Hounsfield Units on Lumbar Computed Tomography for Predicting Regional Bone Mineral Density

AbstractObjectiveBone mineral density (BMD) is a very important factor in spinal fusion surgery using instrumentation. Our aim was to investigate the utility of Hounsfield units (HU) obtained from preoperative lumbar computed tomography (CT) to predict osteoporosis coupling with data of quantitative computed tomography (QCT) and dual X-ray absorptiometry (DEXA).MethodsWe reviewed 180 patients that underwent both QCT and lumbar CT for spine surgery. HU was retrospectively calculated on the lumbar CT of 503 lumbar vertebrae from L1 to L3. Femur DEXA was performed in all patients and spine DEXA was tested in 120 patients (331 vertebrae). BMD was grouped as osteoporosis (QCT<80mg/cm3, DEXA T score≤-2.5) and non-osteoporosis (QCT≥80mg/cm3, DEXA T score>-2.5) for comparison of HU value.ResultsHU value and BMD showed significant correlations. The optima cut-off value based on QCT was higher than that of DEXA scans which had the best correlation for predicting osteoporosis. ROC curve analysis demonstrated that HU value with QCT of 146 has a sensitivity of 94.3% and a specificity of 87.5% for osteoporosis.ConclusionsSignificant correlation was found between HU measurement and BMD value. These findings provide evidence that HU measurement can be established as a means for predicting osteoporosis before spine fusion surgery with reduced radiation hazard.

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Computed Tomography Diagnostic of Uncommon Case of Osteopetrosis in 80-Year-Old Man—Case Report

Medicina ◽

10.3390/medicina56100518 ◽

2020 ◽

Vol 56 (10) ◽

pp. 518

Author(s):

Witold Krupski ◽

Joanna Kruk-Bachonko ◽

Marcin R. Tatara

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Z Score ◽

Mineral Density ◽

T Score ◽

Uncommon Case ◽

Densitometric Data

Background and Objectives: During osteopetrosis course, impaired bone remodeling induces skeletal osteosclerosis and abnormally dense bones, which, however, are brittle and susceptible to low-energy fractures. In this study, radiological evaluation and densitometric measurements of several bones of the skeleton in one of the oldest patients in the world suffering from osteopetrosis was presented. Materials and Methods: Volumetric bone mineral density measurements of the examined bones in an 80-year-old man were performed using two different quantitative computed tomography techniques. Results: The obtained results show higher values of the volumetric bone mineral density of the trabecular bone in lumbar spine than in the cortical bone compartment. T-score and Z-score in this patient reached values of 27–28 and 31–32, respectively. Conclusions: The obtained densitometric data may serve for further diagnostic purposes of osteopetrosis. As documented, the severity of the osteosclerotic changes of bones were higher in this patient than in most other described cases. Moreover, radiological signs diagnosed in this patient were characteristic for all types of osteopetrosis making this case very uncommon.

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