Proximal Femur Hounsfield Units on CT Colonoscopy Correlate With Dual-energy X-ray Absorptiometry

医学 霍恩斯菲尔德秤 股骨 双能X射线吸收法 核医学 结肠镜检查 放射科 骨科手术 双重能量 计算机断层摄影术 骨矿物 外科 骨质疏松症 病理 结直肠癌 内科学 癌症
作者
Daniel Christensen,Kyle E. Nappo,Jared A. Wolfe,Sean M. Wade,Daniel I. Brooks,Benjamin K. Potter,Jonathan A. Forsberg,Scott M. Tintle
出处
期刊:Clinical Orthopaedics and Related Research [Lippincott Williams & Wilkins]
卷期号:477 (4): 850-860 被引量:23
标识
DOI:10.1097/corr.0000000000000480
摘要

Quantifying bone mineral density (BMD) on CT using commercial software demonstrates good-to-excellent correlations with dual-energy x-ray absorptiometry (DEXA) results. However, previous techniques to measure Hounsfield units (HUs) within the proximal femur demonstrate less successful correlation with DEXA results. An effective method of measuring HUs of the proximal femur from CT colonoscopy might allow for opportunistic osteoporosis screening.(1) Do proximal femur HU measurements from CT colonoscopy correlate with proximal femur DEXA results? (2) How effective is our single HU measurement technique in estimating the likelihood of overall low BMD? (3) Does the relationship between our comprehensive HU measurement and DEXA results change based on age, sex, or time between studies?This retrospective study investigated the measurement of HU of the femur obtained on CT colonoscopy studies compared with DEXA results. Between 2010 and 2017, five centers performed 9085 CT colonoscopy studies; of those, 277 (3%) also had available DEXA results and were included in this study, whereas 8809 (97%) were excluded for inadequate CT imaging, lack of DEXA screening, or lack of proximal femur DEXA results. The median number of days between CT colonoscopy and DEXA scan was 595 days; no patient was excluded based on time between scans because bone remodeling is a long-term process and this allowed subgroup analysis based on time between scans. Two reviewers performed HU measurements at four points within the proximal femur on the CT colonoscopy imaging and intraclass correlation coefficients were used to evaluate interrater reliability. We used Pearson correlation coefficients to compare the comprehensive (average of eight measurements) and a single HU measurement with each DEXA result-proximal femur BMD, proximal femur T-score, femoral neck BMD, and femoral neck T-score-to identify the best measurement technique within this study. Based on their lowest DEXA T-score, we stratified patients to a diagnosis of osteoporosis, osteopenia, or normal BMD. We then calculated the area under the receiver operator characteristic curves (AUCs) to evaluate the classification ability of a single HU value to identify possible threshold(s) for detecting low BMD. For each subgroup analysis, we calculated Pearson correlation coefficients between DEXA and HUs and evaluated each subgroup's contribution to the overall predictive model using an interaction test in a linear regression model.The Pearson correlation coefficient between both the comprehensive and single HU measurements was highest compared with the proximal femur T-score at 0.75 (95% confidence interval [CI], 0.69-0.80) and 0.74 (95% CI, 0.68-0.79), respectively. Interobserver reliability, measured with intraclass correlation coefficients, for the comprehensive and single HU measurements was 0.97 (95% CI, 0.72-0.99) and 0.96 (95% CI, 0.89-0.98), respectively. Based on DEXA results, 20 patients were osteoporotic, 167 had osteopenia, and 90 patients had normal BMD. The mean comprehensive HU for patients with osteoporosis was 70 ± 30 HUs; for patients with osteopenia, it was 110 ± 36 HUs; and for patients with normal BMD, it was 158 ± 43 HUs (p < 0.001). The AUC of the single HU model was 0.82 (95% CI, 0.77-0.87). A threshold of 214 HUs is 100% sensitive and 59 HUs is 100% specific to identify low BMD; a threshold of 113 HUs provided 73% sensitivity and 76% specificity. When stratified by decade age groups, each decade age group demonstrated a positive correlation between the comprehensive HU and proximal femur T-score, ranging between 0.71 and 0.83 (95% CI, 0.59-0.91). Further subgroup analysis similarly demonstrated a positive correlation between the comprehensive HU and proximal femur T-score when stratified by > 6 months or < 6 months between CT and DEXA (0.75; 95% CI, 0.62-0.84) as well as when stratified by sex (0.70-0.76; 95% CI, 0.48-0.81). The linear regression model demonstrated that the overall positive correlation coefficient between HUs and the proximal femur T-score is not influenced by any subgroup.Our measurement technique provides a reproducible measurement of HUs within the proximal femur HUs on CT colonoscopy. Hounsfield units of the proximal femur based on this technique can predict low BMD. These CT scans are frequently performed before initial DEXA scans are done and therefore may lead to earlier recognition of low BMD. Future research is needed to validate these results in larger studies and to determine if these results can anticipate future fracture risk.Level III, diagnostic study.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
lm发布了新的文献求助10
1秒前
无所归兮应助曲艺采纳,获得10
2秒前
2秒前
yar应助alone采纳,获得30
3秒前
za==应助小赵采纳,获得10
3秒前
4秒前
豆芽发布了新的文献求助10
4秒前
oky发布了新的文献求助10
4秒前
wdy111应助迷路硬币采纳,获得20
6秒前
6秒前
7秒前
艺高人胆大鸡腿完成签到 ,获得积分10
10秒前
乐乐应助焦糖采纳,获得10
10秒前
科研通AI2S应助nalan采纳,获得10
11秒前
静_完成签到 ,获得积分10
11秒前
11秒前
雪白元蝶发布了新的文献求助10
12秒前
12秒前
12秒前
留白完成签到 ,获得积分10
13秒前
共享精神应助小圆采纳,获得10
13秒前
13秒前
慕青应助梵高的向日葵采纳,获得10
13秒前
SYLH应助科研通管家采纳,获得20
13秒前
czh应助科研通管家采纳,获得10
13秒前
13秒前
ding应助科研通管家采纳,获得10
13秒前
搜集达人应助科研通管家采纳,获得10
14秒前
打打应助科研通管家采纳,获得10
14秒前
14秒前
彭于彦祖应助科研通管家采纳,获得10
14秒前
彭于彦祖应助科研通管家采纳,获得30
14秒前
雯雯完成签到,获得积分10
14秒前
14秒前
14秒前
研友_VZG7GZ应助科研通管家采纳,获得10
14秒前
ED应助科研通管家采纳,获得10
14秒前
共享精神应助科研通管家采纳,获得10
14秒前
JamesPei应助科研通管家采纳,获得10
15秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Economic Geography and Public Policy 900
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988786
求助须知:如何正确求助?哪些是违规求助? 3531116
关于积分的说明 11252493
捐赠科研通 3269766
什么是DOI,文献DOI怎么找? 1804771
邀请新用户注册赠送积分活动 881870
科研通“疑难数据库(出版商)”最低求助积分说明 809021