Volumetric computed tomography Hounsfield unit analysis: a superior method for opportunistic osteoporosis screening and assessment.

Cirugia y cirujanos Pub Date : 2026-06-17 DOI:10.24875/CIRU.25000101

Fatih Erdem, Bahar Yanık, Taha Yasin-Arslan, Emrah Akay, Erdoğan Bülbül, Gülen Demirpolat

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Abstract

Objectives: This study investigated the correlation between two-dimensional and volumetric Hounsfield unit (HU) measurements from computed tomography (CT) and T-scores from dual-energy X-ray absorptiometry (DXA), assessing their interchangeability for opportunistic osteoporosis (OP) screening.

Methods: A retrospective analysis included 97 patients (15 males, 82 females; mean age 66.48 ± 9.97 years) who underwent lumbar CT and DXA within 7 months. Two-dimensional HU values were measured from axial images (L1-L4), whereas volumetric HU values were obtained using 3D segmentation. Correlations with DXA T-scores were analyzed, and agreement between methods was assessed using Bland-Altman analysis and intraclass correlation coefficients (ICC).

Results: Both HU methods significantly correlated with DXA T-scores (p < 0.001), with volumetric HU showing stronger correlations (r = 0.572 vs. r = 0.532). Osteoporotic patients had lower HU values, with volumetric HU offering better differentiation. Bland-Altman analysis revealed a systematic bias, with two-dimensional HU underestimating values. ICC showed excellent agreement, with volumetric HU achieving higher reliability (ICC = 0.963 vs. ICC = 0.918).

Conclusions: Volumetric HU measurements provide a more reliable and sensitive assessment of trabecular bone density, making them a superior method for opportunistic OP screening and treatment monitoring.

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容积计算机断层扫描Hounsfield单位分析：一种机会性骨质疏松筛查和评估的优越方法。

目的：本研究探讨了计算机断层扫描（CT）的二维和体积Hounsfield单位（HU）测量与双能x线吸收仪（DXA）的t评分之间的相关性，评估了它们在机会性骨质疏松症（OP）筛查中的互换性。方法：回顾性分析97例患者（男15例，女82例，平均年龄66.48±9.97岁）在7个月内行腰椎CT和DXA检查。从轴向图像（L1-L4）测量二维HU值，而通过三维分割获得体积HU值。分析与DXA t评分的相关性，并使用Bland-Altman分析和类内相关系数（ICC）评估方法之间的一致性。结果：两种HU方法均与DXA t评分显著相关（p < 0.001），其中体积HU方法相关性更强（r = 0.572比r = 0.532）。骨质疏松症患者的HU值较低，容量HU能更好地进行鉴别。Bland-Altman分析显示存在系统性偏差，二维HU低估了数值。ICC显示出极好的一致性，容量HU具有更高的可靠性（ICC = 0.963 vs. ICC = 0.918）。结论：体积HU测量提供了更可靠和敏感的小梁骨密度评估，使其成为机会性OP筛查和治疗监测的优越方法。

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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Cirugia y cirujanos

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