Hounsfield units on abdominal computed tomography: a new tool for predicting osteoporosis
Xiaohui Luo, Jiongfeng Zhang, Zhengzai Dai, Xiang Gong, Gaoyang Qu, Juncheng Li, Zhiping Zhang- Radiology, Nuclear Medicine and imaging
- General Medicine
- Radiological and Ultrasound Technology
Background
Osteoporosis can cause bone fractures and disability, but early diagnosis faces challenges. Our proposed diagnostic indicators offer a new approach for early detection, which benefits early identification.
Purpose
To determine the most appropriate threshold for predicting osteoporosis in patients with each section of vertebral body.
Material and Methods
A retrospective analysis of 210 patients, including 646 vertebrae, who had both abdominal computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) within six months. The correlation between DXA T-score and CT Hounsfield units (HU) values was tested by Pearson. The area under the curve (AUC) was calculated using the threshold obtained from the regression equation.
Results
The thresholds matching the T-score of −2.5 were 85, 95, 85, and 90 HU for the upper axial plane of the vertebral body (Lau), the middle axial plane of the vertebral body (Lam), the lower axial plane of the vertebral body (Lad), and the mid-sagittal plane of the vertebral body (Lsm), respectively. Defining osteoporosis using CT as Lau ≤ 85, Lam ≤ 95, Lad ≤ 85, or Lsm ≤ 90 HU had a specificity of 88.1% (116/134) and sensitivity of 90.8% (69/76) for distinguishing DXA osteoporosis of the lumbar spine in 210 patients. T-score ≤−2.5 defined as Lau ≤85 or Lam ≤95 or Lad ≤85 or Lsm ≤90 HU had a specificity of 85.9% (275/320) and sensitivity of 82.8% (270/326) for DXA T-score ≤−2.5 in 646 lumbar vertebrae.
Conclusion
CT HU values obtained based on different sections of the vertebral body in abdominal CT can be used as a supplementary measure to assess osteoporosis.