Timothy J Ziemlewicz1, Alyssa Maciejewski1, Neil Binkley2, Alan D Brett3, J Keenan Brown3, Perry J Pickhardt1. 1. 1 Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave. Madison, WI 53792-3252. 2. 2 Department of Medicine, School of Medicine and Public Health, University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI. 3. 3 Mindways Software, Inc., Austin, TX.
Abstract
OBJECTIVE: For patients undergoing contrast-enhanced CT examinations that include the proximal femur, an opportunity exists for concurrent screening bone mineral density (BMD) measurement. We investigated the effect of IV contrast enhancement on CT-derived x-ray absorptiometry areal BMD measurement. MATERIALS AND METHODS: Our cohort included 410 adults (mean age, 65.3 ± 10.0 years; range, 49-95 years) who underwent split-bolus CT urography at 120 kVp. Areal femoral neck BMD in g/cm(2) was measured on both unenhanced and contrast-enhanced CT series with asynchronous phantom calibration. Constant offset and multiplicative factor corrections for the contrast-enhanced series were derived from the Bland-Altman plot linear regression slopes. RESULTS: Mean unenhanced and contrast-enhanced areal femoral neck BMD values were 0.681 ± 0.118 and 0.713 ± 0.123 g/cm(2), respectively. The SD of the distribution of residuals for the constant offset and multiplicative model corrections were 0.0232 and 0.0231, respectively. The constant offset correction associated with contrast enhancement was 0.032 ± 0.023 g/cm(2), which corresponds to 0.29 ± 0.21 T-score units using the CT-derived x-ray absorptiometry young normal areal femoral neck BMD reference SD of 0.111 g/cm(2). CONCLUSION: For the purposes of opportunistic osteoporosis screening, contrast-enhanced abdominopelvic CT studies are equivalent to unenhanced CT and can therefore be used for femoral neck BMD assessment. This measure could greatly enhance osteoporosis screening.
OBJECTIVE: For patients undergoing contrast-enhanced CT examinations that include the proximal femur, an opportunity exists for concurrent screening bone mineral density (BMD) measurement. We investigated the effect of IV contrast enhancement on CT-derived x-ray absorptiometry areal BMD measurement. MATERIALS AND METHODS: Our cohort included 410 adults (mean age, 65.3 ± 10.0 years; range, 49-95 years) who underwent split-bolus CT urography at 120 kVp. Areal femoral neck BMD in g/cm(2) was measured on both unenhanced and contrast-enhanced CT series with asynchronous phantom calibration. Constant offset and multiplicative factor corrections for the contrast-enhanced series were derived from the Bland-Altman plot linear regression slopes. RESULTS: Mean unenhanced and contrast-enhanced areal femoral neck BMD values were 0.681 ± 0.118 and 0.713 ± 0.123 g/cm(2), respectively. The SD of the distribution of residuals for the constant offset and multiplicative model corrections were 0.0232 and 0.0231, respectively. The constant offset correction associated with contrast enhancement was 0.032 ± 0.023 g/cm(2), which corresponds to 0.29 ± 0.21 T-score units using the CT-derived x-ray absorptiometry young normal areal femoral neck BMD reference SD of 0.111 g/cm(2). CONCLUSION: For the purposes of opportunistic osteoporosis screening, contrast-enhanced abdominopelvic CT studies are equivalent to unenhanced CT and can therefore be used for femoral neck BMD assessment. This measure could greatly enhance osteoporosis screening.
Entities:
Keywords:
bone mineral density; contrast-enhanced CT; musculoskeletal system; osteoporosis; quantitative CT; screening
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