Bone mineral assessment: new dual-energy CT approach.

Abstract

Most clinical quantitative computed tomographic (CT) determinations of bone mineral content are hampered by inability to properly account for the various substances contained within the spongiosa (spongy bone). In general, the presence of adipose tissue lowers the CT numbers (Hounsfield units) and leads to underestimation of bone mineral content. Collagen matrix has the opposite effect. A new approach to obtaining data from postreconstruction dual-energy CT scans accounts for five principal constituents of the spongiosa. In addition to bone mineral values, the method also provides the adipose tissue concentration, calcium content, and density of the total trabecular space. Since calcium values are provided, the measurements can be compared with prereconstruction dual-energy data that are acquired simultaneously. A new solid-plastic calibration phantom was utilized in this study, and data were obtained from 26 subjects. Dual-energy data were correlated with single-energy measurements (r greater than .96), and calcium measurements were correlated with the bone mineral determinations (r = .97) in these 26 cases. All measurements of the various vertebral constituents agreed with published values.

Bone Densitometry for Diagnosis and Monitoring Osteoporosis

“…It is possible to reduce this 5-fold (66,69). A high kilovoltage also is undesirable because it increases the large accuracy errors (at least 15-25%) associated with variable marrow fat and varying osteoid (83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98). Gluer et al (99) showed an error of ash density of 8 mg/cm3 for every 100 mg/cm3 change of marrow fat, but the error at higher energies is 10-13 mg/cm3, i.e., 30-50% greater (85,92,(99)(100)(101).…”

Dual-Energy CT–based Phantomless in Vivo Three-dimensional Bone Mineral Density Assessment of the Lumbar Spine

“…Initial studies involving early dual-energy CT concepts for BMD evaluation were published more than 2 decades ago (14,15). Recently, a novel approach for regional BMD assessment with dual-energy CT has been presented (16).…”

The feasibility of dual-energy CT in differentiation of vertebral compression fractures

“…Image analysis was based on a threematerial decomposition algorithm for the bone mineral, yellow marrow and red marrow. [18][19][20][21] For our evaluation of the vertebral bodies, the relative contrast material ratio was set to a value of 1.75, and the range of the filter was set to 3 based on the experience from previous studies. 5,11,22,23 Non-calcium images were displayed in greyscale.…”