Use of computed tomography for assessing bone mineral density

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.

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

Endocrine Practice ◽

10.4158/ep-2019-0122 ◽

2019 ◽

Vol 25 (9) ◽

pp. 869-876 ◽

Cited By ~ 1

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

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Mechanical torque measurement in the proximal femur correlates to failure load and bone mineral density ex vivo

Orthopedic Reviews ◽

10.4081/or.2013.e16 ◽

2013 ◽

Vol 5 (2) ◽

pp. 16 ◽

Cited By ~ 9

Author(s):

Stefan Grote ◽

Tatjana Noeldeke ◽

Michael Blauth ◽

Wolf Mutschler ◽

Dominik Bürklein

Keyword(s):

Bone Mineral Density ◽

Femoral Neck ◽

Bone Quality ◽

Bone Mineral ◽

Proximal Femur ◽

Failure Load ◽

Peak Torque ◽

Mineral Density ◽

Local Bone ◽

Load To Failure

Knowledge of local bone quality is essential for surgeons to determine operation techniques. A device for intraoperative measurement of local bone quality has been developed by the AO-Research Foundation (DensiProbe®). We used this device to experimentally measure peak breakaway torque of trabecular bone in the proximal femur and correlated this with local bone mineral density (BMD) and failure load. Bone mineral density of 160 cadaver femurs was measured by <em>ex situ </em>dual-energy X-ray absorptiometry. The failure load of all femurs was analyzed by side-impact analysis. Femur fractures were fixed and mechanical peak torque was measured with the DensiProbe® device. Correlation was calculated whereas correlation coefficient and significance was calculated by Fisher’s Z-transformation. Moreover, linear regression analysis was carried out. The unpaired Student’s t-test was used to assess the significance of differences. The Ward triangle region had the lowest BMD with 0.511 g/cm2 (±0.17 g/cm2), followed by the upper neck region with 0.546 g/cm2 (±0.16 g/cm2), trochanteric region with 0.685 g/cm2 (±0.19 g/cm2) and the femoral neck with 0.813 g/cm2 (±0.2 g/cm2). Peak torque of DensiProbe® in the femoral head was 3.48 Nm (±2.34 Nm). Load to failure was 4050.2 N (±1586.7 N). The highest correlation of peak torque measured by Densi Probe® and load to failure was found in the femoral neck (r=0.64, P<0.001). The overall correlation of mechanical peak torque with T-score was r=0.60 (P<0.001). A correlation was found between mechanical peak torque, load to failure of bone and BMD <em>in vitro</em>. Trabecular strength of bone and bone mineral density are different aspects of bone strength, but a correlation was found between them. Mechanical peak torque as measured may contribute additional information about bone strength, especially in the perioperative testing.

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Relationship between Systemic Bone Mineral Density and Local Bone Quality as Effectors of Dental Implant Survival

Clinical Implant Dentistry and Related Research ◽

10.1111/j.1708-8208.2009.00206.x ◽

2011 ◽

Vol 13 (1) ◽

pp. 29-33 ◽

Cited By ~ 19

Author(s):

Christopher M. Holahan ◽

Jennifer L. Wiens ◽

Amy Weaver ◽

Daniel Assad ◽

Sreenivas Koka

Keyword(s):

Bone Mineral Density ◽

Dental Implant ◽

Bone Quality ◽

Bone Mineral ◽

Implant Survival ◽

Mineral Density ◽

Local Bone

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Cortical bone thickness of the distal radius predicts the local bone mineral density

Bone and Joint Research ◽

10.1302/2046-3758.1012.bjr-2020-0271.r1 ◽

2021 ◽

Vol 10 (12) ◽

pp. 820-829 ◽

Cited By ~ 1

Author(s):

Florian Schmidutz ◽

Christoph Schopf ◽

Shuang G. Yan ◽

Marc-Daniel Ahrend ◽

Christoph Ihle ◽

...

