ISSN 1004-4140
CN 11-3017/P
Turn off MathJax
Article Contents
Abstract
References
LI Y J, ZHAO J L, ZHANG J K, et al. L1 Vertebral CT Attenuation Value in Abdominal CT Scanning for the Opportunistic Screening of Osteoporosis[J]. CT Theory and Applications, xxxx, x(x): 1-7. DOI: 10.15953/j.ctta.2024.134. (in Chinese).
Citation: LI Y J, ZHAO J L, ZHANG J K, et al. L1 Vertebral CT Attenuation Value in Abdominal CT Scanning for the Opportunistic Screening of Osteoporosis[J]. CT Theory and Applications, xxxx, x(x): 1-7. DOI: 10.15953/j.ctta.2024.134. (in Chinese).
shu

L1 Vertebral CT Attenuation Value in Abdominal CT Scanning for the Opportunistic Screening of Osteoporosis

  • 1.

    Department of Medical Imaging, the Affiliated Hospital of Hebei University of Engineering, Handan 056001, China

  • 2.

    Department of Radiology and Nuclear Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China

More Information
  • Received Date: July 16, 2024
  • Revised Date: September 22, 2024
  • Accepted Date: October 11, 2024
  • Available Online: November 26, 2024
    Graphical Abstract
    • Abstract

  • Objective: This study investigates the feasibility and diagnostic value of L1 vertebral computed tomography (CT) attenuation for the opportunistic screening of osteoporosis via routine abdominal CT scans. Methods: Data from 1117 patients who underwent quantitative computed tomography (QCT) and abdominal CT were analyzed retrospectively. The bone mineral density (BMD) and CT attenuation values of the L1 and L2 vertebrae were measured, and patients were divided into three groups according to the BMD measured using QCT: osteoporosis, osteopenia, or normal BMD. The correlation between the two measurements was analyzed. The L1 attenuation CT value was measured by two observers at two time points separated by at least two weeks. Bland–Altman plots were used to assess the agreement between the predicted and measured QCT values. Receiver operating characteristic (ROC) curves were generated to determine the optimal diagnostic thresholds and the area under the curve (AUC). Results: The L1 and L2 vertebral CT attenuation values correlated well with the QCT BMD values (correlation coefficients of 0.956 and 0.902; all P < 0.001). There was excellent intra- and interobserver agreement in the L1 vertebral attenuation CT value measurements (ICC = 0.995 and 0.985) for the two observers. An analysis of the Bland–Altman plot showed that there was good agreement between the predicted and measured QCT BMD values. The CT and mean CT attenuation values from the L1 and L2 vertebrae predicted osteoporosis and normal BMD with high accuracy. The CT attenuation values of the L1 and L2 vertebrae predicted osteoporosis and normal BMD with high accuracy but no significant differences. The AUC of the L1 and L2 vertebrae CT attenuation values and combined mean CT attenuation values of L1 and L2 for predicting osteoporosis were 0.982, 0.977, and 0.984, respectively, and those for predicting normal BMD were 0.969, 0.964, and 0.970, respectively. The optimal thresholds of the L1 vertebrae for predicting osteoporosis and normal BMD were 106.33 HU and 149.33 HU, respectively. Conclusion: L1 vertebral CT attenuation values on abdominal CT scans are highly reliable and valuable for opportunistic osteoporosis screening. Thus, the L1 vertebral attenuation CT value can be used for opportunistic osteoporosis screening.

    • FullText(HTML)
    • References (19)
  • [1]
    PATEL N, DAHL K, O'ROURKE R, et al. Vertebral CT attenuation outperforms standard clinical fracture risk prediction tools in detecting osteoporotic disease in lung cancer screening participants[J]. The British Journal of Radiology, 2023, 96(1151): 20220992. DOI: 10.1259/bjr.20220992.
    [2]
    EMOHARE O, DITTMER A, MORGAN R A, et al. Osteoporosis in acute fractures of the cervical spine: The role of opportunistic CT screening[J]. Journal of Neurosurgery Spine, 2015, 23(1): 1-7. DOI: 10.3171/2014.10.SPINE14233.
    [3]
    GERETY E L, HOPPER M A, BEARCROFT P W. The reliability of measuring the density of the L1 vertebral body on CT imaging as a predictor of bone mineral density[J]. Clinical Radiology, 2017, 72(2): 177. e9-177. e15. DOI: 10.1016/j.crad.2016.09.022.
    [4]
    中华医学会放射学分会骨关节学组. 骨质疏松的影像学与骨密度诊断专家共识[J]. 中华放射学杂志, 2020, 54(8): 745-751. DOI: 10.3760/cma.j.cn112149-20200331-00485.

    Bone and Joint Group of Chinese Society of Radiology of Chinese Medical Association. Consensus on the diagnosis of osteoporosis by imaging and bone mineral densitymeasurement[J]. Chinese Journal of Radiology, 2020, 54(8): 745-751. DOI: 10.3760/cma.j.cn112149-20200331-00485.
    [5]
    ABBOUCHIE H, RAJU N, LAMANNA A, et al. Screening for osteoporosis using L1 vertebral density on abdominal CT in an Australian population[J]. Clinical Radiology, 2022, 77(7): e540-e548. DOI: 10.1016/j.crad.2022.04.002.
    [6]
    CHIA K K, HARON J, NIK MALEK N F S. Accuracy of computed tomography attenuation value of lumbar vertebra to assess bone mineral density[J]. The Malaysian Journal of Medical Sciences, 2021, 28(1): 41-45. DOI: 10.21315/mjms2021.28.1.6.
    [7]
    章玲惠, 卢向军, 何东, 等. 基于胸部低剂量CT扫描测量腰椎CT值机会性筛查骨质疏松[J]. 实用放射学杂志, 2023, 39(4): 626-630. DOI: 10.3969/j.issn.1002-1671.2023.04.027.

