The accuracy and clinical utility of spectral CT bone density measurement in the lumbar spine of unenhanced images: A narrative review

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2024-10-01 DOI:10.1016/j.radi.2024.08.009

J. Hepburn, C. Currie, L.C. Trinder

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引用次数: 0

Abstract

Objectives

To review and evaluate available literature on spectral computed tomography (SCT) bone mineral density (BMD) measurement in adult thoracolumbar vertebrae of unenhanced images compared to quantitative computed tomography (QCT), to understand its current clinical utility.

Key findings

Keyword searches in four databases identified four cross-sectional studies which acquired an SCT BMD measurement in thoracolumbar vertebrae and compared this respectively to QCT, which were then critically appraised using the AXIS tool for cross-sectional studies. 862 vertebrae were measured between T10-S1 in 368 patients. Three studies demonstrated a statistically significant correlation between SCT and QCT for the measurement of Hydroxyapatite (HAP) and calcium (r = 0.86–0.96). One study demonstrated a diagnostic accuracy of 96% using a receiver operating curve.

Conclusions

SCT measurements of HAP and calcium in the lumbar vertebrae are comparable to QCT for patients with no additional pathology present. However, further research is required to evaluate diagnostic accuracy before clinical application.

Implications for practice

SCT BMD measurement has the potential to be developed as a screening tool for osteoporosis within the fracture liaison service (FLS). This could aid in the identification of patients with osteoporosis and address the current treatment gap. Nonetheless, many factors must be considered for this application including staff training, radiation protection and patient engagement with the screening programme.

查看原文本刊更多论文

未增强图像腰椎骨密度CT频谱测量的准确性和临床实用性：综述。

目的回顾并评估光谱计算机断层扫描（SCT）与定量计算机断层扫描（QCT）对比测量成人胸腰椎未增强图像的骨矿密度（BMD）的现有文献，以了解其目前的临床实用性：在四个数据库中进行关键词搜索后发现了四项横断面研究，这些研究获得了胸腰椎SCT BMD测量结果，并分别与QCT进行了比较，然后使用横断面研究AXIS工具对这些研究进行了严格评估。对 368 名患者 T10-S1 之间的 862 个椎骨进行了测量。三项研究表明，在测量羟磷灰石（HAP）和钙方面，SCT 和 QCT 之间存在统计学意义上的显著相关性（r = 0.86-0.96）。一项研究利用接收者操作曲线显示诊断准确率为 96%：结论：对于没有其他病变的患者，SCT 测量腰椎的 HAP 和钙的结果与 QCT 相当。然而，在临床应用之前，还需要进一步的研究来评估诊断的准确性：SCT BMD 测量有可能发展成为骨折联络服务（FLS）中的骨质疏松症筛查工具。这有助于识别骨质疏松症患者，解决目前的治疗缺口。然而，这一应用必须考虑许多因素，包括人员培训、辐射防护和患者对筛查计划的参与度。

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

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.