Measurement of Phantomless Thoracic Bone Mineral Density on Coronary Artery Calcium CT Scans Acquired with Various CT Scanner Models

Budoff, Matthew J.; Malpeso, Jennifer; Zeb, Irfan; Gao, Yanlin; Li, Dong; Choi, Tae‐Young; Dailing, Christopher; Mao, Song

doi:10.1148/radiol.13111987

Cited by 58 publications

(44 citation statements)

References 19 publications

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“…By using the calibration factor to calculate BMD, the accuracy error has been decreased significantly. The variation of re-scan or re-measurement is b5%, b3% and b2% (CV) in phantom rods with a 50, 100 and 200 mg/cm 3 of CaHA respectively displayed by the prior study [36]. Osteoporosis is a bone mineral metabolic disorder.…”

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 97%

“…Since the variation exists within individual spinal BMD [35], fixing the levels is an important issue for decreasing the precision error of BMD assessment. The continuous three thoracic spines (3 T) beginning from the level of the left coronary artery are commonly used to assess the trabecular BMD on CAC scanning [21,36]. A similar segmenting and calculating method with the lumbar spine is used in the thoracic QCT (shown in Fig.…”

Section: 2mentioning

confidence: 99%

“…To date, three methods were used for the phantomless BMD measurement at spine: 1) Using an individual body tissue as a calibration reference, such as the paraspinal fat and psoas [38,39]; 2) Using a modified calibration factor (calibration curve) [40,41]; 3) Using the CTHU directly [42]. Although the standardization of CTHU was done by individual manufacturers, and the calibration procedure was performed before the row data reconstruction, a significant variation between scanners still exists [36,43]. The stabilization of CTHU can be influenced by numerous factors, including the scanner's model, scan algorithm parameters [44], patient's body size [35] and many other factors, which needs to be corrected before any quantitative assessment.…”

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

“…The calibration factor (ratio in true density phantom rod and CTHU, mg/cm 3 /CTHU) may benefit BMD assessment, and the calibrating factors were established for most current scanners [36]. With this method, the CTHU was measured at three continuous thoracic spines described above.…”

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

“…The uniformed CTHU can be obtained from any CT workstation. The individual BMD can be obtained, CTHU×calibration factor (mg/cm 3 ) [36].…”

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

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Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

et al. 2016

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a b s t r a c t a r t i c l e i n f oOsteoporosis is a common metabolic bone disease, causing increased skeletal fragility characterized by a low bone mass and trabecular microarchitectural deterioration. Assessment of the bone mineral density (BMD) is the primary determinant of skeletal fragility. Computed tomography (CT)-based trabecular microarchitectural and mechanical assessments are important methods to evaluate the skeletal strength. In this review, we focus the feasibility of QCT BMD measurement using a calibration phantom or phantomless. The application of QCT could extend the bone mineral density assessment to all patients who underwent a heart, lung, whole-body, and as well as all routine clinical implications of CT scan.

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Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 97%

Section: 2mentioning

confidence: 99%

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

“…The uniformed CTHU can be obtained from any CT workstation. The individual BMD can be obtained, CTHU×calibration factor (mg/cm 3 ) [36].…”

Section: Phantomless Assessment Of the Thoracic Vertebral Bmd Using Amentioning

confidence: 99%

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Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

et al. 2016

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Sacral bone mineral density (BMD) assessment using opportunistic CT scans

