Chaisen Molaya, Sritara Chanika, Chitrapazt Niyata, Suppasilp Chaiyawat, Chamroonrat Wichana, Promma Sasivimol, Kositwattanarerk Arpakorn, Sakulpisuti Chaninart, Thamnirat Kanungnij
Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Division of Nuclear Medicine, Department of Radiology, Maharaj Nakorn Si Thammarat Hospital, Naimueng, Mueng, Nakorn Si Thammarat 80000, Thailand.
Diagnostics (Basel). 2024 Dec 18;14(24):2846. doi: 10.3390/diagnostics14242846.
Osteoporosis is commonly evaluated using dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD). Non-contrast computed tomography (CT) scans provide an alternative for opportunistic osteoporosis assessment. This study aimed to evaluate screening thresholds for osteoporosis based on CT attenuation values in Hounsfield units (HU) of L1-L4 vertebrae from CT scans of the abdominal region, compared to DXA assessments of the lumbar spine and hips.
Conducted retrospectively over approximately two years, the analysis included 109 patients who had both CT and DXA scans within 12 months, excluding those with metal artifacts affecting the vertebrae. CT attenuation values in the trabecular region of the vertebrae were measured and compared among three groups based on the lowest T-score from DXA.
In a predominantly female cohort (mean age 66.3 years), the lowest CT attenuation values for L1-L4 vertebrae showed a moderate correlation with the lowest T-score, with a Pearson correlation coefficient of 0.542 (95% CI: 0.388, 0.667). A HU threshold of ≤142 at the L1 vertebra showed 91.9% sensitivity and 48.4% specificity, while a threshold of ≤160 HU showed 97.3% sensitivity and 31.3% specificity for screening osteoporosis.
This study supports the use of non-contrast CT with these HU thresholds as an opportunistic tool for osteoporosis assessment.
骨质疏松症通常使用双能X线吸收测定法（DXA）来评估骨矿物质密度（BMD）。非增强计算机断层扫描（CT）可为机会性骨质疏松症评估提供一种替代方法。本研究旨在根据腹部CT扫描中L1-L4椎体的Hounsfield单位（HU）的CT衰减值，与腰椎和髋部的DXA评估结果相比较，评估骨质疏松症的筛查阈值。
该分析回顾性进行了约两年，纳入了109例在12个月内同时进行了CT和DXA扫描的患者，排除了有影响椎体的金属伪影的患者。根据DXA得出的最低T值，测量并比较了三组患者椎体小梁区域的CT衰减值。
在一个以女性为主的队列（平均年龄66.3岁）中，L1-L4椎体的最低CT衰减值与最低T值呈中度相关，Pearson相关系数为0.542（95%CI：0.388，0.667）。L1椎体HU阈值≤142时，筛查骨质疏松症的灵敏度为91.9%，特异度为48.4%；而阈值≤160 HU时，灵敏度为97.3%，特异度为31.3%。
本研究支持使用具有这些HU阈值的非增强CT作为骨质疏松症评估的机会性工具。
