitesi)
Yıl: 2020Cilt: 50Sayı: 1ISSN: 1300-0144 / 1303-6165Sayfa Aralığı: 110 - 116İngilizce

56 0
Diagnostic efficacy of routine contrast-enhanced abdominal CT for the assessment of osteoporosis in the Turkish population
Background/aim: This study aimed to evaluate the diagnostic efficacy of vertebral Hounsfield unit (HU) values on routine contrastenhanced abdominal computed tomography (CT) scans for the assessment of osteoporosis using dual-energy X-ray absorptiometry (DXA) T-scores as a reference standard. Materials and methods: A total of 111 consecutive patients who underwent contrast-enhanced abdominal CT examination for any indication and DXA within a 6-month period were retrospectively analyzed. The CT attenuation values of trabecular bone in HUs were measured in axial and sagittal planes from lumbar vertebrae 1–4 (L1–L4). The correlation between the DXA T-scores and HU values measured on the CT scans was evaluated by Pearson’s correlation test. Areas under the curves (AUCs) were calculated by receiver operating characteristic analysis for diagnostic proficiency, and threshold values were determined. Paired t-test and Bland–Altman plot test were used to evaluate the correlation between axial and sagittal HU values. Results: There was a strong correlation between the DXA T-scores and HU values of all the lumbar vertebrae (P < 0.001). The highest correlation was for the L3 vertebra; L3 was thus chosen for additional analyses. The mean axial and sagittal L3 attenuations were 133.7 HU and 131.9 HU, respectively. The axial measurements were not significantly different from the sagittal measurements, with a mean difference of 1.8 HU (P > 0.05). The L3 axial CT attenuation threshold for 90% sensitivity was 170 HU and that for 90% specificity was 102 HU for distinguishing osteoporosis from osteopenia and normal bone mineral density (BMD). To distinguish the low BMD group from the normal group, the L3 axial CT attenuation threshold for approximately 90% sensitivity was 102 HU and for 90% specificity was 165 HU. Conclusion: The HUs derived from routine contrast-enhanced abdominal CT scans can be used for the evaluation of osteoporosis, without additional radiation exposure and cost.
Fen > Tıp > Cerrahi
DergiAraştırma MakalesiErişime Açık
  • 1. National Institute of Health. Consensus Development Conference: Diagnosis, prophylaxis and treatment of osteoporosis. American Journal of Medicine 1993; 94: 645-650.
  • 2. Cohen AJ, Roe FJC. Review of risk factors for osteoporosis with particular reference to a possible aetiological role of dietary salt. Food and Chemical Toxicology 2000; 38: 237-253.
  • 3. Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporosis International 1997; 7: 407-413.
  • 4. Cooper C, Campion G, Melton L 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporosis International 1992; 2: 285-289.
  • 5. Masi L. Epidemiology of osteoporosis. Clinical Cases in Mineral and Bone Metabolism 2008; 5: 11-13.
  • 6. WHO. WHO Scientific Group Report on the Assessment of Osteoporosis at Primary Health Care Level. Report of a WHO Scientific Group; Summary Meeting Report. Brussels, Belgium, 5–7 May 2004. Geneva, Switzerland: WHO; 2004.
  • 7. Leslie WD, Giangregorio LM, Yogendran M, Azimaee M, Morin S et al. A population-based analysis of the postfracture care gap 1996-2008: the situation is not improving. Osteoporosis International 2012; 23: 1623-1629.
  • 8. Watts NB. Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporosis International 2004; 15: 847-854.
  • 9. Carberry GA, Pooler BD, Binkley N, Lauder TB, Bruce RJ et al. Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology 2013; 268: 120-126.
  • 10. Pickhardt PJ, Bodeen G, Brett A, Brown JK, Binkley N. Comparison of femoral neck BMD evaluation obtained using lunar DXA and QCT with asynchronous calibration from CT colonography. Journal of Clinical Densitometry 2015; 18: 5-12.
  • 11. Pickhardt PJ, Lee LJ, Del Rio AM, Lauder T, Bruce RJ et al. Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. Journal of Bone and Mineral Research 2011; 26: 2194-2203.
  • 12. Pickhardt PJ, Pooler BD, Lauder T, Del Rio AM, Bruce RJ et al. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Annals of Internal Medicine 2013; 158: 588-595.
  • 13. Summers RM, Baecher N, Yao J, Liu J, Pickhardt PJ et al. Feasibility of simultaneous computed tomographic colonography and fully automate bone mineral densitometry in a single examination. Journal of Computer Assisted Tomography 2011; 35: 212-216.
  • 14. Gausden EB, Nwachukwu BU, Schreiber JJ, Lorich DG, Lane JM. Opportunistic use of CT imaging for osteoporosis screening and bone density assessment: a qualitative systematic review. Journal of Bone & Joint Surgery 2017; 99: 1580-1590.
  • 15. Pickhardt PJ, Lauder T, Pooler BD, Del Rio AM, Rosas H et al. Effect of IV contrast on lumbar trabecular attenuation at routine abdominal CT: correlation with DXA and implications for opportunistic osteoporosis screening. Osteoporosis International 2016; 27: 147-152.
  • 16. Pompe E, Willemink MJ, Dijkhuis GR, Verhaar HJJ, Mohamed Hoesein FAA et al. Intravenous contrast injection significantly affects bone mineral density measured on CT. European Radiology 2015; 25: 283-289.
  • 17. Alacreu E, Moratal D, Arana E. Opportunistic screening for osteoporosis by routine CT in Southern Europe. Osteoporosis International 2017; 28: 983-990.
  • 18. Ward RJ, Roberts CC, Bencardino JT, Arnold E, Baccei SJ et al. ACR appropriateness criteria: Osteoporosis and bone mineral density. Journal of the American College of Radiology 2017; 14: S189-S202.
  • 19. Kara K, Sivrioglu AK, Aribal S, Ozyürek S, Saglam M et al. The diagnosis of osteoporosis by measuring lumbar vertebrae density with MDCT: a comparative study with quantitative computerized tomography (QCT). Acta Medica Mediterranea 2013; 29: 775-779.
  • 20. Lee SJ, Binkley N, Lubner MG, Bruce RJ, Ziemlewicz TJ et al. Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density. Osteoporosis International 2016; 27: 1131-1136.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.