Journal of Clinical Densitometry最新文献

{"title":"Performance of Progressive Generations of GPT on an Exam Designed for Certifying Physicians as Certified Clinical Densitometrists","authors":"Dustin Valdez , Arianna Bunnell , Sian Y. Lim , Peter Sadowski , John A. Shepherd","doi":"10.1016/j.jocd.2024.101480","DOIUrl":"10.1016/j.jocd.2024.101480","url":null,"abstract":"<div><p><em>Background</em>: Artificial intelligence (AI) large language models (LLMs) such as ChatGPT have demonstrated the ability to pass standardized exams. These models are not trained for a specific task, but instead trained to predict sequences of text from large corpora of documents sourced from the internet. It has been shown that even models trained on this general task can pass exams in a variety of domain-specific fields, including the United States Medical Licensing Examination. We asked if large language models would perform as well on a much narrower subdomain tests designed for medical specialists. Furthermore, we wanted to better understand how progressive generations of GPT (generative pre-trained transformer) models may be evolving in the completeness and sophistication of their responses even while generational training remains general. In this study, we evaluated the performance of two versions of GPT (GPT 3 and 4) on their ability to pass the certification exam given to physicians to work as osteoporosis specialists and become a certified clinical densitometrists. The CCD exam has a possible score range of 150 to 400. To pass, you need a score of 300.</p><p><em>Methods</em>: A 100-question multiple-choice practice exam was obtained from a 3rd party exam preparation website that mimics the accredited certification tests given by the ISCD (International Society for Clinical Densitometry). The exam was administered to two versions of GPT, the free version (GPT Playground) and ChatGPT+, which are based on GPT-3 and GPT-4, respectively (OpenAI, San Francisco, CA). The systems were prompted with the exam questions verbatim. If the response was purely textual and did not specify which of the multiple-choice answers to select, the authors matched the text to the closest answer. Each exam was graded and an estimated ISCD score was provided from the exam website. In addition, each response was evaluated by a rheumatologist CCD and ranked for accuracy using a 5-level scale. The two GPT versions were compared in terms of response accuracy and length.</p><p><em>Results</em>: The average response length was 11.6 ±19 words for GPT-3 and 50.0±43.6 words for GPT-4. GPT-3 answered 62 questions correctly resulting in a failing ISCD score of 289. However, GPT-4 answered 82 questions correctly with a passing score of 342. GPT-3 scored highest on the “Overview of Low Bone Mass and Osteoporosis” category (72 % correct) while GPT-4 scored well above 80 % accuracy on all categories except “Imaging Technology in Bone Health” (65 % correct). Regarding subjective accuracy, GPT-3 answered 23 questions with nonsensical or totally wrong responses while GPT-4 had no responses in that category.</p><p><em>Conclusion</em>: If this had been an actual certification exam, GPT-4 would now have a CCD suffix to its name even after being trained using general internet knowledge. Clearly, more goes into physician training than can be captured in this exam. However, G","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101480"},"PeriodicalIF":2.5,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139921246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Sarcopenia and Osteoporosis in Elderly Male Patients with Obstructive Sleep Apnea Syndrome: A Multicenter Study","authors":"Zhen Xue ,&nbsp;Shengguan Song ,&nbsp;Changan Hu ,&nbsp;Shanglong Zhao ,&nbsp;Juan Wang","doi":"10.1016/j.jocd.2024.101481","DOIUrl":"10.1016/j.jocd.2024.101481","url":null,"abstract":"<div><p>The aim of this study was to assess the risk of sarcopenia and osteoporosis in elderly patients with obstructive sleep apnea syndrome (OSAS). We recruited both OSAS patients and non-OSAS subjects from multiple centers and evaluated their skeletal muscle index (SMI), bone mineral density (BMD), and inflammatory factors. All participants underwent polysomnography (PSG) testing, handgrip strength testing, chest CT, and dual-energy x-ray BMD testing. Based on the PSG diagnosis results, the participants were divided into a control group and an OSAS group. The analysis results revealed a higher incidence of sarcopenia in the OSAS group (<em>χ²</em> = 22.367; <em>P</em> = 0.000) and osteoporosis (<em>χ²</em> = 11.730^a; <em>P</em> = 0.001). There were statistically significant differences in BMI (<em>P</em> = 0.000), grip strength (<em>P</em> = 0.000), SMI (<em>P</em> = 0.000), bone density (<em>P</em> = 0.000) and vitamin D (<em>P</em> = 0.000). The independent sample t test results showed that there was no statistical difference between IL-6 (<em>P</em> = 0.247) and CRP (<em>P</em> = 0.246). Considering the potential impact of body weight on the observed indicators, we employed covariance analysis to calculate the modified <em>P</em> value for each observation indicator. The findings demonstrated that the grip strength, IL-6, and CRP levels in the OSAS group were significantly higher compared to the control group. Conversely, the SMI, bone density, and Vitamin D levels were found to be significantly lower in the OSAS group than in the control group. These results suggest a higher likelihood of sarcopenia and osteoporosis among OSAS patients. Further studies should be conducted in larger study populations.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101481"},"PeriodicalIF":2.5,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139921247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Health ECHO Case Report: Fractures and Hypercalcemia in a Patient with Stage 5 Chronic Kidney Disease","authors":"E. Michael Lewiecki ,&nbsp;Dale G. Erickson ,&nbsp;Roger W. Gildersleeve","doi":"10.1016/j.jocd.2024.101478","DOIUrl":"10.1016/j.jocd.2024.101478","url":null,"abstract":"<div><p>Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual community of practice with the aim of enhancing global capacity to deliver best practice skeletal healthcare. The prototype program, established at the University of New Mexico, has been meeting online weekly since 2015, focusing on presentation and discussion of patient cases. These discussions commonly cover issues that are relevant to a broad range of patients, thereby serving as a force multiplier to improve the care of many patients. This is a case report from Bone Health ECHO about a patient with stage 5 chronic kidney disease, hypercalcemia, and low bone density, and the discussion that followed.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101478"},"PeriodicalIF":2.5,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139879959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopenia and Osteoporosis Screening Detection: Calcaneal Quantitative Ultrasound with and without Calibration Factor Comparison to Gold Standard Dual X-ray Absorptiometry","authors":"Nutthapong Moonkum ,&nbsp;Thanat Withayanuluck ,&nbsp;Arun Somarungsan ,&nbsp;Naphondej Sichai ,&nbsp;Arisa Wongsiri ,&nbsp;Witchayada Chawkhaodin ,&nbsp;Podjana Ruengdach ,&nbsp;Pasinee Boonsuk ,&nbsp;Marut Pukdeeyorng ,&nbsp;Gunjanaporn Tochaikul","doi":"10.1016/j.jocd.2024.101470","DOIUrl":"10.1016/j.jocd.2024.101470","url":null,"abstract":"<div><p><em>Background</em>: osteoporosis is a worldwide major health problem that normally diagnosed in advanced stages. So, an early detection at preclinical stage is now an interesting issue. A key factor to early diagnosis the disease is the used of noninvasive bone densitometry. Dual energy x-ray absorptiometry (DXA) is the gold standard techniques for the proposed. However, the high cost, non-widely available and exposed to ionizing radiation are still a drawback of the machine. Therefore, a cheaper, smaller and non-ionizing device such quantitative ultrasound (QUS) is now a favor alternative method, but the possibility of used QUS measurement instead of DXA is still limited due to their uncertainties. So, the aim of our study was to calibrated the QUS with the DXA to allowing the possible to establish a calibration factor (CF) to improve the measured value closer to the standard method.</p><p><em>Methodology</em>: 135 healthy men and women aged 30–88 years were recruited for lumbar spine/femoral neck DXA and calcaneal QUS scanning. The Pearson's correlation between T- and Z-score from the two systems were studied. Moreover, the sensitivity, specificity and percentage of diagnosed accuracy for both with and without CF were calculated.</p><p><em>Results</em>: The significant correlation between the two systems showed a positive trajectory in highly correlation (<em>r</em> = 0.784–0.899). Analyses showed a higher sensitivity, specificity and reduced the misdiagnosed rates when applied the CF in QUS values.</p><p><em>Conclusions</em>: QUS results showed a significantly correlated with DXA results for both lumbar spine and femoral neck sites with some percentage differences. These differences can be reduced by applied an individual specific machine CF to improve a QUS results. As identification of high risk of osteopenia and osteoporosis to reduce the demand of DXA propose, using a QUS alternative method can be a reliable that provide a cheaper and lack of ionizing radiation.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101470"},"PeriodicalIF":2.