Accuracy and precision of volumetric bone mineral density assessment using dual-source dual-energy versus quantitative CT: a phantom study

  • Background: Dual-source dual-energy computed tomography (DECT) offers the potential for opportunistic osteoporosis screening by enabling phantomless bone mineral density (BMD) quantification. This study sought to assess the accuracy and precision of volumetric BMD measurement using dual-source DECT in comparison to quantitative CT (QCT). Methods: A validated spine phantom consisting of three lumbar vertebra equivalents with 50 (L1), 100 (L2), and 200 mg/cm3 (L3) calcium hydroxyapatite (HA) concentrations was scanned employing third-generation dual-source DECT and QCT. While BMD assessment based on QCT required an additional standardised bone density calibration phantom, the DECT technique operated by using a dedicated postprocessing software based on material decomposition without requiring calibration phantoms. Accuracy and precision of both modalities were compared by calculating measurement errors. In addition, correlation and agreement analyses were performed using Pearson correlation, linear regression, and Bland-Altman plots. Results: DECT-derived BMD values differed significantly from those obtained by QCT (p < 0.001) and were found to be closer to true HA concentrations. Relative measurement errors were significantly smaller for DECT in comparison to QCT (L1, 0.94% versus 9.68%; L2, 0.28% versus 5.74%; L3, 0.24% versus 3.67%, respectively). DECT demonstrated better BMD measurement repeatability compared to QCT (coefficient of variance < 4.29% for DECT, < 6.74% for QCT). Both methods correlated well to each other (r = 0.9993; 95% confidence interval 0.9984–0.9997; p < 0.001) and revealed substantial agreement in Bland-Altman plots. Conclusions: Phantomless dual-source DECT-based BMD assessment of lumbar vertebra equivalents using material decomposition showed higher diagnostic accuracy compared to QCT.

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Author:Vitali KochORCiDGND, Nils Große Hokamp, Moritz Hans Ernst AlbrechtORCiDGND, Leon David GrünewaldORCiDGND, Ibrahim YelORCiDGND, Jan BorggrefeORCiDGND, Stefan Wesarg, Katrin EichlerGND, Iris BurckORCiDGND, Tatjana Gruber-RouhORCiDGND, Lukas Fabian LengaORCiDGND, Thomas J. VoglORCiDGND, Simon MartinORCiDGND, Julian WichmannORCiDGND, Renate Maria HammerstinglGND, Leona Soraja AlizadehORCiDGND, Christoph MaderORCiDGND, Nicole A. Huizinga, Tommaso D’AngeloORCiD, Giorgio Ascenti, Silvio MazziottiORCiD, Christian BoozORCiDGND
Parent Title (English):European radiology experimental
Publisher:Springer International Publishing
Place of publication:[Cham]
Document Type:Article
Date of Publication (online):2021/10/05
Date of first Publication:2021/10/05
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/01/25
Tag:Bone density; Dual-energy computed tomography; Osteoporosis; Phantoms (imaging); Tomography (x-ray computed)
Issue:art. 43
Page Number:10
First Page:1
Last Page:10
Open Access funding enabled and organised by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0