Early detection and treatment of osteoporosis through bone mineral density (BMD) measurement could aid in the prevention of osteoporosis-related fractures. We aimed to assess the parameter of dual-energy spectral CT (DesCT) consistency with BMD determination using quantitative computed tomography (QCT), thereby establishing a basis for further DesCT application for BMD determination. Methods: We subjected the European spine phantom, which contains three vertebral bodies (V1, V2, and V3), to DesCT with different radiation doses. The basis material pairs were hydroxyapatite (water), calcium (water), and hydroxyapatite (fat). Additionally, the medical records of 152 patients who underwent QCT and DesCT for chest scans in a two-month period were reviewed to measure BMD values. Results: No significant differences were found in the basis pair values of the V1, V2, or V3 vertebrae under different radiation doses in the phantom; in particular, the hydroxyapatite (water), hydroxyapatite (fat), relative error values of V1, V2, and V3 under different radiation doses were not significantly different (all p > 0.05). For patients, the hydroxyapatite (water), hydroxyapatite (fat), and hydroxyapatite (average) values measured by DesCT had a significant correlation with BMD measured by QCT Among 242 vertebrae (152 T12 and 90 L1 vertebrae), there was no significant difference between the BMD measured by QCT and the HAP (average) measured by DesCT (p = 0.071). The interclass correlation coefficient (ICC) value was 0.925 between the HAP (average) and HAP (average) with DesCT and BMD measured by QCT (p < 0.001). Bland-Altman diagram indicated that both measurements were in good agreement. Discussion: We showed that BMD values measured by DesCT were stable and repeatable under different radiation doses. DesCT and QCT measurements of human BMD were highly correlated. Thus, DesCT-based BMD assessment of the spine in a clinical setting could be considered feasible.
Background: The update in technology may impact the accuracy in measuring bone mineral density (BMD). However, the application of the new fast kilovoltage (kV)-switching dual-energy computed tomography (DECT) for BMD measurement has not yet been reported. This study aimed to examine the accuracy and precision of the new fast kV-switching DECT in measuring BMD and to evaluate its applicability in clinical BMD measurement.Methods: Forty sets of the new fast kV-switching DECT scans and one quantitative computed tomography (QCT) scan were performed on the European Spine Phantom. Their relative errors and relative standard deviations were compared. A retrospective analysis was performed on patients who underwent chest plain DECT and abdominal monoenergetic plain CT at the same time. The relationship between hydroxyapatitewater and hydroxyapatite-fat measured using DECT and BMD measured using QCT was analyzed by multivariate regression analysis. Results:The relative errors of the new fast kV-switching DECT with low tube speeds (0.8 and 1.0 s/r) were all less than 6% and were less than those of QCT, except for those at 515 mA. The relative standard deviation values with high tube rotation speeds (0.5 and 0.6 s/r) were higher than those with low tube speeds (0.8 and 1.0 s/r) under most tube current conditions. The new fast kV-switching DECT-derived BMD values corrected by multiple linear regression (predicted hydroxyapatite) were significantly positively correlated with the QCT-based BMD values (R 2 =0.912; P<0.001). The results of the Bland-Altman analysis demonstrated high consistency between the 2 measurement methods.Conclusions: Results of the phantom measurements indicated that the new fast kV-switching DECT could measure BMD with relatively high accuracy and precision. The results of a subsequent clinical in vivo experiment demonstrated that vertebral BMD measurements derived from DECT and QCT were mostly consistent and highly accurate. Therefore, patients who undergo DECT for other clinical indications can simultaneously have their BMD determined.
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