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Calcium and Vitamin D Supplementation (Dairy vs. Pharmacological) on Bone Health of Underprivileged Indian Children and Youth with Type-1 Diabetes: A Randomized Controlled Trial","authors":"Anuradha Khadilkar ,&nbsp;Chirantap Oza ,&nbsp;Misha Antani ,&nbsp;Nikhil Shah ,&nbsp;Nikhil Lohiya ,&nbsp;Vaman Khadilkar ,&nbsp;Shital Bhor ,&nbsp;Neha Kajale ,&nbsp;Ketan Gondhalekar ,&nbsp;Chidvilas More ,&nbsp;Tarun Reddy Katapally ,&nbsp;Zulf Mughal ,&nbsp;Jasmin Bhawra ,&nbsp;Raja Padidela","doi":"10.1016/j.jocd.2024.101468","DOIUrl":"10.1016/j.jocd.2024.101468","url":null,"abstract":"<div><p><em>Background</em>: Bone health is affected by chronic childhood disorders including type-1 diabetes mellitus (T1DM). We conducted this randomized controlled trial with the objective of investigating the effect of 1-year supplementation of vitamin-D with milk or with pharmacological calcium on bone mass accrual in underprivileged Indian children and youth with T1DM.</p><p><em>Methods</em>: 5 to 23year old (<em>n</em> = 203) underprivileged children and youth with T1DM were allocated to one of three groups: Milk (group A-received 200 ml milk + 1000 international unit (IU) vitamin-D3/day), Calcium supplement (group B-received 500 mg of calcium carbonate + 1000 IU of vitamin-D3/day) or standard of care/control (group C). Anthropometry, clinical details, biochemistry, diet (3-day 24-h recall), physical activity (questionnaires adapted for Indian children) and bone health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography- DXA and pQCT respectively) were evaluated at enrolment and end of 12 month intervention.</p><p><em>Results</em>: Total body less head(TBLH) bone mineral content (BMC(g)) and bone mineral density (BMD(gm/cm²)) were significantly higher at end of study in girls in both supplemented groups (TBLHBMC-A-1011.8 ± 307.8, B-983.2 ± 352.9, C-792.8 ± 346.8. TBLHBMD-A-± 0.2, B-0.8 ± 0.2, C-0.6 ± 0.2, <em>p</em> &lt; 0.05). Z score of lumbar spine bone mineral apparent density of supplemented participants of both sexes was significantly higher than controls (Boys- A-0.7 ± 1.1, B-0.6 ± 1.4, C- −0.7 ± 1.1; Girls- A-1.1 ± 1.1, B-0.9 ± 3.4, C- −1.7 ± 1.3, <em>p</em> &lt; 0.05). A significantly higher percentage increase was found in cortical thickness in girls in both supplemented groups (A-17.9 ± 28.6, B-15.3 ± 16.5, C-7.6 ± 26.2); the differences remained after adjusting for confounders.</p><p><em>Conclusion</em>: Supplementation with milk or pharmacological calcium (+vitaminD3) improved bone outcomes–particularly geometry in children with T1DM with more pronounced effect in girls. Pharmacological calcium may be more cost effective in optimising bone health in T1DM in resource limited settings.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101468"},"PeriodicalIF":2.5,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-DXA based finite element modelling for femur strength prediction: evaluation against QCT.","authors":"Muhammad Qasim ,&nbsp;Mirella López Picazo ,&nbsp;Carlos Ruiz Wills ,&nbsp;Jérôme Noailly ,&nbsp;Silvana Di Gregorio ,&nbsp;Luis Miguel Del Río Barquero ,&nbsp;Jorge Malouf Sierra ,&nbsp;Ludovic Humbert","doi":"10.1016/j.jocd.2024.101471","DOIUrl":"10.1016/j.jocd.2024.101471","url":null,"abstract":"<div><p><span><span><span><span>Osteoporosis is characterised by the loss of bone density resulting in an increased risk of </span>fragility fractures. The clinical gold standard for diagnosing osteoporosis is based on the areal bone mineral density (aBMD) used as a surrogate for bone strength, in combination with clinical risk factors. Finite element (FE) analyses based on </span>quantitative computed tomography<span> (QCT) have been shown to estimate bone strength better than aBMD. However, their application in the osteoporosis clinics is limited due to exposure of patients to increased X-rays radiation dose. Statistical modelling<span> methods (3D-DXA) enabling the estimation of 3D femur shape and volumetric bone density from dual energy X-ray absorptiometry (DXA) scan have been shown to improve osteoporosis management. The current study used 3D-DXA based FE analyses to estimate femur strength from the routine clinical DXA scans and compared its results against 151 QCT based FE analyses, in a clinical cohort of 157 subjects. The </span></span></span>linear regression between the femur strength predicted by QCT-FE and 3D-DXA-FE models correlated highly (coefficient of determination R</span>² = 0.86) with a root mean square error (RMSE) of 397 N. In conclusion, the current study presented a 3D-DXA-FE modelling tool providing accurate femur strength estimates noninvasively, compared to QCT-FE models.