Ayşegül CANSU, Dilara ATASOY, İlker EYÜBOĞLU, Murat KARKUCAK

Diagnostic efficacy of routine contrast-enhanced abdominal CT for the assessment of osteoporosis in the Turkish population

Background/aim: This study aimed to evaluate the diagnostic efficacy of vertebral Hounsfield unit HU values on routine contrast-enhanced abdominal computed tomography CT scans for the assessment of osteoporosis using dual-energy X-ray absorptiometry DXA T-scores as a reference standard.Materials and methods: A total of 111 consecutive patients who underwent contrast-enhanced abdominal CT examination for any indication and DXA within a 6-month period were retrospectively analyzed. The CT attenuation values of trabecular bone in HUs were measured in axial and sagittal planes from lumbar vertebrae 1-4 L1-L4 . The correlation between the DXA T-scores and HU values measured on the CT scans was evaluated by Pearson's correlation test. Areas under the curves AUCs were calculated by receiver operating characteristic analysis for diagnostic proficiency, and threshold values were determined. Paired t-test and Bland-Altman plot test were used to evaluate the correlation between axial and sagittal HU values.Results: There was a strong correlation between the DXA T-scores and HU values of all the lumbar vertebrae P 0.05 . The L3 axial CT attenuation threshold for 90% sensitivity was 170 HU and that for 90% specificity was 102 HU for distinguishing osteoporosis from osteopenia and normal bone mineral density BMD . To distinguish the low BMD group from the normal group, the L3 axial CT attenuation threshold for approximately 90% sensitivity was 102 HU and for 90% specificity was 165 HU.Conclusion: The HUs derived from routine contrast-enhanced abdominal CT scans can be used for the evaluation of osteoporosis, without additional radiation exposure and cost.

Keywords:

Contrast-enhanced CT, bone mineral density, dual-energy X-ray absorptiometry, osteoporosis,

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