Quantitative calcium-based assessment of osteoporosis in dual-layer spectral CT.

To evaluate a novel calcium-only imaging technique (VCa) with subtracted bone marrow in osteoporosis in dual-layer CT (DLCT) compared to conventional CT images (CI) and dual-energy X-ray absorptiometry (DXA). Images of a multi-energy CT phantom with calcium inserts, quantitative CT calibration phantom, and of 55 patients (mean age: 64.6 ± 11.5 years) were acquired on a DLCT to evaluate bone mineral density (BMD). CI, calcium-suppressed images, and VCa were calculated. For investigating the association of VCa and CI with DXA a subsample of 30 patients (<90 days between DXA and CT) was used. Multiple regression analysis was performed to identify further factors improving the prediction of DXA BMD. The calcium concentrations of the CT phantom inserts were significantly associated with CT numbers from VCa (R VCa images showed better agreement with DXA and known calcium concentrations than CI, and could be used to estimate BMD. A VCa cut-off of 126HU could be used to identify abnormal bone mineral density.

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Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Stephan Skornitzke has ownership interests in investment funds containing stock of healthcare companies. Dr. Stephan Skornitzke has become an employee of Philips Healthcare after his work on this study. Dr. Wolfram Stiller is a member of the CT Advisory Board of Philips Medical Systems. Dr. Thuy Duong Do was supported by the Olympia-Morata research grant by the Medical Faculty of the University of Heidelberg. Prof. Hans-Ulrich Kauczor receives grant support by Philips Medical Systems (paid to the institution) and honoraria from the speaker’s bureau. Otherwise, the authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article..