Keyword(s):

Bone Mineral Density ◽

Cortical Bone ◽

Correlation Coefficient ◽

Distal Radius ◽

Bone Mineral ◽

Ct Scans ◽

Bone Thickness ◽

Mineral Density ◽

Cortical Index ◽

Local Bone

Aims The distal radius is a major site of osteoporotic bone loss resulting in a high risk of fragility fracture. This study evaluated the capability of a cortical index (CI) at the distal radius to predict the local bone mineral density (BMD). Methods A total of 54 human cadaver forearms (ten singles, 22 pairs) (19 to 90 years) were systematically assessed by clinical radiograph (XR), dual-energy X-ray absorptiometry (DXA), CT, as well as high-resolution peripheral quantitative CT (HR-pQCT). Cortical bone thickness (CBT) of the distal radius was measured on XR and CT scans, and two cortical indices mean average (CBTavg) and gauge (CBTg) were determined. These cortical indices were compared to the BMD of the distal radius determined by DXA (areal BMD (aBMD)) and HR-pQCT (volumetric BMD (vBMD)). Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC) were used to compare the results and degree of reliability. Results The CBT could accurately be determined on XRs and highly correlated to those determined on CT scans (r = 0.87 to 0.93). The CBTavg index of the XRs significantly correlated with the BMD measured by DXA (r = 0.78) and HR-pQCT (r = 0.63), as did the CBTg index with the DXA (r = 0.55) and HR-pQCT (r = 0.64) (all p < 0.001). A high correlation of the BMD and CBT was observed between paired specimens (r = 0.79 to 0.96). The intra- and inter-rater reliability was excellent (ICC 0.79 to 0.92). Conclusion The cortical index (CBTavg) at the distal radius shows a close correlation to the local BMD. It thus can serve as an initial screening tool to estimate the local bone quality if quantitative BMD measurements are unavailable, and enhance decision-making in acute settings on fracture management or further osteoporosis screening. Cite this article: Bone Joint Res 2021;10(12):820–829.

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The Use of CT Hounsfield Unit Values to Identify The Bone Quality in Patients With Cervical Degenerative Diseases.

10.21203/rs.3.rs-75561/v1 ◽

2020 ◽

Author(s):

Lei He ◽

Fei Fei Zhou ◽

Yu Sun ◽

Wei-Shi Li

Keyword(s):

Bone Mineral Density ◽

Bone Quality ◽

Bone Mineral ◽

Cervical Vertebrae ◽

Hounsfield Unit ◽

Dual Energy ◽

Degenerative Diseases ◽

Mineral Density ◽

X Ray ◽

T Score

Abstract Background It is well known that osteoporosis may lead to the failure of spinal surgery. As the gold standard, dual-energy X-ray absorptiometry (DXA) is used to evaluate the overall bone mineral density (BMD). Previous studies have used CT (Computed tomography) value to evaluate local bone mineral density. The objective of this study was to investigate the application value of cervical CT value in preoperative bone quality evaluation of cervical degenerative diseases. Methods A total of 939 patients who received surgical treatment for cervical degenerative diseases in our center from January 2015 to December 2017 were retrospectively reviewed. The Hounsfield unit (HU) values were measured in middle transverse CT images of the C2–C7 on the picture archiving and communication system (PACS), and the total bone mineral density T-score of L1–L4 was obtained by dual-energy X-ray absorptiometry. The changes in the HU values of C2–C7 were observed, the correlation between the HU value of C2–C7 and the total BMD T-score of L1–L4 was analyzed, and the HU thresholds of C2–C7 for different T-scores (-2.5 < T-score <-1 or T-score ≤2.5, respectively) were identified. Results The HU values of C2–C7 show a decreasing trend. The mean HU value of C2–C7 was 322.52 ± 89.27 HU. The average BMD T-score of L1-L4 was -0.73. The average HU value of C2–C7 was positively correlated with the average BMD T-score of L1–L4 (r = 0.487, P < 0.001). The HU threshold of C2–C7 was 269 HU when -2.5＜T-score＜-1, and it had a sensitivity of 75.7% and a specificity of 59.8% when used for screening for osteopenia; the HU threshold of C2–C7 was 269H U when T-score ≤-2.5, and it had a sensitivity of 63.8% and a specificity of 80.8% when used for screening for osteoporosis. Conclusions The HU values of cervical vertebrae gradually decrease from C2 to C7 in patients undergoing surgical treatment for cervical degenerative disorders. The CT HU value of cervical vertebrae is positively correlated with the BMD T-score provided by lumbar DXA, which is helpful for clinical evaluation of bone quality before surgery.