    ZHANG L H, LU X J, HE D, et al. OpportunisticscreeningofosteoporosisbasedonthemeasurementofCTvalueoflumbarspineusingchestlow-doseCT[J]. Journal of Practical Radiology, 2023, 39(4): 626-630. DOI: 10.3969/j.issn.1002-1671.2023.04.027.
    [8]
    BUENGER F, ECKARDT N, SAKR Y, et al. Correlation of bone density values of quantitative computed tomography and hounsfield units measured in native computed tomography in 902 vertebral bodies[J]. World Neurosurgery, 2021, 151: e599-e606. DOI: 10.1016/j.wneu.2021.04.093.
    [9]
    JANG S, GRAFFY PM, ZIEMLEWICZ TJ, et al. Opportunistic osteoporosis screening at routine abdominal and thoracic CT: Normative L1 trabecular attenuation values in more than 20000 adults[J]. Radiology, 2019, 291(2): 360-367. DOI: 10.1148/radiol.2019181648.
    [10]
    ULLRICH BW, SCHWARZ F, MCLEAN AL, et al. Inter-rater reliability of hounsfield units as a measure of bone density: applications in the treatment of thoracolumbar fractures[J]. World Neurosurgery, 2022, 158: e711-e716. DOI: 10.1016/j.wneu.2021.11.043.
    [11]
    MOONEY J, MORGAN S, BROCKINGTON D, et al. Inter-rater reliability and correlation of L1 hounsfield unit measurements with DXA scores[J]. Journal of Clinical Densitometry, 2022, 25(4): 668-673. DOI: 10.1016/j.jocd.2022.09.002.
    [12]
    ZHU Y, TRIPHURIDET N, YIP R, et al. Opportunistic CT screening of osteoporosis on thoracic and lumbar spine: a meta-analysis[J]. C linical Imaging, 2021, 80: 382-390. DOI: 10.1016/j.clinimag.2021.08.005.
    [13]
    ALAWI M, BEGUM A, HARRAZ M, et al. Dual-energy X-ray absorptiometry (DEXA) scan versus computed tomography for bone density assessment[J]. Cureus, 2021, 13(2): e13261. DOI: 10.7759/cureus.13261.
    [14]
    YAO Q, LIU J, YUAN K, et al. Comparison of L1 CT-attenuation and cortical thickness in predicting osteoporosis by opportunistic CT[J]. Journal of X-Ray Science and echnology, 2022, 30(3): 631-640. DOI: 10.3233/XST-211106.
    [15]
    WANG P, SHE W, MAO Z, et al. Use of routine computed tomography scans for detecting osteoporosis in thoracolumbar vertebral bodies[J]. Skeletal Radiology, 2021, 50(2): 371-379. DOI: 10.1007/s00256-020-03573-y.
    [16]
    王力平, 连天星, 胡永荣, 等. 胸部CT椎体HU值在2型糖尿病骨质疏松症机会性筛查中的价值[J]. 中国组织工程研究, 2024, 28(6): 950-954. DOI: 10.12307/2023.795.

    WANG L P, LIAN T X, HU Y R, et al. HU value of chest CT vertebral body in the opportunistic screening of type 2 diabetes mellitus osteoporosis[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(6): 950-954. DOI: 10.12307/2023.795.
    [17]
    GARNER H W, PATURZO M M, GAUDIER G, et al. Variation in attenuation in L1 trabecular bone at different tube voltages: Caution is warranted when screening for osteoporosis with the use of opportunistic CT[J]. American Journal of Roentgenology, 2017, 208(1): 165-170. DOI: 10.2214/AJR.16.16744.
    [18]
    GRAFFY P M, LEE S J, ZIEMLEWICZ T J, et al. Prevalence of vertebral compression fractures on routine CT scans according to L1 trabecular attenuation: Determining relevant thresholds for opportunistic osteoporosis screening[J]. American Journal of Roentgenology, 2017, 209(3): 491-496. DOI: 10.2214/AJR.17.17853.
    [19]
    王勇朋, 阳琰, 何生生, 等. 不同重建层厚对定量CT椎体骨密度测量值的影响[J]. 放射学实践, 2018, 13(11): 1191-1193. DOI: 10.13609/j.cnki.1000-0313.2018.11.016.

    WANG Y P, YANG Y, HE S S, et al. Effect of different reconstruction slice thickness on vertebral bone mineral density using quantitative CT[J]. Radiology Practice, 2018, 13(11): 1191-1193. DOI: 10.13609/j.cnki.1000-0313.2018.11.016.
    • Related Articles

  • Cited by

    Periodical cited type(1)

    1. 黄小燕，刘锟，林正秀，付玉川. 儿童游离脾伴脾蒂及胰尾扭转一例. 肝胆胰外科杂志. 2024(06): 378-380 .

    Other cited types(0)

Catalog

    Get Citation
    PDF
    XML
    Article views (42) PDF downloads (5) Cited by(1)
    Related

    Website Copyright © Editorial Office of Computerized Tomography Theory and Applications

    Address：No.5 Minzudaxue Nanlu,Haidian District,Beijing 100081,P.R.China（100081）

    E-mail：cttacn@cea-igp.ac.cn

    Phone：010-68729234

    京ICP备08002722号-11

    震球期刊
    CT理论与应用研究-中英文
    E-mail
    RSS

    Supported by: Beijing Renhe Information Technology Co. Ltd     Baidu Analytics

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return