scholarly journals Computed Tomography of the Chest as a Screening Tool for Low Bone Mineral Density

2021 ◽  
Author(s):  
Alan T Vanier ◽  
Donald Colantonio ◽  
Sameer K Saxena ◽  
Daniel Rodkey ◽  
Scott Wagner
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Negative Predictive Value ◽  
Thoracic Spine ◽  
Predictive Value ◽  
Screening Tool ◽  
Ct Scans ◽  
Mineral Density ◽  
Dxa Scans

ABSTRACT Introduction Computed tomography (CT) Hounsfield units (HU) recently emerged as a promising screening tool for low bone mineral density (BMD). We hypothesized that CT HU measurements of the thoracic spine would significantly and positively correlate with dual X-ray absorptiometry (DXA) BMD scans of the femoral neck. Materials and methods The study included patients with DXA scans and thoracic CT scans at the Walter Reed National Military Medical Center. One author, blinded to the DXA scans, measured HU from the cancellous bone in T4 vertebrae. Another author statistically compared femoral neck DXA T-scores to the CT HU measurements. Results The study included 145 patients with CT scans and femoral neck DXAs. The osteoporotic and osteopenic groups had a significant difference in HU measurements compared to the normal group within the study (P < .0001 and .002, respectively). A low BMD screening value of 231 HU provided a sensitivity of 90.1% and negative predictive value of 85.7%. Conclusion Thoracic vertebrae HU measurements correlate with a low BMD of the femoral neck as determined by DXA T-scores. A high sensitivity and negative predictive value was achieved with a screening value of 231 HU. Utilization of chest or thoracic spine CT imaging as a screening method provides a quick and available screening tool for assessing low BMD in patients with these scans. Level of Evidence: III (Diagnostic)

OPPORTUNISTIC EVALUATION OF BONE MINERAL DENSITY BY PET-CT IN HODGKIN LYMPHOMA PATIENTS

2019 ◽  
Vol 25 (9) ◽  
pp. 869-876 ◽  
Author(s):  
Bar Cohen ◽  
Nurith Hiller ◽  
Auryan Szalat ◽  
Vladimir Vainstein
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Hodgkin Lymphoma ◽  
Bone Mineral ◽  
Ct Scans ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Positron Emission ◽  
Pet Ct ◽  
Ct Attenuation

Objective: Bone density loss and increased risk for osteoporosis are of concern in Hodgkin lymphoma (HL) patients. Routinely performed positron emission tomography–computed tomography (PET-CT) scans could be informative in assessing bone mineral density (BMD). Methods: This retrospective study included 80 adults with newly diagnosed HL treated with standard first-line chemotherapy regimens. PET-CT scans performed at diagnosis (PET-CT1), at the end of chemotherapy (PET-CT2), and at follow-up after remission (PET-CT3) were used to assess BMD changes by measuring lumbar vertebrae CT attenuation. A CT attenuation threshold of 160 Hounsfield units was used to define abnormal BMD. Results: Following chemotherapy, comparison of PET-CT2 with PET-CT1 revealed a mean (standard deviation) 14.2% (10.4%) BMD reduction ( P<.001). On PET-CT3 performed at 14.6 (3.25) months after the last course of chemotherapy, a slight improvement (4.6% [10.4%]) in comparison to PET-CT2 was noted. Twelve patients (15%) converted from normal baseline BMD on PET-CT1 to abnormal BMD after chemotherapy on PET-CT2. Age, baseline BMD, and steroid cumulative dose were associated with BMD decline and risk for abnormal BMD after chemotherapy. No clinical fractures were reported, and only one rib fracture was incidentally captured (1.25%). Conclusion: HL patients treated with common first-line chemotherapies demonstrate a significant decline in bone density on routine PET-CT scans. Opportunistic use of PET-CT scan has the potential to detect HL patients at high risk for developing osteoporosis and to guide clinicians regarding monitoring and intervention. Abbreviations: BMD = bone mineral density; CT = computed tomography; DXA = dual-energy X-ray absorptiometry; HL = Hodgkin lymphoma; HU = Hounsfield units; L = lumbarvertebra; PET-CT = positron emission tomography-computed tomography; T = thoracic vertebra

scholarly journals A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography

2016 ◽  
Vol 6 (4) ◽  
pp. 113 ◽  
Author(s):  
Kwanmoon Jeong ◽  
Hoon Ko ◽  
Chang-Hoon Lee ◽  
Myeung Lee ◽  
Kwon-Ha Yoon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Mineral Density ◽  
Novel Method

scholarly journals Use of computed tomography for assessing bone mineral density

2014 ◽  
Vol 37 (1) ◽  
pp. E4 ◽  
Author(s):  
Joseph J. Schreiber ◽  
Paul A. Anderson ◽  
Wellington K. Hsu
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Bone Quality ◽  
Bone Mineral ◽  
Normative Data ◽  
Hounsfield Unit ◽  
Ct Scans ◽  
Implant Stability ◽  
Mineral Density ◽  
Local Bone

Assessing local bone quality on CT scans with Hounsfield unit (HU) quantification is being used with increasing frequency. Correlations between HU and bone mineral density have been established, and normative data have been defined throughout the spine. Recent investigations have explored the utility of HU values in assessing fracture risk, implant stability, and spinal fusion success. The information provided by a simple HU measurement can alert the treating physician to decreased bone quality, which can be useful in both medically and surgically managing these patients.

