Cervicothoracic volumetric bone mineral density assessed by opportunistic QCT may be a reliable marker for osteoporosis in adults.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Osteoporosis International Pub Date : 2024-12-31 DOI:10.1007/s00198-024-07373-1

Constanze Ramschütz, Nico Sollmann, Malek El Husseini, Karina Kupfer, Karolin J Paprottka, Maximilian T Löffler, Moritz R Hernandez Petzsche, Julian Schwarting, Jannis Bodden, Thomas Baum, Su Hwan Kim, Maria Wostrack, Claus Zimmer, Jan S Kirschke, Sebastian Rühling

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Abstract

This study aimed to validate the correlation between volumetric bone mineral density in the cervicothoracic and lumbar spine using measurements from opportunistic CT scans. The bone density assessment proved feasible, allowing us to propose optimal cut-off values for diagnosing osteoporosis and predicting vertebral fractures in the cervical and thoracic spine.

Objectives: To investigate the performance of cervicothoracic volumetric bone mineral density (vBMD), obtained through opportunistic quantitative computed tomography (QCT), in discriminating patients with/without osteoporosis and with/without vertebral fractures (VFs), using lumbar vBMD as the reference.

Methods: Three hundred twenty-five patients (65.3 ± 19.2 years, 140 women) with routine non-contrast or contrast-enhanced multi-detector CT (MDCT) scans were included. Trabecular vBMD was automatically extracted from each vertebra using a convolutional neural network (CNN)-based framework (SpineQ software v1.0) with asynchronous calibration and contrast phase correction. The correlations of vBMD between each vertebra spanning C2-T12 and the averaged lumbar spine (L1-L3, or L4 and L5) vBMD values were analyzed, considering fracture status and degeneration. Vertebra-specific linear regression equations were used to approximate lumbar vBMD at the cervicothoracic spine.

Results: Cervicothoracic vBMD correlated well with lumbar vBMD (r = 0.79), with significant improvement after excluding degenerated vertebrae (p < 0.05; r = 0.89), except for C7-T3 and T9. Cervical (AUC = 0.94) and thoracic vBMD (AUC = 0.97) showed strong discriminatory ability for osteoporosis (vBMD < 80 mg/cm³). Excluding degenerated vertebrae at the cervical spine increased the AUC to 0.97. Cervical and thoracic vBMD (AUC = 0.74, AUC = 0.72) were comparable to lumbar vBMD (AUC = 0.72) in differentiating patients with and without prevalent VFs. Trabecular vBMD < 190 mg/cm³ for the cervical spine and < 100 mg/cm³ for the thoracic spine were potential indicators of osteoporosis, similar to < 80 mg/cm³ at the lumbar spine.

Conclusion: Cervicothoracic vBMD may allow for determination of osteoporosis and prediction of VFs.

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机会性QCT评估的颈胸体积骨密度可能是成人骨质疏松症的可靠标志。

本研究旨在通过CT扫描来验证颈椎和腰椎体积骨密度之间的相关性。骨密度评估被证明是可行的，使我们能够提出诊断骨质疏松症和预测颈椎和胸椎椎体骨折的最佳临界值。目的：探讨通过机会性定量计算机断层扫描（QCT）获得的颈胸容积骨密度（vBMD）在鉴别有无骨质疏松症和有无椎体骨折（VFs）患者中的作用，并以腰椎vBMD为参考。方法：325例（65.3±19.2岁，女性140例）行常规非对比或增强多层螺旋CT （MDCT）扫描。使用基于卷积神经网络（CNN）的框架（SpineQ软件v1.0），通过异步校准和对比相位校正，从每个椎体自动提取小梁vBMD。考虑骨折状态和退变，分析C2-T12各椎体vBMD与腰椎（L1-L3，或L4和L5）平均vBMD值的相关性。使用椎体特异性线性回归方程来近似计算颈胸椎的腰椎vBMD。结果：颈胸段vBMD与腰椎vBMD相关性良好（r = 0.79），排除退变椎体后显著改善（p < 3）。排除颈椎退行性椎体后，AUC增加到0.97。颈椎和胸椎vBMD （AUC = 0.74, AUC = 0.72）与腰椎vBMD （AUC = 0.72）在区分有无VFs患者方面相当。颈椎骨小梁vBMD值为3，胸椎为3，与腰椎相似，是骨质疏松症的潜在指标。结论：颈胸vBMD可用于骨质疏松症的诊断和VFs的预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.