Leon David Grünewald, Vitali Koch, Simon Martin, Ibrahim Yel, Katrin Eichler, Tatjana Gruber-Rouh, Lukas Fabian Lenga, Julian Wichmann, Leona Soraja Alizadeh, Moritz Hans Ernst Albrecht, Christoph Mader, Nicole A. Huizinga, Tommaso D’Angelo, Silvio Mazziotti, Stefan Wesarg, Thomas J. Vogl, Christian Booz
- Objectives: To evaluate the predictive value of volumetric bone mineral density (BMD) assessment of the lumbar spine derived from phantomless dual-energy CT (DECT)-based volumetric material decomposition as an indicator for the 2-year occurrence risk of osteoporosis-associated fractures. Methods: L1 of 92 patients (46 men, 46 women; mean age, 64 years, range, 19–103 years) who had undergone third-generation dual-source DECT between 01/2016 and 12/2018 was retrospectively analyzed. For phantomless BMD assessment, dedicated DECT postprocessing software using material decomposition was applied. Digital files of all patients were sighted for 2 years following DECT to obtain the incidence of osteoporotic fractures. Receiver operating characteristic (ROC) analysis was used to calculate cut-off values and logistic regression models were used to determine associations of BMD, sex, and age with the occurrence of osteoporotic fractures. Results: A DECT-derived BMD cut-off of 93.70 mg/cm3 yielded 85.45% sensitivity and 89.19% specificity for the prediction to sustain one or more osteoporosis-associated fractures within 2 years after BMD measurement. DECT-derived BMD was significantly associated with the occurrence of new fractures (odds ratio of 0.8710, 95% CI, 0.091–0.9375, p < .001), indicating a protective effect of increased DECT-derived BMD values. Overall AUC was 0.9373 (CI, 0.867–0.977, p < .001) for the differentiation of patients who sustained osteoporosis-associated fractures within 2 years of BMD assessment. Conclusions: Retrospective DECT-based volumetric BMD assessment can accurately predict the 2-year risk to sustain an osteoporosis-associated fracture in at-risk patients without requiring a calibration phantom. Lower DECT-based BMD values are strongly associated with an increased risk to sustain fragility fractures.
Key Points: Dual-energy CT–derived assessment of bone mineral density can identify patients at risk to sustain osteoporosis-associated fractures with a sensitivity of 85.45% and a specificity of 89.19%. The DECT-derived BMD threshold for identification of at-risk patients lies above the American College of Radiology (ACR) QCT guidelines for the identification of osteoporosis (93.70 mg/cm 3 vs 80 mg/cm 3 ).
MetadatenAuthor: | Leon David GrünewaldORCiDGND, Vitali KochORCiDGND, Simon MartinORCiDGND, Ibrahim YelORCiDGND, Katrin EichlerGND, Tatjana Gruber-RouhORCiDGND, Lukas Fabian LengaORCiDGND, Julian WichmannORCiDGND, Leona Soraja AlizadehORCiDGND, Moritz Hans Ernst AlbrechtORCiDGND, Christoph MaderORCiDGND, Nicole A. Huizinga, Tommaso D’AngeloORCiD, Silvio MazziottiORCiD, Stefan Wesarg, Thomas J. VoglORCiDGND, Christian BoozORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-640558 |
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DOI: | https://doi.org/10.1007/s00330-021-08323-9 |
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ISSN: | 1432-1084 |
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Parent Title (English): | European radiology |
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Publisher: | Springer |
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Place of publication: | Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/10/29 |
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Date of first Publication: | 2021/10/29 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2022/02/09 |
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Tag: | Bone density; Bone diseases, Metabolic; CT dual-energy computed tomography; Osteoporosis; Osteoporotic fractures |
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Volume: | 2021 |
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Page Number: | 9 |
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HeBIS-PPN: | 492049823 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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