Cervical Spine Computed Tomography Hounsfield Units Accurately Predict Low Bone Mineral Density of the Femoral Neck

2020 ◽  
Vol 33 (2) ◽  
pp. E58-E62
Author(s):  
Donald F. Colantonio ◽  
Sameer K. Saxena ◽  
Alan Vanier ◽  
Daniel Rodkey ◽  
Scott Tintle ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Cervical Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Low Bone Mineral Density

Selective Densitometry of the Lumbar Spine

2013 ◽  
Author(s):  
Bryant Chu ◽  
Jeremi Leasure ◽  
Dimitriy Kondrashov
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Lumbar Vertebrae ◽  
Ct Scans ◽  
Screw Loosening ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Pedicle Screw Loosening ◽  
Posterior Elements

Bone mineral density (BMD) has been identified as a major factor in spine construct strength, with failures resulting in pedicle screw loosening and pullout2. Computed tomography (CT) scans have been shown to effectively measure BMD1,4. Previous research has utilized this linear correlation of CT Hounsfield Units (HU) to BMD in order to determine BMD as a function of anatomic location within cervical vertebrae1; however, the lumbar spine has not yet been reported on. The goal of this study was to describe BMD of anatomical regions within lumbar vertebrae using the correlation between HU and BMD. It was hypothesized that posterior elements of the spine would exhibit significantly different BMD than the vertebral body. This was tested through means comparison of BMD for each anatomical region.

scholarly journals Intraoperative cone beam computed tomography is as reliable as conventional computed tomography for identification of pedicle screw breach in thoracolumbar spine surgery

2020 ◽  
Author(s):  
Gustav Burström ◽  
Paulina Cewe ◽  
Anastasios Charalampidis ◽  
Rami Nachabe ◽  
Michael Söderman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Negative Predictive Value ◽  
Spine Surgery ◽  
Cone Beam Computed Tomography ◽  
Predictive Value ◽  
Pedicle Screws ◽  
Ct Scans ◽  
Cone Beam ◽  
Spinal Fixation

Abstract Objectives To test the hypothesis that intraoperative cone beam computed tomography (CBCT) using the Allura augmented reality surgical navigation (ARSN) system in a dedicated hybrid operating room (OR) matches computed tomography (CT) for identification of pedicle screw breach during spine surgery. Methods Twenty patients treated with spinal fixation surgery (260 screws) underwent intraoperative CBCT as well as conventional postoperative CT scans (median 12 months after surgery) to identify and grade the degree of pedicle screw breach on both scan types, according to the Gertzbein grading scale. Blinded assessments were performed by three independent spine surgeons and the CT served as the standard of reference. Screws graded as Gertzbein 0 or 1 were considered clinically accurate while grades 2 or 3 were considered inaccurate. Sensitivity, specificity, and negative predictive value were the primary metrics of diagnostic performance. Results For this patient group, the negative predictive value of an intraoperative CBCT to rule out pedicle screw breach was 99.6% (CI 97.75–99.99%). Among 10 screws graded as inaccurate on CT, 9 were graded as such on the CBCT, giving a sensitivity of 90.0% (CI 55.5–99.75%). Among the 250 screws graded as accurate on CT, 244 were graded as such on the CBCT, giving a specificity of 97.6% (CI 94.85–99.11%). Conclusions CBCT, performed intraoperatively with the Allura ARSN system, is comparable and non-inferior to a conventional postoperative CT scan for ruling out misplaced pedicle screws in spinal deformity cases, eliminating the need for a postoperative CT. Key Points • Intraoperative cone beam computed tomography (CT) using the Allura ARSN is comparable with conventional CT for ruling out pedicle screw breaches after spinal fixation surgery. • Intraoperative cone beam computed tomography can be used to assess need for revisions of pedicle screws making routine postoperative CT scans unnecessary. • Using cone beam computed tomography, the specificity was 97.6% and the sensitivity was 90% for detecting pedicle screw breaches and the negative predictive value for ruling out a pedicle screw breach was 99.6%.

scholarly journals Comparative studies of bone density by quantitative ultrasound (QUS) with dual-energy X-ray absorptiometry (DEXA) scan

2019 ◽  
Vol 9 (1) ◽  
pp. 8-12
Author(s):  
Alark Devkota Rajouria ◽  
Madur Dev Bhattarai ◽  
Manil Ratna Bajracharya ◽  
Buddha Bahadur Karki
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Quantitative Ultrasound ◽  
Screening Tool ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorp­tiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis. Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius. Results: Significant correlations were observed between QUS and DEXA T score. Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.

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