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101471"},"PeriodicalIF":2.5,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139559501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a nomogram model for individualizing the risk of osteopenia in abdominal obesity","authors":"Gangjie Wu ,&nbsp;Chun Lei ,&nbsp;Xiaobing Gong","doi":"10.1016/j.jocd.2024.101469","DOIUrl":"10.1016/j.jocd.2024.101469","url":null,"abstract":"<div><p><strong>Objective:</strong> This study was aimed to create and validate a risk prediction model for the incidence of osteopenia in individuals with abdominal obesity.</p><p><strong>Methods:</strong> Survey data from the National Health and Nutrition Examination Survey (NHANES) database for the years 2013–2014 and 2017–2018 was selected and included those with waist circumferences ≥102 m in men and ≥88 cm in women, which were defined as abdominal obesity. A multifactor logistic regression model was constructed using LASSO regression analysis to identify the best predictor variables, followed by the creation of a nomogram model. The model was then verified and evaluated using the consistency index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA).</p><p><strong>Results</strong> Screening based on LASSO regression analysis revealed that sex, age, race, body mass index (BMI), alkaline phosphatase (ALP) and Triglycerides (TG) were significant predictors of osteopenia development in individuals with abdominal obesity (P &lt; 0.05). These six variables were included in the nomogram. In the training and validation sets, the C indices were 0.714 (95 % CI: 0.689–0.738) and 0.701 (95 % CI: 0.662–0.739), respectively, with corresponding AUCs of 0.714 and 0.701. The nomogram model exhibited good consistency with actual observations, as demonstrated by the calibration curve. The DCA nomogram showed that early intervention for at-risk populations has a net positive impact.</p><p><strong>Conclusion:</strong> Sex, age, race, BMI, ALP and TG are predictive factors for osteopenia in individuals with abdominal obesity. The constructed nomogram model can be utilized to predict the clinical risk of osteopenia in the population with abdominal obesity.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101469"},"PeriodicalIF":2.5,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139559621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cafeteria Diet Can Affect Bone Microarchitecture in Sedentary and Trained Male Rats","authors":"Marcio Koiti Saito ,&nbsp;Beatriz Kawano de Oliveira ,&nbsp;Ana Paula Macedo ,&nbsp;Caio Sorrentino dos Santos ,&nbsp;Ricardo Tadeu Lopes ,&nbsp;Jéssica Suzuki Yamanaka ,&nbsp;Antonio Carlos Shimano","doi":"10.1016/j.jocd.2024.101467","DOIUrl":"10.1016/j.jocd.2024.101467","url":null,"abstract":"<div><p><em>Introduction</em><span>: Poor eating habits and a sedentary lifestyle can impair health. Regular physical activity improves the quality of life<span> and is essential for bone health. Therefore, the present study aimed to evaluate the effects of the cafeteria diet on bone quality of sedentary and exercised rats.</span></span></p><p><em>Methods</em>: Sixty young male <em>Wistar</em><span> rats were divided into six groups (n=10) according to diet composition and activity level, being: SD+CON, standard diet and control; SD+SED, standard diet and sedentary; SD+EX, standard diet and exercised; CD+CON, cafeteria diet and control; CD+SED, cafeteria diet and sedentary; CD+EX, cafeteria diet and exercised. The exercise protocol consisted of 10 ladder-climbing sessions/day, 5 days/week, and the sedentary rats were maintained in individual cages with limited mobility. Body mass and food intake were evaluated weekly. After 10 weeks, the animals were euthanized, and white adipose tissue<span> was collected. The bone structure was evaluated by densitometry, mechanical tests, histomorphometric, and micro-computed tomography analyses.</span></span></p><p><em>Results</em><span>: The cafeteria diet increased adipose tissue (</span><em>p</em>&lt;0.001), decreased bone mineral density (<em>p</em>=0.004), and impaired biomechanical properties (<em>p</em><span>&lt;0.05) and histomorphometry parameters (</span><em>p</em>=0.044). The sedentarism decreased bone mineral density (<em>p</em>&lt;0.001) and biomechanical properties (<em>p</em>&lt;0.05), and the exercise did not improve bone properties.</p><p><em>Conclusion</em><span>: In this experimental model, it was concluded that the cafeteria diet and a sedentary lifestyle negatively affect bone, and ladder-climbing exercise could not prevent the effects of the unhealthy diet.