OBJECTIVES: Osteoporosis and bone fractures are of particular concern in patients with inflammatory bowel disease (IBD). Biomechanical computed tomography (BCT) is an image-analysis technique that can measure bone strength and dual-energy X-ray absorptiometry (DXA)-equivalent bone mineral density (BMD) from noncontrast CT images. This study seeks to determine whether this advanced technology can be applied to patients with IBD undergoing CT enterography (CTE) with IV contrast. METHODS: Patients with IBD who underwent a CTE and DXA scan between 2007 and 2011 were retrospectively identified. Femoral neck BMD (g/cm(2)) and T-scores were measured and compared between DXA and BCT analysis of the CTE images. Femoral strength (Newtons) was also determined from BCT analysis. RESULTS: DXA- and CTE-generated BMD T-score values were highly correlated (R(2)=0.84, P<0.0001) in this patient cohort (n=136). CTE identified patients with both osteoporosis (sensitivity, 85.7%; 95% confidence interval (CI), 48.7-97.4 and specificity, 98.5%; 95% CI, 94.5-99.6) and osteopenia (sensitivity, 85.1%; 95% CI, 72.3-92.6 and specificity, 85.4%; 95% CI, 76.6-91.3). Of the 16 patients who had "fragile" bone strength by BCT (placing them at the equivalent high risk of fracture as for osteoporosis), 6 had osteoporosis and 10 had osteopenia by DXA. CONCLUSIONS: CTE scans can provide hip BMD, T-scores, and clinical classifications that are comparable to those obtained from DXA; when combined with BCT analysis, CTE can identify a subset of patients with osteopenia who have clinically relevant fragile bone strength. This technique could markedly increase bone health assessments in IBD patients already undergoing CTE to evaluate small bowel disease.
OBJECTIVES:Osteoporosis and bone fractures are of particular concern in patients with inflammatory bowel disease (IBD). Biomechanical computed tomography (BCT) is an image-analysis technique that can measure bone strength and dual-energy X-ray absorptiometry (DXA)-equivalent bone mineral density (BMD) from noncontrast CT images. This study seeks to determine whether this advanced technology can be applied to patients with IBD undergoing CT enterography (CTE) with IV contrast. METHODS:Patients with IBD who underwent a CTE and DXA scan between 2007 and 2011 were retrospectively identified. Femoral neck BMD (g/cm(2)) and T-scores were measured and compared between DXA and BCT analysis of the CTE images. Femoral strength (Newtons) was also determined from BCT analysis. RESULTS: DXA- and CTE-generated BMD T-score values were highly correlated (R(2)=0.84, P<0.0001) in this patient cohort (n=136). CTE identified patients with both osteoporosis (sensitivity, 85.7%; 95% confidence interval (CI), 48.7-97.4 and specificity, 98.5%; 95% CI, 94.5-99.6) and osteopenia (sensitivity, 85.1%; 95% CI, 72.3-92.6 and specificity, 85.4%; 95% CI, 76.6-91.3). Of the 16 patients who had "fragile" bone strength by BCT (placing them at the equivalent high risk of fracture as for osteoporosis), 6 had osteoporosis and 10 had osteopenia by DXA. CONCLUSIONS:CTE scans can provide hip BMD, T-scores, and clinical classifications that are comparable to those obtained from DXA; when combined with BCT analysis, CTE can identify a subset of patients with osteopenia who have clinically relevant fragile bone strength. This technique could markedly increase bone health assessments in IBDpatients already undergoing CTE to evaluate small bowel disease.
Authors: J A Kanis; O Johnell; A Oden; H Johansson; J A Eisman; S Fujiwara; H Kroger; R Honkanen; L J Melton; T O'Neill; J Reeve; A Silman; A Tenenhouse Journal: Osteoporos Int Date: 2006-01-10 Impact factor: 4.507
Authors: Helena Johansson; Anders Oden; Olof Johnell; Bengt Jonsson; Chris de Laet; Alan Oglesby; Eugene V McCloskey; Karthik Kayan; Tarja Jalava; John A Kanis Journal: J Bone Miner Res Date: 2004-06 Impact factor: 6.741
Authors: H Gudmundsdottir; B Jonsdottir; S Kristinsson; A Johannesson; D Goodenough; G Sigurdsson Journal: Osteoporos Int Date: 1993-03 Impact factor: 4.507
Authors: Edward V Loftus; Sara J Achenbach; William J Sandborn; William J Tremaine; Ann L Oberg; L Joseph Melton Journal: Clin Gastroenterol Hepatol Date: 2003-11 Impact factor: 11.382
Authors: S R Cummings; M C Nevitt; W S Browner; K Stone; K M Fox; K E Ensrud; J Cauley; D Black; T M Vogt Journal: N Engl J Med Date: 1995-03-23 Impact factor: 91.245
Authors: Benedikt J Schwaiger; David L Kopperdahl; Lorenzo Nardo; Luca Facchetti; Alexandra S Gersing; Jan Neumann; Kwang J Lee; Tony M Keaveny; Thomas M Link Journal: Bone Date: 2017-04-24 Impact factor: 4.398
Authors: D Rebello; D Anjelly; D J Grand; J T Machan; M D Beland; M S Furman; J Shapiro; N LeLeiko; B E Sands; M Mallette; R Bright; H Moniz; M Merrick; S A Shah Journal: Osteoporos Int Date: 2018-03-08 Impact factor: 4.507
Authors: Daniel L Christensen; Kyle E Nappo; Jared A Wolfe; Sean M Wade; Daniel I Brooks; Benjamin K Potter; Jonathan A Forsberg; Scott M Tintle Journal: Clin Orthop Relat Res Date: 2019-04 Impact factor: 4.176
Authors: Annette L Adams; Heidi Fischer; David L Kopperdahl; David C Lee; Dennis M Black; Mary L Bouxsein; Shireen Fatemi; Sundeep Khosla; Eric S Orwoll; Ethel S Siris; Tony M Keaveny Journal: J Bone Miner Res Date: 2018-04-17 Impact factor: 6.741
Authors: B T Allaire; D Lu; F Johannesdottir; D Kopperdahl; T M Keaveny; M Jarraya; A Guermazi; M A Bredella; E J Samelson; D P Kiel; D E Anderson; S Demissie; M L Bouxsein Journal: Osteoporos Int Date: 2018-10-10 Impact factor: 4.507