Photon-counting CT Spectral Localizer Radiographs for Lumbar Areal Bone Mineral Density Quantification: A Clinical Study on Accuracy, Reliability, and Diagnostic Performance for Osteoporosis.

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Academic Radiology Pub Date : 2025-02-11 DOI:10.1016/j.acra.2025.01.038

Shanshui Zhou, Shutian Zhao, Rui Chang, Haipeng Dong, Lianjun Du, Yong Lu, Qiang Zhang, Yin Zhang, Zhe Chen, Tristan Nowak, Zhihan Xu, Le Qin, Fuhua Yan

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引用次数: 0

Abstract

Rationale and objectives: To explore the accuracy, reliability, and diagnostic performance of photon-counting CT (PCCT) spectral localizer radiographs (SLRs) for quantifying lumbar areal bone mineral density (BMD) and detecting osteoporosis (T-score ≤-2.5).

Materials and methods: This prospective study recruited consecutive participants from April to July 2024. Participants each underwent a dual-energy X-ray absorptiometry (DXA) examination serving as the gold-standard reference for aBMD (aBMD_DXA) and a PCCT scan to obtain SLR. The SLRs were reconstructed into hydroxyapatite (HA) and water maps. Lumbar vertebrae (L1 to L4) and soft tissue were blindly and semiautomatically segmented on HA and water maps to calculate aBMD_SLR. The agreement and relative absolute error (RAE) between aBMD_SLR and aBMD_DXA were calculated. Factors that might influence the RAE were evaluated. Using DXA results as the reference, the diagnostic performance of PCCT-SLRs for osteoporosis was assessed.

Results: A total of 159 participants (88 females) with a median age of 66 years (interquartile range [IQR], 55-72 years) were included. The median (IQR) aBMD_DXA and aBMD_SLR values were 1.095 (0.936-1.261) g/cm² and 1.086 (0.932-1.255) g/cm², respectively. There was excellent agreement between the two methods (mean bias=-0.57%). The median (IQR) RAE was 2.65% (1.23-4.07%). The RAE was unaffected by age, body mass index, aBMD, sex, tube voltage, or tube current. The sensitivity and specificity of PCCT-SLRs for osteoporosis diagnosis were 92.31% (12/13) and 98.63% (144/146), respectively.

Conclusion: The PCCT-SLR is an accurate and reliable approach for lumbar aBMD quantification in humans, with high diagnostic performance for osteoporosis.

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.