Christopher John Burke1, Manjiri M Didolkar2, Huiman X Barnhart3, Emily N Vinson2. 1. Hospital for Joint Diseases, NYU Langone Medical Center, Department of Radiology, Division of Musculoskeletal Radiology, NY, NY, USA. 2. Duke University Medical Center, Department of Radiology, Division of Musculoskeletal Radiology, Durham, NC, USA. 3. Duke University, Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, NC, USA.
Abstract
OBJECTIVES: To evaluate whether lumbar vertebral body density CT attenuation values measured in Hounsfield Units (HUs) on routine Computed Tomography (CT) examinations can be reliably measured with limited variability, and to evaluate for a correlation between HUs and bone mineral density as measured by dual energy X-ray absorptiometry (DXA) scan. METHODS: Retrospective review of a total of 249 routine MDCT examinations, performed to measure HUs at the first non-rib bearing lumbar vertebral body on axial images, cross-referenced to the lateral scout image. RESULTS: The overall ICC and RC for intra-reader variability on CT HU were 0.987 (95% CI 0.973 - 0.999) and 15.664 (95% CI 11.66-16.97). The overall ICC and RDC for inter-reader variability on CT HU were 0.952 (95% CI 0.892 - 0.999) and 30.20 (95% CI 23.73 - 34.48). The ICC and RC for interscanner variability were 0.98 (95% CI 0.95 - 0.99) and 16.67 (95% CI 13.13 - 22.85). The correlation between the L1 HUs and L1 BMD, L1 t-score, and overall t-score was 0.437, 0.392, and 0.400, respectively. CONCLUSIONS: CT attenuation values of the first lumbar vertebra can be measured on routine abdomen CTs with limited variability despite multiple readers and scanners. Correlation between HU and BMD as measured by DXA scan was only weakly positive, and by this method measuring the density of a lumbar vertebral body from a routine MDCT scan does not provide the sensitivity or specificity necessary for a screening test. However above a certain measured value (180 HU), patients have a low chance of osteoporosis and therefore may not need additional screening, potentially limiting radiation exposure and cost.
OBJECTIVES: To evaluate whether lumbar vertebral body density CT attenuation values measured in Hounsfield Units (HUs) on routine Computed Tomography (CT) examinations can be reliably measured with limited variability, and to evaluate for a correlation between HUs and bone mineral density as measured by dual energy X-ray absorptiometry (DXA) scan. METHODS: Retrospective review of a total of 249 routine MDCT examinations, performed to measure HUs at the first non-rib bearing lumbar vertebral body on axial images, cross-referenced to the lateral scout image. RESULTS: The overall ICC and RC for intra-reader variability on CT HU were 0.987 (95% CI 0.973 - 0.999) and 15.664 (95% CI 11.66-16.97). The overall ICC and RDC for inter-reader variability on CT HU were 0.952 (95% CI 0.892 - 0.999) and 30.20 (95% CI 23.73 - 34.48). The ICC and RC for interscanner variability were 0.98 (95% CI 0.95 - 0.99) and 16.67 (95% CI 13.13 - 22.85). The correlation between the L1 HUs and L1BMD, L1 t-score, and overall t-score was 0.437, 0.392, and 0.400, respectively. CONCLUSIONS: CT attenuation values of the first lumbar vertebra can be measured on routine abdomen CTs with limited variability despite multiple readers and scanners. Correlation between HU and BMD as measured by DXA scan was only weakly positive, and by this method measuring the density of a lumbar vertebral body from a routine MDCT scan does not provide the sensitivity or specificity necessary for a screening test. However above a certain measured value (180 HU), patients have a low chance of osteoporosis and therefore may not need additional screening, potentially limiting radiation exposure and cost.
Entities:
Keywords:
bone mineral density; computed tomography; dual-energy X-ray absorptiometry; osteoporosis
Authors: Perry J Pickhardt; B Dustin Pooler; Travis Lauder; Alejandro Muñoz del Rio; Richard J Bruce; Neil Binkley Journal: Ann Intern Med Date: 2013-04-16 Impact factor: 25.391
Authors: Markus B Huber; Julio Carballido-Gamio; Jan S Bauer; Thomas Baum; Felix Eckstein; Eva M Lochmüller; Sharmila Majumdar; Thomas M Link Journal: Radiology Date: 2008-05 Impact factor: 11.105
Authors: Frank Oliver Henes; Michael Groth; Harald Kramer; Christian Schaefer; Marc Regier; Thorsten Derlin; Gerhard Adam; Peter Bannas Journal: Eur J Radiol Date: 2013-09-25 Impact factor: 3.528
Authors: Michael C Burke; Ankur Garg; Jonathan M Youngner; Swati D Deshmukh; Imran M Omar Journal: Skeletal Radiol Date: 2018-10-20 Impact factor: 2.199
Authors: Ana Amador Martínez; Eleazar Lara Padilla; Juan Antonio Pérez Rodríguez; Alfonso Alfaro; Dania Guadalupe Solis Cano; Cindy Bandala; Nancy Guzman Journal: Cureus Date: 2019-08-28
Authors: Min Kyun Na; Yu Deok Won; Choong Hyun Kim; Jae Min Kim; Jin Hwan Cheong; Je Il Ryu; Myung-Hoon Han Journal: PLoS One Date: 2018-05-10 Impact factor: 3.240