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Correlation Of Bone Mineral Density Measured In Quantitative Computed Tomography With Hounsfield Unit

10.21203/rs.3.rs-34551/v1 ◽

2020 ◽

Author(s):

R Lalruatfela ◽

Rahul P Kotian ◽

Nitika C Panakkal

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Lumbar Spine ◽

Trabecular Bone ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Hounsfield Unit ◽

Mineral Density ◽

Ct Attenuation ◽

The Mean

Abstract Background: Bone mineral density scan (BMD) is a simple, non-invasive procedure used to assess the strength of the bones by measuring the composition of minerals mainly calcium in the bones. In this study, BMD was measured using Quantitative Computed Tomography (QCT) and Hounsfield unit (HU) in the lumbar spine and the values were correlated.Methods: 240 participants referred for CT Abdomen and CT Lumbar spine were scanned using 64 slice Brilliance CT. Using BMD software, three different vertebral bodies from L1-L3 were taken and ROI was placed at the central portion of the trabecular bone. Two references ROI one in retro spinal muscle and one in fat tissue was also placed. To measure CT attenuation value an ROI graphic tool was drawn at the trabecular bone. The average of BMD in QCT and HU value was taken from L1-L3. Pearson Correlation Coefficient was used to correlate QCT and HU values.Results: The mean BMD for the 21-40 age group was found to be 156.3 and 228.0 for QCT and HU respectively. Similarly, the mean BMD for 41-60 and 61-80 age groups was found to be 125.5, 173.6 and 109.1, 140.4 for QCT and HU respectively. The results showed a strong positive correlation between QCT and HU BMD (r = 0.94) with a p-value less than 0.001.Discussion: In our present study, 64.53% (n=155) were found to have normal BMD based on the WHO diagnostic category for spine BMD in QCT. Whereas 24.58% were found to have a low bone mass (osteopenia) and 10.83% were found to have osteoporosis. The equivalent mean HU was found to be 211.98 ±31.06, 139.64 ±18.58, 87.22 ±15.92 for normal, osteopenia and osteoporosis respectively.Conclusion: The study shows a strong correlation between QCT BMD with HU. Therefore, the CT attenuation technique can also be used to derive bone mineral density values from routine abdomen and lumbar spine MDCT for osteoporosis screening with no additional cost to the patient

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Differences in bone mineral density and morphometry measurements by fixed versus relative offset methods in high-resolution peripheral quantitative computed tomography

Bone ◽

10.1016/j.bone.2021.115973 ◽

2021 ◽

pp. 115973

Author(s):

Narihiro Okazaki ◽

Ko Chiba ◽

Andrew J. Burghardt ◽

Choko Kondo ◽

Mitsuru Doi ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

High Resolution ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Mineral Density

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Bone Mineral Density Attenuation in Obstructive Sleep Apnea by Derived Computed Tomography Screening

10.21203/rs.3.rs-1049040/v1 ◽

2021 ◽

Author(s):

Sharon Daniel ◽

Yafit Cohen-Freud ◽

Ilan Shelef ◽

Ariel Tarasiuk

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Bone Mineral ◽

Clinical Information ◽

Mineral Density ◽

Peak Voltage ◽

Arousal Index ◽

Obstructive Sleep

Abstract The association between obstructive sleep apnea (OSA) and bone mineral density (BMD) is poorly elucidated with contradictory findings. We retrospectively explored the association between OSA and BMD by examining abdominal computed tomography (CT) vertebrae images using clinical information. We included 315 subjects (174 with OSA and 141 without OSA) who performed at least two CT scans (peak voltage of 120 kV). Bone mineral density was attenuated in those with OSA and increased age. BMD attenuation was not associated with the apnea–hypopnea score, nocturnal oxygen saturation, or arousal index. A multivariate linear regression indicated that OSA is associated with BMD attenuation after controlling for age, gender, and cardiovascular diseases. Here, we report that OSA is associated with BMD attenuation. Further studies are required to untangle the complex affect of OSA on BMD loss and possible clinical implication of vertebra depressed fracture or femoral neck fracture.

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