The impact of obesity on the accuracy of DXA BMD for DXA-equivalent BMD estimation

Abstract

Introduction As the radiomics technique using texture features in CT is adopted for accessing DXA-equivalent bone mineral density (BMD), this study aims to compare BMD by DXA and predicted BMD to investigate the impact of obesity and central obesity in general patients. Materials and methods A total of 710 cases (621 patients) obtained from May 6, 2012, to June 30, 2021, were used in the study. We focused both their abdomen & pelvis CT’s first lumbar vertebrae axial cuts to predict estimated BMD and bone mineral content (BMC). In each patient’s CT, we extracted the largest trabecular region of the L1 vertebral body as a region of interest (ROI) using the gray-level co-occurrence matrices (GLCM) technique, and linear regression was applied to predict the indices. Cases were divided by central obesity/overall obesity and normal group by body mass index (BMI), waist circumference (WC), or index of central obesity (ICO) standard. Results The coefficients were all above 0.73, respectively. P-values from ICO were over 0.05 when the measures were Hip BMD and Hip BMC. In contrast, those from ICO were 0.0131 and 0.0351 when the measures were L1 BMD and L1 BMC, respectively, which show a difference between the two groups. Conclusions The CT HU texture analysis method was an effective and economical method for measuring estimated BMD and BMC and evaluating the impact of obesity. We found that central obesity especially exerted an effect on the disturbance of the clinical BMD measurements since groups were significantly different under the ICO standard.

Discordance between dual-energy X-ray absorptiometry bone mineral density and spinal computed tomography texture analysis: An investigation into low correlation rates

“…Interestingly, our study also revealed discordance between the CT and DXA measurements in certain scenarios. This discordance could stem from various factors, including differences in the measured regions, methodological discrepancies, or inherent inaccuracies in DXA scanning, particularly in patients with degenerative changes or abdominal obesity [ 10 ]. DXA measurements are known to be susceptible to inaccuracies in individuals with high abdominal fat content due to overlaying soft tissue artifacts [ 3 ].…”

Association of type 2 Diabetes Mellitus and bone mineral density: a two-sample Mendelian randomization study

“…Numerous intricate pathways exist through which obesity might affect the connection between diabetes and BMD. The influence of body fatness on the precision of DXA-based BMD assessments, as evidenced in obese individuals with diabetes, is noteworthy [ 23 ]. However, the potential measurement error should be of minimal concern, given that this phenomenon has been demonstrated to potentially result in either underestimation or overestimation of values.…”

Elucidating the Correlation between Bone Mineral Density and Multifidus Muscle Characteristics: A Cross-Modal Study with Dual-Energy X-ray Absorptiometry and Spinal Computed Tomography Texture Analysis

“…In contrast to previous studies, our investigation is not limited to the L1 region. Instead, we considered a broader range, spanning from T12 to S1, a factor that enhances the robustness of our findings [26,27]. We chose to employ spine CT scans for this texture analysis due to their frequent usage during health checkups, often alongside DXA scans for osteoporosis diagnosis.…”