Kang Woo Young, Yang Zepa, Park Heejun, Lee Jemyoung, Hong Suk-Joo, Shim Euddeum, Woo Ok Hee
Department of Radiology, Korea University Guro Hospital, Seoul 08308, Republic of Korea.
Department of Applied Bioengineering, Seoul National University, Seoul 08826, Republic of Korea.
Diagnostics (Basel). 2024 Aug 16;14(16):1789. doi: 10.3390/diagnostics14161789.
Opportunistic osteoporosis screening using deep learning (DL) analysis of low-dose chest CT (LDCT) scans is a potentially promising approach for the early diagnosis of this condition. We explored bone mineral density (BMD) profiles across all adult ages and prevalence of osteoporosis using LDCT with DL in a Korean population. This retrospective study included 1915 participants from two hospitals who underwent LDCT during general health checkups between 2018 and 2021. Trabecular volumetric BMD of L1-2 was automatically calculated using DL and categorized according to the American College of Radiology quantitative computed tomography diagnostic criteria. BMD decreased with age in both men and women. Women had a higher peak BMD in their twenties, but lower BMD than men after 50. Among adults aged 50 and older, the prevalence of osteoporosis and osteopenia was 26.3% and 42.0%, respectively. Osteoporosis prevalence was 18.0% in men and 34.9% in women, increasing with age. Compared to previous data obtained using dual-energy X-ray absorptiometry, the prevalence of osteoporosis, particularly in men, was more than double. The automated opportunistic BMD measurements using LDCT can effectively predict osteoporosis for opportunistic screening and identify high-risk patients. Patients undergoing lung cancer screening may especially profit from this procedure requiring no additional imaging or radiation exposure.
利用低剂量胸部CT（LDCT）扫描的深度学习（DL）分析进行机会性骨质疏松筛查，是早期诊断这种疾病的一种潜在的有前景的方法。我们在韩国人群中使用LDCT结合DL探索了所有成年人年龄组的骨密度（BMD）情况和骨质疏松患病率。这项回顾性研究纳入了来自两家医院的1915名参与者，他们在2018年至2021年的一般健康检查期间接受了LDCT检查。使用DL自动计算L1-2的小梁体积骨密度，并根据美国放射学会定量计算机断层扫描诊断标准进行分类。男性和女性的骨密度均随年龄下降。女性在二十多岁时骨密度峰值较高，但50岁后低于男性。在50岁及以上的成年人中，骨质疏松症和骨质减少的患病率分别为26.3%和42.0%。男性骨质疏松症患病率为18.0%，女性为34.9%，且随年龄增加。与之前使用双能X线吸收法获得的数据相比，骨质疏松症的患病率，尤其是男性的患病率增加了一倍多。使用LDCT进行自动机会性骨密度测量可以有效地预测机会性筛查中的骨质疏松症，并识别高危患者。接受肺癌筛查的患者可能尤其受益于这种无需额外成像或辐射暴露的检查程序。
