Quantitative calcium-based assessment of osteoporosis in dual-layer spectral CT
Objectives - To evaluate a novel calcium-only imaging technique (VCa) with subtracted bone marrow in osteoporosis in dual-layer CT (DLCT) compared to conventional CT images (CI) and dual-energy X-ray absorptiometry (DXA). - Material and methods - Images of a multi-energy CT phantom with calcium inse...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
6 July 2024
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| In: |
European journal of radiology
Year: 2024, Volume: 178, Pages: 1-9 |
| ISSN: | 1872-7727 |
| DOI: | 10.1016/j.ejrad.2024.111606 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejrad.2024.111606 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0720048X2400322X 
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| Author Notes: | T.D. Do, S. Rahn, C. Melzig, C.P. Heußel, W. Stiller, H.U. Kauczor, T.F. Weber, S. Skornitzke |
| Summary: | Objectives - To evaluate a novel calcium-only imaging technique (VCa) with subtracted bone marrow in osteoporosis in dual-layer CT (DLCT) compared to conventional CT images (CI) and dual-energy X-ray absorptiometry (DXA). - Material and methods - Images of a multi-energy CT phantom with calcium inserts, quantitative CT calibration phantom, and of 55 patients (mean age: 64.6 ± 11.5 years) were acquired on a DLCT to evaluate bone mineral density (BMD). CI, calcium-suppressed images, and VCa were calculated. For investigating the association of VCa and CI with DXA a subsample of 30 patients (<90 days between DXA and CT) was used. Multiple regression analysis was performed to identify further factors improving the prediction of DXA BMD. - Results - The calcium concentrations of the CT phantom inserts were significantly associated with CT numbers from VCa (R2 = 0.94) and from CI (R2 = 0.89-0.92). VCa showed significantly higher CT numbers than CI in the phantom (p ≤ 0.001) and clinical setting (p < 0.001). CT numbers from VCa were significantly associated with CI (R2 = 0.95, p < 0.001) and with DXA (R2 = 0.31, p = 0.007), whereas no significant association between DXA and CI was found. Prediction of DXA BMD based on CT numbers derived from VCa yielded R2 = 0.76 in multiple regression analysis. ROC for the differentiation of normal from pathologic BMD in VCa yielded an AUC of 0.7, and a cut-off value of 126HU (sensitivity: 0.90; specificity: 0.47). - Conclusion - VCa images showed better agreement with DXA and known calcium concentrations than CI, and could be used to estimate BMD. A VCa cut-off of 126HU could be used to identify abnormal bone mineral density. |
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| Item Description: | Gesehen am 02.12.2024 |
| Physical Description: | Online Resource |
| ISSN: | 1872-7727 |
| DOI: | 10.1016/j.ejrad.2024.111606 |