Quantitative computed tomography in measurement of vertebral trabecular bone mass. A modified method.

Measurement of bone mineral concentration (BMC) can be done by several modalities. Quantitative computed tomography (QCT) can be used for measurements at different sites and with different types of bone (trabecular-cortical). This study presents a modified method reducing the influence of fat. Determination of BMC was made from measurements with single-energy computed tomography (CT) of the mean Hounsfield number in the trabecular part of the L1 vertebra. The method takes into account the age-dependent composition of the trabecular part of the vertebra. As the amount of intravertebral fat increases with age, the effective atomic number for these parts decreases. This results in a non-linear calibration curve for single-energy CT. Comparison of BMC values using the non-linear calibration curve or the traditional linear calibration with those obtained with a pixel-by-pixel based electron density calculation method (theoretically better) showed results clearly in favor of the non-linear method. The material consisted of 327 patients aged 6 to 91 years, of whom 197 were considered normal. The normal data show a sharp decrease in trabecular bone after the age of 50 in women. In men a slower decrease was found. The vertebrae were larger in men than in women.