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
CodeCraft应助科研通管家采纳,获得10
1秒前
脑洞疼应助科研通管家采纳,获得10
1秒前
1秒前
地表飞猪应助科研通管家采纳,获得10
1秒前
科研通AI2S应助科研通管家采纳,获得10
1秒前
传奇3应助科研通管家采纳,获得10
1秒前
情怀应助科研通管家采纳,获得10
1秒前
英俊的铭应助科研通管家采纳,获得10
1秒前
YamDaamCaa应助科研通管家采纳,获得30
1秒前
1秒前
orixero应助科研通管家采纳,获得10
1秒前
大个应助科研通管家采纳,获得10
1秒前
SciGPT应助科研通管家采纳,获得10
1秒前
2秒前
所所应助过氧化氢采纳,获得10
4秒前
青山发布了新的文献求助50
5秒前
5秒前
大白发布了新的文献求助10
5秒前
5秒前
热情的达完成签到,获得积分10
5秒前
酷波er应助十九岁的时差采纳,获得10
5秒前
gj发布了新的文献求助10
6秒前
Hairee发布了新的文献求助10
6秒前
momo发布了新的文献求助10
10秒前
称心尔曼完成签到,获得积分10
11秒前
13秒前
15秒前
谷蓝完成签到,获得积分10
15秒前
17秒前
希望天下0贩的0应助Hairee采纳,获得10
18秒前
Rondab应助ali采纳,获得30
19秒前
懒羊羊完成签到,获得积分10
19秒前
好吃完成签到,获得积分20
19秒前
好吃发布了新的文献求助10
22秒前
22秒前
23秒前
24秒前
量子星尘发布了新的文献求助10
24秒前
张雯思发布了新的文献求助10
24秒前
fjm完成签到,获得积分10
24秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
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
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
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 3989297
求助须知:如何正确求助?哪些是违规求助? 3531418
关于积分的说明 11253893
捐赠科研通 3270097
什么是DOI,文献DOI怎么找? 1804884
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809158