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 2","pages":"Article 101467"},"PeriodicalIF":2.5,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139579092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Use of Trabecular Bone Score: The 2023 ISCD Official Positions","authors":"Heenam Goel,&nbsp;Neil Binkley,&nbsp;Miranda Boggild,&nbsp;Wing P. Chan,&nbsp;William D. Leslie,&nbsp;Eugene McCloskey,&nbsp;Sarah L. Morgan,&nbsp;Barbara C. Silva,&nbsp;Angela M. Cheung","doi":"10.1016/j.jocd.2023.101452","DOIUrl":"10.1016/j.jocd.2023.101452","url":null,"abstract":"<div><p><span><span>Osteoporosis<span> can currently be diagnosed by applying the WHO classification to bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry (DXA). However, skeletal factors other than BMD contribute to bone strength and fracture risk. </span></span>Lumbar spine<span><span> TBS, a grey-level texture measure which is derived from DXA images has been extensively studied, enhances fracture prediction independent of BMD and can be used to adjust fracture probability from FRAX® to improve </span>risk stratification<span>. The purpose of this International Society for Clinical Densitometry task force was to review the existing evidence and develop recommendations to assist clinicians regarding when and how to perform, report and utilize TBS. Our review concluded that TBS is most likely to alter clinical management </span></span></span>in patients<span> aged ≥ 40 years who are close to the pharmacologic intervention threshold by FRAX<span>. The TBS value from L1-L4 vertebral levels, without vertebral exclusions, should be used to calculate adjusted FRAX probabilities. L1-L4 vertebral levels can be used in the presence of degenerative changes and lumbar compression fractures. It is recommended not to report TBS if extreme structural or pathological artifacts are present. Monitoring and reporting TBS change is unlikely to be helpful with the current version of the TBS algorithm. The next version of TBS software will include an adjustment based upon directly measured tissue thickness. This is expected to improve performance and address some of the technical factors that affect the current algorithm which may require modifications to these Official Positions as experience is acquired with this new algorithm.</span></span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101452"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138528861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative CT Evaluation of Bone Mineral Density in the Thoracic Spine on 18F-Fluorocholine PET/CT Imaging in Patients With Primary Hyperparathyroidism","authors":"Erik T. te Beek ,&nbsp;Chris P.W. van Duijnhoven ,&nbsp;Riemer H.J.A. Slart ,&nbsp;Joop P. van den Bergh ,&nbsp;Marc R.J. ten Broek","doi":"10.1016/j.jocd.2023.101464","DOIUrl":"10.1016/j.jocd.2023.101464","url":null,"abstract":"<div><p><em>Introduction</em><span><span>: Measurement of bone mineral density (BMD) with quantitative CT (QCT) carries several advantages over other densitometric techniques, including superior assessment of the spine. As most QCT studies evaluated the lumbar spine<span>, measurements of the thoracic spine are limited. We performed QCT analysis of the thoracic spine in a cohort of patients with </span></span>primary hyperparathyroidism. </span><em>Materials and methods</em>: This study was a retrospective QCT analysis of the thoracic spine on ¹⁸<span>F-fluorocholine PET/CT scans in patients<span><span> with primary hyperparathyroidism patients between March 2018 and December 2022. Correlations between QCT-derived BMD or Hounsfield units (HU) and demographic data, laboratory parameters, results from histopathological examination after parathyroidectomy and results of </span>DXA imaging were analyzed, when available. </span></span><em>Results</em>: In 189 patients, mean QCT-derived BMD at the thoracic spine was 85.6 mg/cm³<span><span>. Results from recent DXA were available in 122 patients. Mean thoracic QCT-derived BMD and HU were significantly correlated with DXA-derived BMD in lumbar spine, total hip and femoral neck and with the lowest T-score at DXA imaging. Only weak correlations were found with </span>BMI or </span>¹⁸<span><span>F-fluorocholine uptake, while no significant correlations were found with adenoma weight, </span>PTH or calcium levels. </span><em>Conclusion</em><span>: Our study confirms correlation between QCT-derived BMD in the thoracic spine with age and DXA-derived BMD measurements within a population of patients with primary hyperparathyroidism. Establishment of reference BMD values for individual thoracic vertebrae<span>, may allow direct osteoporosis classification on thoracic CT imaging.</span></span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101464"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138693159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}