Diagnostic accuracy of quantitative dual-energy CT-based bone mineral density assessment in comparison to Hounsfield unit measurements using dual x-ray absorptiometry as standard of reference.
Bone density
Bone diseases, metabolic
Multidetector computed tomography
Osteoporosis
Journal
European journal of radiology
ISSN: 1872-7727
Titre abrégé: Eur J Radiol
Pays: Ireland
ID NLM: 8106411
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
11
01
2020
revised:
26
08
2020
accepted:
23
09
2020
pubmed:
6
10
2020
medline:
15
4
2021
entrez:
5
10
2020
Statut:
ppublish
Résumé
To assess the diagnostic accuracy of phantomless dual-energy computed tomography (DECT)-based volumetric material decomposition to assess bone mineral density (BMD) of the lumbar spine for the detection of osteoporosis compared to Hounsfield unit (HU) measurements with dual x-ray absorptiometry (DXA) as reference standard. A total of two hundred lumbar vertebrae in 53 patients (28 men, 25 women; mean age, 52 years, range, 23-87 years) who had undergone clinically-indicated third-generation dual-source DECT and DXA within 30 days were retrospectively analyzed. For volumetric BMD assessment, dedicated DECT postprocessing software using material decomposition was applied, which enables color-coded three-dimensional mapping of the trabecular BMD distribution. Manual HU measurements were performed by defining five trabecular regions of interest (ROI) per vertebra as suggested by literature. The DXA T-score served as standard of reference (osteoporosis: T < -2.5). Sensitivity, specificity and the area under the curve (AUC) were primary metrics of diagnostic accuracy. An optimal patient-based DECT-derived BMD cut-off of 84 mg/cm³ yielded 96 % sensitivity (22/23) and 93 % specificity (28/30) for detecting osteoporosis, while an optimal CT attenuation cut-off of 139 HU showed 65 % sensitivity (15/23) and 93 % specificity (28/30) for the detection of osteoporosis. Overall patient-based AUC were 0.930 (volumetric DECT) and 0.790 (HU analysis) (p < .001). Pearson's product-moment correlation showed higher correlation between DECT BMD and DXA values (r=0.780) compared to HU and DXA values (r=0.528) (p < .001). Phantomless volumetric DECT yielded significantly more accurate BMD assessment of the lumbar spine and superior diagnostic accuracy of osteoporosis compared to HU measurements.
Identifiants
pubmed: 33017775
pii: S0720-048X(20)30510-6
doi: 10.1016/j.ejrad.2020.109321
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
109321Informations de copyright
Copyright © 2020. Published by Elsevier B.V.