Abstract
To compare bone mineral density (BMD) measurement accuracy by dual-energy spectral computed tomography (CT) and quantitative CT (QCT) using an anthropomorphic European spine phantom (ESP). An ESP containing three hydroxyapatite inserts with densities of 50, 100, and 200 mg/cm3 was scanned 10 times each using spectral CT and QCT protocols. Their BMD values were measured using hydroxyapatite-based spectral CT material decomposition images and QCT images and compared with the true values in ESP. Both protocols had good repeatability in BMD measurement with low coefficient-of-variance (spectral CT: <2.31%; QCT: <1.17%). There were biases in BMD measurement for the 50, 100, and 200 mg/cm3 hydroxyapatite insert with relative errors of 2.34% (48.83±1.13 mg/cm3), 2% (98±1.25 mg/cm3) and 5.96% (188.09±2.11 mg/cm3), in spectral CT, and 11% (55.5±0.65 mg/cm3), 9.85% (109.85±0.42 mg/cm3) and 4.04% (208.07±0.54 mg/cm3) in QCT, respectively. BMD can be accurately measured using either QCT or spectral CT, and spectral CT has smaller bias than QCT.
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