Kirzner N, Gallagher C, Kimmel L, Fischer D, Mc Laurin W, Liew S and Humadi A
Background: This retrospective study aimed to investigate a correlation between computed tomography (CT) imaging obtained opportunistically during screening for lumbar spine fractures and dual-energy x-ray absorptiometry (DEXA) scans.
Methods: A total of 159 patients over a 5-year study period who had undergone CT scan to investigate for a lumbar spine fracture and a DEXA scan within 12-months of each other were included in the study. Measurements of the region of interest (ROI) through the first 4 lumbar vertebrae were performed to establish Hounsfield unit (HU) values. Measurements for each level were made at three separate locations: mid-vertebral body, and just above and below the inferior and superior endplates, respectively. The HU values were correlated with T-scores obtained from DEXA scans and were further analyzed according to age and gender.
Results: There was a statistically significant correlation between HU values with T-score. Using the Pearson correlation coefficients, a moderate correlation of HU value to hip DEXA for T-score. There was a moderate-strong correlation between DEXA lumbar spine with mid-vertebral body HU, with L3 having the strongest correlation (r2=0.7269). The normal group had a mean HU value of 139.3 (95% CI 119–159.2), the osteopenic group had a mean of 105.9 (95% CI 90.4–123.4), and the osteoporotic group had a mean of 72.4 (95% CI 60.1–81.7).
Conclusion: This current study demonstrated that opportunistic CT imaging can be utilized to infer bone quality and provide information about the presence of osteoporosis and subsequently fracture risk without the need for additional imaging, radiation exposure, cost, or patient time.
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