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
liang19640908完成签到 ,获得积分10
1秒前
奋斗的雪曼完成签到 ,获得积分10
7秒前
粗心的飞槐完成签到 ,获得积分10
7秒前
LELE完成签到 ,获得积分10
14秒前
了0完成签到 ,获得积分10
15秒前
apocalypse完成签到 ,获得积分10
20秒前
guhao完成签到 ,获得积分10
21秒前
指导灰完成签到 ,获得积分10
21秒前
善良的火完成签到 ,获得积分10
32秒前
优雅夕阳完成签到 ,获得积分10
34秒前
Jasper应助光亮的自行车采纳,获得10
34秒前
miki完成签到,获得积分10
35秒前
量子星尘发布了新的文献求助10
36秒前
糖宝完成签到 ,获得积分10
43秒前
KX2024完成签到,获得积分10
46秒前
松松发布了新的文献求助20
49秒前
nusiew完成签到,获得积分10
49秒前
huiluowork完成签到 ,获得积分10
50秒前
陶醉的翠霜完成签到 ,获得积分10
50秒前
50秒前
冷静如松完成签到 ,获得积分10
57秒前
59秒前
浮云完成签到 ,获得积分10
1分钟前
屈岂愈完成签到,获得积分10
1分钟前
1分钟前
Pupil完成签到,获得积分10
1分钟前
偏偏意气用事完成签到,获得积分10
1分钟前
安安完成签到,获得积分10
1分钟前
cttc完成签到,获得积分10
1分钟前
Chnimike完成签到 ,获得积分10
1分钟前
1分钟前
红茸茸羊完成签到 ,获得积分10
1分钟前
年轻千愁完成签到 ,获得积分10
1分钟前
liu完成签到,获得积分10
1分钟前
量子星尘发布了新的文献求助10
1分钟前
Wanyeweiyu完成签到,获得积分10
1分钟前
Fury完成签到 ,获得积分10
1分钟前
风中幻梦完成签到,获得积分10
1分钟前
bigpluto完成签到,获得积分10
1分钟前
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
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 4038066
求助须知:如何正确求助?哪些是违规求助? 3575779
关于积分的说明 11373801
捐赠科研通 3305584
什么是DOI,文献DOI怎么找? 1819239
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022