Trabecular Bone Mineral Density Measurement Using Thoracic and Lumbar Quantitative Computed Tomography

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

“…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].…”

“…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. Moreover, the attenuation Fig.…”

“…The optimal results were obtained in most studies [33,34,36], including the chest [55,57,66], heart [21,23,36] and abdomen or pelvis CT scan [42,67,68]. A long calibration phantom (at least about 85 cm or longer, developed by Image Analysis, Columbia, KY, USA) is beneficial for the QCT BMD assessment with the whole-body scan [35].…”

“…However, only the lumbar QCT was commonly used in clinical practice. The associations between the lumbar and thoracic spine, as well as hip and/or peripheral bones were studied previously [23,35]. There were a significant associations between L1-3 (lumbar spine 1-3) and any individual vertebrae from the first thoracic to the fifth lumbar spine (R value, from 0.62 to 0.98, Pb .001).…”

“…A significant association between the mean value of 3 T (three continuous thoracic spines from the slice level in containing left main coronary artery) and L1-3 with a 0.89 of R values was found in both genders. Both 3 T and L1-3 were used in the QCT assessment with a routine heart or lumbar scan [35]. In our knowledge, no association in the BMD value or agreement in the T score between the lumbar and hip or peripheral measurement using QCT was documented to date.…”