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Diagnostic Accuracy of Quantitative Dual-energy CT-based Volumetric Bone Mineral Density Assessment for the Prediction of Osteoporosis-associated Fractures

 
: Gruenewald, Leon D.; Koch, Vitali; Martin, Simon S.; Yel, Ibrahim; Eichler, Katrin; Gruber-Rouh, Tatjana; Lenga, Lukas; Wichmann, Julian L.; Alizadeh, Leona S.; Albrecht, Moritz H.; Mader, Christoph; Huizinga, Nicole A.; D'Angelo, Tommaso; Mazziotti, Silvio; Wesarg, Stefan; Vogl, Thomas J.; Booz, Christian

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Fulltext ()

European radiology (2021), Online First, 9 pp.
ISSN: 0938-7994
ISSN: 1613-3749
ISSN: 1432-1084
English
Journal Article, Electronic Publication
Fraunhofer IGD ()
Lead Topic: Individual Health; Research Line: Computer vision (CV); Research Line: Modeling (MOD); dual-energy CT; bone mineral density (BMD); Osteoporosis

Abstract
Objectives: To evaluate the predictive value of volumetric bone mineral density (BMD) assessment of the lumbar spine derived from phantomless dual-energy CT (DECT)-based volumetric material decomposition as an indicator for the 2-year occurrence risk of osteoporosis-associated fractures.
Methods: L1 of 92 patients (46 men, 46 women; mean age, 64 years, range, 19-103 years) who had undergone third-generation dual-source DECT between 01/2016 and 12/2018 was retrospectively analyzed. For phantomless BMD assessment, dedicated DECT postprocessing software using material decomposition was applied. Digital files of all patients were sighted for 2 years following DECT to obtain the incidence of osteoporotic fractures. Receiver operating characteristic (ROC) analysis was used to calculate cut-off values and logistic regression models were used to determine associations of BMD, sex, and age with the occurrence of osteoporotic fractures.
Results: A DECT-derived BMD cut-off of 93.70 mg/cm3 yielded 85.45% sensitivity and 89.19% specificity for the prediction to sustain one or more osteoporosis-associated fractures within 2 years after BMD measurement. DECT-derived BMD was significantly associated with the occurrence of new fractures (odds ratio of 0.8710, 95% CI, 0.091–0.9375, p < .001), indicating a protective effect of increased DECT-derived BMD values. Overall AUC was 0.9373 (CI, 0.867–0.977, p < .001) for the differentiation of patients who sustained osteoporosis-associated fractures within 2 years of BMD assessment.
Conclusions: Retrospective DECT-based volumetric BMD assessment can accurately predict the 2-year risk to sustain an osteoporosis-associated fracture in at-risk patients without requiring a calibration phantom. Lower DECT-based BMD values are strongly associated with an increased risk to sustain fragility fractures.

: http://publica.fraunhofer.de/documents/N-643247.html