Orthopaedic Medical Center, The Second Norman Bethune Hospital of Jilin University, Changchun, People's Republic of China.
Jilin Provincial Key Laboratory of Orthopaedics, Changchun, People's Republic of China.
Osteoporos Int. 2024 Jun;35(6):1049-1059. doi: 10.1007/s00198-024-07047-y. Epub 2024 Mar 9.
This study aimed to apply a newly developed semi-automatic phantom-less QCT (PL-QCT) to measure proximal humerus trabecular bone density based on chest CT and verify its accuracy and precision.
Subcutaneous fat of the shoulder joint and trapezius muscle were used as calibration references for PL-QCT BMD measurement. A self-developed algorithm based on a convolution map was utilized in PL-QCT for semi-automatic BMD measurements. CT values of ROIs used in PL-QCT measurements were directly used for phantom-based quantitative computed tomography (PB-QCT) BMD assessment. The study included 376 proximal humerus for comparison between PB-QCT and PL-QCT. Two sports medicine doctors measured the proximal humerus with PB-QCT and PL-QCT without knowing each other's results. Among them, 100 proximal humerus were included in the inter-operative and intra-operative BMD measurements for evaluating the repeatability and reproducibility of PL-QCT and PB-QCT.
A total of 188 patients with 376 shoulders were involved in this study. The consistency analysis indicated that the average bias between proximal humerus BMDs measured by PB-QCT and PL-QCT was 1.0 mg/cc (agreement range - 9.4 to 11.4; P > 0.05, no significant difference). Regression analysis between PB-QCT and PL-QCT indicated a good correlation (R-square is 0.9723). Short-term repeatability and reproducibility of proximal humerus BMDs measured by PB-QCT (CV: 5.10% and 3.41%) were slightly better than those of PL-QCT (CV: 6.17% and 5.64%).
We evaluated the bone quality of the proximal humeral using chest CT through the semi-automatic PL-QCT system for the first time. Comparison between it and PB-QCT indicated that it could be a reliable shoulder BMD assessment tool with acceptable accuracy and precision. This study developed and verify a semi-automatic PL-QCT for assessment of proximal humeral bone density based on CT to assist in the assessment of proximal humeral osteoporosis and development of individualized treatment plans for shoulders.
本研究旨在应用新开发的基于胸部 CT 的半自动无模 QCT（PL-QCT）测量肱骨近端松质骨密度，并验证其准确性和精密度。
肩关节皮下脂肪和斜方肌被用作 PL-QCT 骨密度测量的校准参考。PL-QCT 中使用的基于卷积图的自开发算法用于半自动骨密度测量。PL-QCT 测量中 ROI 的 CT 值直接用于基于体模的定量 CT（PB-QCT）骨密度评估。本研究共纳入 376 例肱骨近端用于比较 PB-QCT 和 PL-QCT。两名运动医学医生在不知道彼此结果的情况下使用 PB-QCT 和 PL-QCT 对肱骨近端进行测量。其中，100 例肱骨近端纳入术中 PL-QCT 和 PB-QCT 重复测量，以评估 PL-QCT 和 PB-QCT 的可重复性和再现性。
本研究共纳入 188 例患者的 376 个肩部。一致性分析表明，PB-QCT 和 PL-QCT 测量的肱骨近端骨密度的平均偏差为 1.0mg/cc（一致性范围为 9.4 至 11.4；P＞0.05，无显著性差异）。PB-QCT 和 PL-QCT 之间的回归分析表明具有良好的相关性（R 平方为 0.9723）。PB-QCT 测量的肱骨近端骨密度的短期重复性和再现性（CV：5.10%和 3.41%）略优于 PL-QCT（CV：6.17%和 5.64%）。
我们首次通过半自动 PL-QCT 系统使用胸部 CT 评估肱骨近端骨质量。与 PB-QCT 的比较表明，它可能是一种可靠的肩部骨密度评估工具，具有可接受的准确性和精密度。本研究开发并验证了一种基于 CT 的半自动 PL-QCT 评估肱骨近端骨密度的方法，以辅助评估肱骨近端骨质疏松症，并制定个体化的肩部治疗计划。
