Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation

Müeller, Dirk; Kutscherenko, Alex; Bartel, Hans; Vlassenbroek, Alain; Ouředníček, Petr; Erckenbrecht, J. F.

doi:10.1016/j.ejrad.2010.02.008

Cited by 100 publications

(81 citation statements)

References 25 publications

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“…For example, heterogeneous or varying density values of muscle and fat, which are used as reference standards, due to differences in hydration status can influence the measurements [14]. In accordance with that, previous studies have already shown that intravenous contrast media administration also leads to higher BMD values measured on routine MDCT scans [15 -18].…”

Section: Introductionsupporting

confidence: 56%

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Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

Toelly

Bardach

Weber

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Ziel der Studie war den Einfluss einer intravenösen Kontrastmittelgabe auf phantomlos gemessene volumetrische Knochendichtewerte im Routine-MDCT zu evaluieren. Zusätz-lich sollte eine Formel zur Berechnung der wahrheitsgetreuen Knochendichte aus arteriell und venös gemessenen Werten aufgestellt werden. Material und Methodik 112 postmenopausale Frauen imAlter von 40 bis 77 Jahren (mittleres Alter 57,31; SD 9,61), die ein triphasisches MDCT (nativ, arteriell und venös) ABSTR AC TAim To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value.Materials and Methods 112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool.Results The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p < 0.001) was found between BMD values on unenhanced and contrastenhanced MDCT scans. There was no significant difference between BMD values in the arterial and venous phases (p = 0.228). The following conversion formulas were calculated using linear regression: unenhanced BMD = -2.287 + 0.964 * . The intrarater agreement of BMD measurements was calculated with an intraclass correlation (ICC) of 0.984 and the interobserver reliability was calculated with an ICC of 0.991.Conclusion Phantom-less BMD measurements in contrastenhanced MDCT scans result in increased mean BMD values, but, with the formulas applied in our study, a reliable BMD value can be calculated. However, the mean BMD values did not differ significantly between the arterial and venous phases. Key points▪ BMD can be assessed on routine CT scans using a phantom-less tool.

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Section: Introductionsupporting

confidence: 56%

“…This saves the patient from additional radiation exposure. Furthermore, beam-hardening and scatter effects, which might be induced by an external phantom, do not play a role in phantom-less BMD measurement methods [13,14].…”

Section: Introductionmentioning

confidence: 99%

Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

Toelly

Bardach

Weber

et al. 2017

Fortschr Röntgenstr

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“…Furthermore, the modified QCT methodology (phantomless) also is acceptable to assess BMD, but the calibration factors need to be calculated for a given scanner before or after the studies [36,40,41]. The psoas or fat tissue of paravertibrae can be used as a calibration mark [38,39]. Further studies well be needed to demonstrate the role of QCT in predicting fracture risk and monitoring anti-osteoporosis by using BMD, micro-architectural and mechanical assessments.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, high-precision results were found in most studies. The average coefficient variation of a precision error (CV% by RMS or SD/mean methods) was b3% from 1.8 to 4.0% in most studies [8,21,38,77,78,82,83]. The precision error among scan parameters can be limited to 2% of CV.…”

Section: Precision Of the Qct In Central Peripheral And Ctdx Assessmentmentioning

confidence: 98%

“…A phantomless thoracic BMD measurement would be a great advance in clinical practice. 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].…”

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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Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD

Romme

Murchison

Phang

et al. 2012

Journal of Bone and Mineral Research

113

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Chronic obstructive pulmonary disease (COPD), although primarily a disease of the lungs, is associated with extrapulmonary effects such as muscle weakness and osteoporosis. Fractures owing to osteoporosis cause significant morbidity and mortality, particularly in patients with COPD. To prevent osteoporotic fractures, it is important to diagnose osteoporosis in an early stage and to start anti-osteoporotic therapy in at-risk patients. Because routine chest computed tomography (CT) is increasingly used to assess the extent of emphysema and airways disease in patients with COPD, we investigated whether simple attenuation measurement of the thoracic spine on routine chest CT may provide useful information on bone health in patients with COPD. Fifty-eight patients with moderate to very severe COPD were included in our study. The average attenuation of thoracic vertebrae 4, 7, and 10 on chest CT was correlated with the lowest bone mineral density (BMD) of the hip and lumbar spine (L 1 to L 4 ) on dual-energy X-ray absorptiometry (DXA) in patients with COPD. The inter-and intra-observer variabilities of the attenuation measurements were low as shown by Bland-Altman plots. Pearson's correlation coefficient between the average attenuation of the three thoracic vertebrae and the lowest BMD of the hip and lumbar spine was high (r ¼ 0.827, p < 0.001). A receiver-operating characteristic (ROC) analysis of the area under the curve for osteoporosis was 0.969 (p < 0.001), corresponding to an attenuation threshold of 147 Hounsfield Units (HU). In conclusion, our data demonstrated that bone attenuation measured on routine chest CT correlated strongly with BMD assessed on DXA in patients with COPD. Routine chest CT may provide useful information on bone health in patients with COPD. ß

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Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation

Cited by 100 publications

References 25 publications

Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

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

Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD

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