Diagnostic accuracy of quantitative dual-energy CT-based volumetric bone mineral density assessment for the prediction of osteoporosis-associated fractures

  • 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 ).
Metadaten
Author:Leon David GrünewaldORCiDGND, Vitali KochORCiDGND, Simon Martin, Ibrahim YelORCiDGND, Katrin EichlerGND, Tatjana Gruber-RouhORCiDGND, Lukas Fabian LengaORCiDGND, Julian WichmannORCiDGND, Leona Soraja Alizadeh, Moritz Hans Ernst AlbrechtORCiDGND, Christoph MaderORCiDGND, Nicole A. Huizinga, Tommaso D’Angelo, Silvio MazziottiORCiD, Stefan Wesarg, Thomas J. VoglORCiDGND, Christian BoozORCiDGND
URN:urn:nbn:de:hebis:30:3-640558
DOI:https://doi.org/10.1007/s00330-021-08323-9
ISSN:1432-1084
Parent Title (English):European radiology
Publisher:Springer
Place of publication:Berlin ; Heidelberg
Document Type:Article
Language:English
Date of Publication (online):2021/10/29
Date of first Publication:2021/10/29
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/02/09
Tag:Bone density; Bone diseases, Metabolic; CT dual-energy computed tomography; Osteoporosis; Osteoporotic fractures
Volume:2021
Page Number:9
HeBIS-PPN:492049823
Institutes:Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0