The Suitable Population for Opportunistic Low Bone Mineral Density Screening Using Computed Tomography

IF 3.6 3区医学 Clinical Interventions in Aging Pub Date : 2024-05-11 DOI:10.2147/cia.s461018

Jiongfeng Zhang, Xiaohui Luo, Ruiling Zhou, Chong Guo, Kai Xu, Gaoyang Qu, Le Zou, Wenye Yao, Shifan Lin, Zhiping Zhang

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Abstract

Objective: To explore the suitable population of CT value for predicting low bone mineral density (low-BMD).
Methods: A total of 1268 patients who underwent chest CT examination and DXA within one-month period retrospectively analyzed. The CT attenuation values of trabecular bone were measured in mid-sagittal plane from thoracic vertebra 7 (T7). Receiver operating characteristic (ROC) curves were used to evaluate the ability to diagnose low-BMD.
Results: The AUC for diagnosing low BMD was larger in women than in men (0.894 vs 0.744, p < 0.05). The AUC increased gradually with the increase of age but decreased gradually with the increase in height and weight (p < 0.05). In females, when specificity was adjusted to approximately 90%, a threshold of 140.25 HU has a sensitivity of 69.3%, which is higher than the sensitivity of 36.5% in males for distinguishing low-BMD from normal. At the age of 70 or more, when specificity was adjusted to approximately 90%, a threshold of 126.31 HU has a sensitivity of 76.1%, which was higher than that of other age groups.
Conclusion: For patients who had completed chest CTs, the CT values were more effective in predicting low-BMD in female, elderly, lower height, and lower weight patients.

Keywords: bone mineral density, chest computed tomography, dual-energy X-ray absorptiometry, attenuation value

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使用计算机断层扫描进行低骨密度机会性筛查的合适人群

目的探讨 CT 值预测低骨矿物质密度（低 BMD）的适用人群：方法：回顾性分析一个月内接受胸部 CT 检查和 DXA 的 1268 例患者。在胸椎 7（T7）的中矢状面上测量骨小梁的 CT 衰减值。采用接收者操作特征曲线（ROC）评估诊断低 BMD 的能力：女性诊断低 BMD 的 AUC 大于男性（0.894 vs 0.744，p < 0.05）。随着年龄的增加，AUC 逐渐增加，但随着身高和体重的增加，AUC 逐渐减少（p <0.05）。在女性中，当特异性调整到约 90% 时，140.25 HU 临界值的灵敏度为 69.3%，高于男性区分低 BMD 和正常值的灵敏度 36.5%。在 70 岁或以上的人群中，当特异性调整到约 90% 时，126.31 HU 临界值的灵敏度为 76.1%，高于其他年龄组：对于已完成胸部 CT 检查的患者，CT 值在预测女性、老年、身高较低和体重较轻患者的低骨矿物质密度方面更为有效。关键词：骨矿物质密度；胸部计算机断层扫描；双能 X 射线吸收测量；衰减值

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.