Opportunistic screening for osteoporosis using routine clinical care computed tomography brain studies.

IF 1.9 3区 医学 Q2 ORTHOPEDICS
Skeletal Radiology Pub Date : 2025-01-01 Epub Date: 2024-05-16 DOI:10.1007/s00256-024-04703-6
Dee Zhen Lim, Milo Macbain, Marcus Kok, Ghanda Wiggins, Hussein Abbouchie, Sze Ting Lee, Eddie Lau, Ruth P Lim, Cherie Chiang, Numan Kutaiba
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引用次数: 0

Abstract

Objective: Osteoporosis and falls are both prevalent in the elderly, and CT brain (CTB) is frequently performed post head-strike. We aim to validate the relationship between frontal bone density (Hounsfield unit) from routine CTB and bone mineral density from dual-energy X-ray absorptiometry (DEXA) scan for opportunistic osteoporosis screening.

Materials and methods: Patients who had a non-contrast CTB followed by a DEXA scan in the subsequent year were included in this multi-center retrospective study. The relationship between frontal bone density on CT and femoral neck T-score on DEXA was examined using ANOVA, Pearson's correlation, and receiver operating curve (ROC) analysis. Sensitivity, specificity, negative and positive predictive values, and area under the curve (AUC) were calculated.

Results: Three hundred twenty-six patients (205 females and 121 males) were analyzed. ANOVA analysis showed that frontal bone density was lower in patients with DEXA-defined osteoporosis (p < 0.001), while Pearson's correlation analysis demonstrated a fair correlation with femoral neck T-score (r = 0.3, p < 0.001). On subgroup analysis, these were true in females but not in males. On ROC analysis, frontal bone density weakly predicted osteoporosis (AUC 0.6, 95% CI 0.5-0.7) with no optimal threshold identified. HU < 610 was highly specific (87.5%) but poorly sensitive (18.9%). HU > 1200 in females had a strong negative predictive value for osteoporosis (92.6%, 95% CI 87.1-98.1%).

Conclusion: Frontal bone density from routine CTB is significantly different between females with and without osteoporosis, but not between males. However, frontal bone density was a weak predictor for DEXA-defined osteoporosis. Further research is required to determine the role of CTB in opportunistic osteoporosis screening.

Abstract Image

利用常规临床护理计算机断层扫描脑部研究对骨质疏松症进行机会性筛查。
目的:骨质疏松症和跌倒在老年人中都很普遍,而脑部 CTB(CTB)经常在头部撞击后进行。我们的目的是验证常规 CTB 得出的额骨密度(Hounsfield 单位)与双能 X 射线吸收测量法(DEXA)扫描得出的骨矿密度之间的关系,以便择机进行骨质疏松症筛查:这项多中心回顾性研究纳入了在随后一年接受非对比 CTB 和 DEXA 扫描的患者。采用方差分析、皮尔逊相关性和接收器工作曲线(ROC)分析法研究了 CT 上的额骨骨密度与 DEXA 上的股骨颈 T 评分之间的关系。计算了灵敏度、特异性、阴性和阳性预测值以及曲线下面积(AUC):分析了 326 名患者(女性 205 人,男性 121 人)。方差分析显示,在 DEXA 定义的骨质疏松症患者中,额骨密度较低(p 1200),女性对骨质疏松症有很高的阴性预测值(92.6%,95% CI 87.1-98.1%):结论:常规 CTB 得出的额骨骨密度在有骨质疏松症和无骨质疏松症的女性之间有显著差异,但在男性之间无显著差异。然而,额骨密度对 DEXA 定义的骨质疏松症的预测作用较弱。要确定 CTB 在机会性骨质疏松症筛查中的作用,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Skeletal Radiology
Skeletal Radiology 医学-核医学
CiteScore
4.40
自引率
9.50%
发文量
253
审稿时长
3-8 weeks
期刊介绍: Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.
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