Clinical Use of Quantitative Computed Tomography and Peripheral Quantitative Computed Tomography in the Management of Osteoporosis in Adults: The 2007 ISCD Official Positions

Engelke, Klaus; Adams, Judith E.; Armbrecht, Gabriele; Augat, Peter; Bogado, César E.; Bouxsein, Mary L.; Felsenberg, Dieter; Ito, Masako; Prevrhal, Sven; Hans, Didier; Lewiecki, E. Michael

doi:10.1016/j.jocd.2007.12.010

Cited by 455 publications

(372 citation statements)

References 254 publications

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“…To increase the clinical acceptability of 3D QCT of the hip, further optimization of acquisition protocols with lower radiation doses is required, particularly for application in younger subjects than those in our study. (54) QCT should be considered as a powerful tool for studying the etiology of hip fractures and targeting the impact of therapeutic and nonpharmacologic interventions in osteoporosis. In addition to bone-strength assessment, QCT can be used to measure reduction in subcutaneous fat and muscle cross-sectional area and increased muscle adiposity.…”

Section: Discussionmentioning

confidence: 99%

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

Bousson

Adams

Engelke³

et al. 2010

Journal of Bone and Mineral Research

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In assessing osteoporotic fractures of the proximal femur, the main objective of this in vivo case-control study was to evaluate the performance of quantitative computed tomography (QCT) and a dedicated 3D image analysis tool [Medical Image Analysis Framework-Femur option (MIAF-Femur)] in differentiating hip fracture and non-hip fracture subjects. One-hundred and seven women were recruited in the study, 47 women (mean age 81.6 years) with low-energy hip fractures and 60 female non-hip fracture control subjects (mean age 73.4 years). Bone mineral density (BMD) and geometric variables of cortical and trabecular bone in the femoral head and neck, trochanteric, and intertrochanteric regions and proximal shaft were assessed using QCT and MIAF-Femur. Areal BMD (aBMD) was assessed using dual-energy X-ray absorptiometry (DXA) in 96 (37 hip fracture and 59 non-hip fracture subjects) of the 107 patients. Logistic regressions were computed to extract the best discriminates of hip fracture, and area under the receiver characteristic operating curve (AUC) was calculated. Three logistic models that discriminated the occurrence of hip fracture with QCT variables were obtained (AUC ¼ 0.84). All three models combined one densitometric variable-a trabecular BMD (measured in the femoral head or in the trochanteric region)-and one geometric variable-a cortical thickness value (measured in the femoral neck or proximal shaft). The best discriminant using DXA variables was obtained with total femur aBMD (AUC ¼ 0.80, p ¼ .003). Results highlight a synergistic contribution of trabecular and cortical components in hip fracture risk and the utility of assessing QCT BMD of the femoral head for improved understanding and possible insights into prevention of hip fractures. ß

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Section: Discussionmentioning

confidence: 99%

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

Bousson

Adams

Engelke³

et al. 2010

Journal of Bone and Mineral Research

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“…The most recent International Society for Clinical Densitometry guideline does not permit the clinical diagnosis of osteoporosis from T-scores derived from qCT as these values are not equivalent to the T-scores derived by DXA. 19 The L-spine was evaluated by computerized tomographic scan for the degree of DJD. A semiquantitative technique was used to grade the severity of DJD because mild, moderate or severe.…”

Section: Dxa and Qct Imagingmentioning

confidence: 99%

Dual-energy X-ray absorptiometry overestimates bone mineral density of the lumbar spine in persons with spinal cord injury

et al. 2009

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Background: Bone mineral density (BMD) of the lumbar spine (L-spine) has been reported to be normal or increased in persons with chronic spinal cord injury (SCI). Objective: To determine BMD of the L-spine by dual-energy X-ray absorptiometry (DXA) and quantitative computerized tomography (qCT) in men with chronic SCI compared with able-bodied controls. Design: Cross-sectional, comparative study. Setting: Clinical research unit, Veterans Affairs Medical Center, Bronx, NY, USA and Kessler Institute of Rehabilitation, West Orange, NJ, USA. Methods: Measurements of the L-spine were made in 20 men with SCI and compared with 15 ablebodied controls. The DXA images were acquired on a GE Lunar DPX-IQ. The qCT images of the L-spine were acquired on a Picker Q series computerized tomographic scanner. Results: The mean ages for the SCI and control groups were 44±13 vs 42±9 years, and the duration of injury of the group with SCI was 14 ± 11 years. There were no significant differences between the SCI and control groups for L-spine DXA BMD (1.391±0.210 vs 1.315±0.178 g/m 2 ) or for L-spine DXA T-score (1.471 ± 1.794 vs 0.782 ± 1.481). L-spine qCT BMD was significantly lower in the SCI compared with the control group (1.296±0.416 vs 1.572±0.382 g/m 2 , P ¼ 0.05); the T-score approached significance (À1.838 ± 1.366 vs À0.963 ± 1.227, P ¼ 0.059). Subjects with moderate degenerative joint disease (DJD) had significantly higher T-scores by DXA than those without or with mild DJD. Conclusion: Individuals with SCI who have moderate to severe DJD may have bone loss of the L-spine that may be underestimated by DXA, reducing awareness of the risk of fracture.

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“…Quantitative computed tomography (QCT) is a three-dimensional nonprojectional technique to detect "real" bone mineral density, avoiding some pitfalls and overlying structures or disease (e.g., aorta/ soft-tissue calcifications, osteoarthritis) (8,9). This study aimed to investigate vertebral body BMD in patients with lumbar spondylolysis by using QCT and compare the findings with those of healthy controls.…”

mentioning

confidence: 99%

Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT

Gezer

Balcı²,

Kalemcı³

et al. 2017

Diagn Interv Radiol

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Clinical Use of Quantitative Computed Tomography and Peripheral Quantitative Computed Tomography in the Management of Osteoporosis in Adults: The 2007 ISCD Official Positions

Cited by 455 publications

References 254 publications

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

In vivo discrimination of hip fracture with quantitative computed tomography: Results from the prospective European Femur Fracture Study (EFFECT)

Dual-energy X-ray absorptiometry overestimates bone mineral density of the lumbar spine in persons with spinal cord injury

Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT

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