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Correlation between Hounsfield units in lumbar spine and bone mineral density measured by dual-energy X-ray absorptiometry in Vietnamese people
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Abstract
CORRELATION BETWEEN HOUNSFIELD UNITS IN LUMBAR SPINE AND BONE MINERAL DENSITY MEASURED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY
Background: Osteoporosis is a disease that increases the risk of fractures. Evaluation of the Hounsfield Unit in the lumbar spine on computed tomography for any reason has the potential to predict bone density abnormalities that contribute to the warning of osteoporosis.
Objective: The aim of this study was to evaluate the correlation between Hounsfield Units (HU) in Lumbar Spine (LS) and bone mineral density (BMD) measured by Dual-Energy X-Ray Absorptiometry (DEXA).
Method: Retrospective and cross-sectional study of 150 patients comprised CT-DXA pairs within a 6-month period performed for any indication. Measure HU at lumbar vertebrae from L1 to L4. Calculate Spearman correlation coeffificient between the mean HU at lumbar vertebrae and the BMD values from DEXA scan. Using area under the ROC Curve (AUC) and finding cut-off of HU for diferentiating normal BMD and abnormal BMD, osteopenia and osteoporosis.
Result: We noted correlations between the HU at LS and the BMD from DXA scan which is significant, the highest correlation at L2 (Spearman correlation coefficient = 0.68). At L2, normal BMD: ≥ 131 HU, osteopenia: 101 – 131 HU, osteoporosis: ≤ 131 HU, we also determined that threshold of 101 HU was more than 90 % sensitive, and a threshold of 171 HU was more than 90 % specific for distinguishing normal BMD. In addition, cut-off ≤ 132 HU was more than 90 % sensitive, and cut-off ≤ 62 HU was more than 90 % specific for distinguishing osteoporosis from osteopenia.
Conclusion: The correlations between the HU at LS and the BMD from DXA scan is significant.
Keyword: Osteoporosis, DEXA, HU at lumbar spine
Article Details
Keywords
Osteoporosis, DEXA, HU at lumbar spine
References
2. Radiol, J.A.C., ACR Appropriateness Criteria® Osteoporosis and Bone Mineral Density. Journal of the American College of Radiology, 2017. 14 (5S): p. S189-S202.
3. Genant, H.K., et al., Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res, 1996. 11 (7): p. 984-96.
4. Kanis, J.A.J.O.i., Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. 1994. 4 (6): p. 368-381.
5. Pickhardt, P.J., et al., Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med, 2013. 158 (8): p. 588-95.
6. E, A., M. D, and A. E, Opportunistic screening for osteoporosis by routine CT in Southern Europe. Osteoporos Int., 2017. 28 (3): p. 983-990.
7. Kim, K.J., et al., Hounsfield Units on Lumbar Computed Tomography for Predicting Regional Bone Mineral Density. Open Medicine, 2019. 14: p. 545-551.
8. MK, C., K. SM, and L. JK, Diagnostic efficacy of Hounsfield units in spine CT for the assessment of real bone mineral density of degenerative spine: correlation study between T-scores determined by DEXA scan and Hounsfield units from CT. Acta Neurochir (Wien), 2016. 158 (7): p. 1421-1427.
9. Buckens, C.F., et al., Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. 2015. 25 (7): p. 2074-2079.
10. Romme, E.A., et al., Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD. 2012. 27(11): p. 2338-2343.
11. Lee, S.Y., et al., Reliability and validity of lower extremity computed tomography as a screening tool for osteoporosis. 2015. 26 (4): p. 1387-1394.
12. Marinova, M., et al., Use of routine thoracic and abdominal computed tomography scans for assessing bone mineral density and detecting osteoporosis. 2015. 31(10): p. 1871-1881.
13. Lee, S., et al., Correlation between bone mineral density measured by dual-energy X-ray absorptiometry and Hounsfield units measured by diagnostic CT in lumbar spine. 2013. 54 (5): p. 384-389.
14. Pu, H., et al., Correlation between wrist bone mineral density measured by dual-energy X-ray absorptiometry and Hounsfield Units value measured by CT in lumbar spine. 2022.
15. Emohare, O., et al., Opportunistic computed tomography screening shows a high incidence of osteoporosis in ankylosing spondylitis patients with acute vertebral fractures. 2015. 18 (1): p. 17-21.
16. Batawil, N. and S.J.R. Sabiq, Hounsfield unit for the diagnosis of bone mineral density disease: a proof of concept study. 2016. 22 (2): p. e93-e98.
17. Alawi, M., et al., Dual-energy X-ray absorptiometry (DEXA) scan versus computed tomography for bone density assessment. 2021. 13 (2).
18. Kara, K., et al., The diagnosis of osteoporosis by measuring lumbar vertebrae density with MDCT: a comparative study with quantitative computerized tomography (QCT). 2013. 29: p. 775-779.