Abstract
BackgroundCurrent techniques for evaluation of bone mineral density (BMD) commonly require phantom calibration. The purpose of this study was to evaluate a novel algorithm for phantomless in vivo dual-energy computed tomography (DECT)-based assessment of BMD of the lumbar spine in comparison with dual-energy X-ray absorptiometry (DEXA).MethodsData from clinically indicated DECT and DEXA examinations within two months comprising the lumbar spine of 47 patients were retrospectively evaluated. By using a novel automated dedicated post-processing algorithm for DECT, the trabecular bone of lumbar vertebrae L1–L4 was selected and analysed. Linear correlation was analysed using Pearson’s product-moment correlation coefficient for the comparison of the results from DECT and DEXA.ResultsA total of 186 lumbar vertebrae in 47 patients (mean age, 58 years; age range, 24–85 years) were analysed, 24 men (mean age, 55 years; age range, 24–85 years) and 23 women (mean age, 59 years; age range, 31–80 years). Mean BMD of L1–L4 determined with DEXA was 0.985 g/cm2 and 20/47 patients (42.6%) showed an osteoporotic BMD (T score lower than – 2.5) of at least two vertebrae. Average DECT-based BMD of L1–L4 was 86.8 mg/cm3. Regression analysis demonstrated a lack of correlation between DECT- and DEXA-based BMD values with a Pearson’s product-moment correlation coefficient r = 0.4205.ConclusionsDedicated post-processing of DECT data using a novel algorithm for retrospective phantomless BMD assessment of the trabecular bone of lumbar vertebrae from clinically indicated DECT examinations is feasible.
Highlights
Current techniques for evaluation of bone mineral density (BMD) commonly require phantom calibration
According to the official positions of the World Health Organization (WHO) [1], the gold standard for diagnosis and assessment of osteoporosis is the evaluation of BMD by using dual-energy X-ray absorptiometry (DEXA)
The volume of interest (VOI) was manually defined by the user in order to achieve the best delineation of the Results A total of 207 lumbar vertebrae in 47 patients were examined by DEXA and dual-energy computed tomography (DECT) in this study
Summary
Current techniques for evaluation of bone mineral density (BMD) commonly require phantom calibration. Osteoporosis is a common metabolic bone disorder, especially in the elderly population, which is characterised by a loss of bone mineral density (BMD) and an alteration of bony microarchitecture [1, 2]. It is associated with a drastically increased risk of fractures of the hip, Booz et al European Radiology Experimental (2017) 1:11 spine and wrist, deformations of bone and consecutive malpositioning of the skeletal system [3, 4]. A three-dimensional (3D) imaging procedure confined to the trabecular bone would allow a more detailed assessment of changes in BMD [12,13,14,15]
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