{"title":"Conventional chest computed tomography-based radiomics for predicting the risk of thoracolumbar osteoporotic vertebral fractures.","authors":"Yaling Pan, Yidong Wan, Yajie Wang, Taihen Yu, Fang Cao, Dong He, Qin Ye, Xiangjun Lu, Huogen Wang, Yinbo Wu","doi":"10.1007/s00198-024-07338-4","DOIUrl":null,"url":null,"abstract":"<p><p>Our study focused on predicting thoracolumbar osteoporotic vertebral fractures through radiomic analysis of non-fractured thoracic vertebrae using conventional chest CT. Four types of radiomics models were developed and showed acceptable prediction performance. Radiomics models incorporating both cortical-appendicular and trabecular bone may have superior performance compared to those using either feature set individually. The RAD score models based on thoracic vertebral combinations achieved comparable performance with lumbar bone mineral density (BMD) measurements.</p><p><strong>Purpose: </strong>To develop and validate radiomics models based on chest CT for predicting the risk of thoracolumbar osteoporotic vertebral fractures (OVFs).</p><p><strong>Methods: </strong>A total of 494 patients (including 198 patients with thoracolumbar OVFs) who underwent conventional chest CT scans were included in this retrospective analysis and were divided into training set 1 (n = 334) and validation set 1 (n = 160). Radiomics features (RFs) were extracted from each thoracic vertebral level on chest CT images. Four types of radiomics models (trabecular RFs, cortical-appendicular RFs, mixed RFs, and RAD score) were constructed and compared. Additionally, RAD score models based on trabecular and cortical-appendicular bone of different vertebral combinations (T1-T6, T7-T12, and top 3 vertebrae) were performed, respectively. A subset of patients with available bone mineral density (BMD) data formed training set 2 (n = 199) and validation set 2 (n = 88). We combined RAD score of different vertebral combinations with lumbar BMD for predicting thoracolumbar OVFs, and further adjusted for age. Predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among the radiomics models, the RAD score model based on trabecular and cortical-appendicular bone achieved highest AUC at the most vertebral levels. The RAD score model of top 3 (T5 + T8 + T10) vertebrae achieved higher AUC (0.813) than T7-T12 (AUC = 0.780) with a statistically significant difference (P = 0.02) and T1-T6 (AUC = 0.772) without a statistically significant difference (P = 0.062). Prior to adjusting for age, both RAD score models (AUCs 0.774-0.807) and RAD score + BMD models (AUCs 0.771-0.800) demonstrated slightly superior performance compared to BMD (AUC = 0.736) alone in predicting OVFs, although the differences were not statistically significant (P > 0.05). Following adjustment for age, our RAD score models, which utilized different vertebral combinations (AUCs 0.784-0.804), were found to be comparable to lumbar BMD (AUC = 0.785) in predicting OVFs (P > 0.05).</p><p><strong>Conclusion: </strong>Radiomics analysis based on conventional chest CT can provide valuable information for predicting thoracolumbar OVFs. Radiomics models incorporating both cortical-appendicular and trabecular bone may have superior performance compared to those using either feature set alone. RAD score models based on thoracic vertebral combinations comparable performance compared to lumbar BMD highlights its clinical utility.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Osteoporosis International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00198-024-07338-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Our study focused on predicting thoracolumbar osteoporotic vertebral fractures through radiomic analysis of non-fractured thoracic vertebrae using conventional chest CT. Four types of radiomics models were developed and showed acceptable prediction performance. Radiomics models incorporating both cortical-appendicular and trabecular bone may have superior performance compared to those using either feature set individually. The RAD score models based on thoracic vertebral combinations achieved comparable performance with lumbar bone mineral density (BMD) measurements.
Purpose: To develop and validate radiomics models based on chest CT for predicting the risk of thoracolumbar osteoporotic vertebral fractures (OVFs).
Methods: A total of 494 patients (including 198 patients with thoracolumbar OVFs) who underwent conventional chest CT scans were included in this retrospective analysis and were divided into training set 1 (n = 334) and validation set 1 (n = 160). Radiomics features (RFs) were extracted from each thoracic vertebral level on chest CT images. Four types of radiomics models (trabecular RFs, cortical-appendicular RFs, mixed RFs, and RAD score) were constructed and compared. Additionally, RAD score models based on trabecular and cortical-appendicular bone of different vertebral combinations (T1-T6, T7-T12, and top 3 vertebrae) were performed, respectively. A subset of patients with available bone mineral density (BMD) data formed training set 2 (n = 199) and validation set 2 (n = 88). We combined RAD score of different vertebral combinations with lumbar BMD for predicting thoracolumbar OVFs, and further adjusted for age. Predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC).
Results: Among the radiomics models, the RAD score model based on trabecular and cortical-appendicular bone achieved highest AUC at the most vertebral levels. The RAD score model of top 3 (T5 + T8 + T10) vertebrae achieved higher AUC (0.813) than T7-T12 (AUC = 0.780) with a statistically significant difference (P = 0.02) and T1-T6 (AUC = 0.772) without a statistically significant difference (P = 0.062). Prior to adjusting for age, both RAD score models (AUCs 0.774-0.807) and RAD score + BMD models (AUCs 0.771-0.800) demonstrated slightly superior performance compared to BMD (AUC = 0.736) alone in predicting OVFs, although the differences were not statistically significant (P > 0.05). Following adjustment for age, our RAD score models, which utilized different vertebral combinations (AUCs 0.784-0.804), were found to be comparable to lumbar BMD (AUC = 0.785) in predicting OVFs (P > 0.05).
Conclusion: Radiomics analysis based on conventional chest CT can provide valuable information for predicting thoracolumbar OVFs. Radiomics models incorporating both cortical-appendicular and trabecular bone may have superior performance compared to those using either feature set alone. RAD score models based on thoracic vertebral combinations comparable performance compared to lumbar BMD highlights its clinical utility.
期刊介绍:
An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases.
It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition.
While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.