Hoel

Ledonio

Takahashi

et al. 2016

Journal Orthopaedic Research

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This study seeks to establish a method for opportunistic evaluation of sacral bone mineral density. This is a retrospective review of 109 scans from 109 patients who had renal-protocol computed tomography (CT) scans performed for any indication during a 3-month period at a single academic institution in 2014. In the collected CT scans, sacral CT-attenuation in multiple regions of interest (ROI) was compared to the L1 CT-attenuation, an internal reference standard, to determine if a correlation existed. The sacral ROI were analyzed to determine regions of higher and lower attenuation. All sacral ROI had strong correlations with lumbar spine attenuation values, and these values became even stronger when transitional vertebrae were excluded. Sacral attenuation values varied predictably by location, and matched relationships were shown by prior volumetric bone mineral density studies. We conclude that sacral CT-attenuation can be used in opportunistic CT scans to determine sacral bone mineral density. Keywords: bone mineral density; BMD; sacral; sacrum; computed tomography; CT; sacroiliac fixation; lumbosacral fixation Sacroiliac (SI) joint pain is increasingly being recognized as a common lower back pain generator. Prior studies have estimated approximately 15-25% of low back pain comes from the SI joint. [1][2][3][4][5] To address this pathology, sacroiliac fusion techniques are gaining increased attention. 6 These procedures rely upon fixation across the SI joint. 7 Sacral sided loosening appears to be the most common mode of failure, likely due to poor bone quality in that region of the sacrum (Fig. 1).Sacral bone density has previously been studied in relation to lumbosacral fusion. Prior studies have shown up to 45% of sacropelvic instrumentation failures have S1 screw haloing or pullout, with biomechanical studies showing sacral screw pullout strength is weaker in low sacral bone mineral density (BMD). 8,9 Unfortunately, over 50% of females and 15% of males requiring spine surgery after the age of 50 are osteoporotic as evaluated by dual-energy X-ray absorptiometry (DXA). 10 With such high incidence of osteoporosis in this population, further studies are needed to quantify the risk of unsuccessful SI and lumbosacral fixation and fusion with relation to sacral BMD. Development of an accessible method for evaluation of sacral bone density would be instrumental in determining the relation of bone density to successful SI joint and lumbosacral fixation and fusion.Recent studies have shown that cancellous bone computed tomography (CT) attenuation values which correlate with DXA measurements of BMD can be obtained at the L1 vertebra using opportunistic CT scans. [11][12][13][14][15][16][17][18][19] No prior studies have examined sacral BMD using this method. As there are 62 million CT scans performed in the United States every year, a substantial proportion of patients undergoing sacroiliac or lumbosacral fixation will have had prior CT scans. 20 If sacral BMD was able to be assessed from prior CT scans, ...

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Focal osteoporosis defect is associated with vertebral compression fracture prevalence in a bone mineral density‐independent manner

Zhuo

et al. 2022

JOR Spine

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Introduction: Focal osteoporosis defect has shown a high association with the bone fragility and osteoporotic fracture prevalence. However, no routine computed tomography (CT)-based vertebral focal osteoporosis defect measurement and its association with vertebral compression fracture (VCF) were discussed yet. This study aimed to develop a routine CT-based measurement method for focal osteoporosis defect quantification, and to assess its association with the VCF prevalence. Materials and Methods: A total of 205 cases who underwent routine CT scanning, were retrospectively reviewed and enrolled into either the VCF or the control group. The focal bone mineral content loss (focal BMC loss), measured as the cumulated demineralization within bone void space, was proposed for focal osteoporosis defect quantification. Its scan-rescan reproducibility and its correlation with trabecular bone mineral density (BMD) and apparent microarchitecture parameters were evaluated.The association between focal BMC loss and the prevalence of VCF was studied by logistic regression. Results:The measurement of focal BMC loss showed high reproducibility (RMSSD = 0.011 mm, LSC = 0.030 mm, ICC = 0.97), and good correlation with focal bone volume fraction (r = 0.79, P < 0.001), trabecular bone separation (r = 0.76, P < 0.001), but poor correlation with trabecular BMD (r = 0.37, P < 0.001). The focal BMC loss was significantly higher in the fracture group than the control (1.03 ± 0.13 vs. 0.93 ± 0.11 mm; P < 0.001), and was associated with prevalent VCF (1.87, 95% CI = 1.31-2.65, P < 0.001) independent of trabecular BMD level.Discussion: As a surrogate measure of focal osteoporosis defect, focal BMC Loss independently associated with the VCF prevalence. It suggests that focal osteoporosis defect is a common manifestation that positively contributed to compression fracture risk and can be quantified with routine CT using focal BMC Loss.

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Measurement of Phantomless Thoracic Bone Mineral Density on Coronary Artery Calcium CT Scans Acquired with Various CT Scanner Models

Abstract: Phantomless BMD can be measured accurately on CAC CT scans acquired with a variety of CT scanners without additional radiation exposure.

Cited by 58 publications

References 19 publications

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

Sacral bone mineral density (BMD) assessment using opportunistic CT scans

Focal osteoporosis defect is associated with vertebral compression fracture prevalence in a bone mineral density‐independent manner

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