Akifumi Nishida, Presenter: Nothing to Disclose

Masako Ito MD, Abstract Co-Author: Nothing to Disclose

Masataka Uetani MD, Abstract Co-Author: Nothing to Disclose

Aya Shimamoto, Abstract Co-Author: Nothing to Disclose

Yasuo Kido, Abstract Co-Author: Nothing to Disclose

To evaluate the ability of clinical abdominal CT in assessing the risk for osteoporotic vertebral fractures compared with dual-energy X-ray absorptiometry (DXA).

The subjects were 273 patients (109 men and 164 women, aged 56.8±13.6, 21-88 years) who underwent bone mineral density (BMD) measurement by DXA [lumbar spine (L-DXA), total hip (TH-DXA), femoral neck (FN-DXA) and vertebral morphometry] and diagnostic abdominal CT within 6 months from DXA examination. Clinical abdominal CT was performed with a 64–detector row scanner. Unenhanced axial images were obtained with a section thickness of 3 mm. An oval region of interest (ROI) to measure the mean attenuation (in Hounsfield units) was placed in the trabecular region at vertebrae (L2, L3, L4-CT), right femoral head (FH-CT) and right femoral neck (FN-CT) avoiding the surrounding cortical bone and degenerative sclerotic lesion on a standard PACS workstation (SYNAPSE, Fujifilm, Japan). The diagnostic ability of clinical abdominal CT and DXA with respect to discriminate prevalent vertebral fracture was assessed using receiver operating characteristic (ROC) analysis.

CT attenuation measurement correlated with BMD measurement by DXA (r=0.485-0.744). Seventy-three patients (26.7%) had vertebral fractures. For predicting vertebral fracture by CT attenuation measurement, ROC analysis provided area under the curve (AUC) values of 0.822 [95% confidence interval (CI) 0.761–0.883] for L2-CT, 0.818 (95% CI 0.757–0.879) for L3-CT, 0.821 (95% CI 0.757–0.884) for L4-CT, 0.692 (95% CI 0.601–0.782) for FH-CT and 0.762 (95% CI 0.683–0.841) for FN-CT. Except for FH-CT, these values were greater than those of BMD measurement, which were 0.685 (95% CI 0.604–0.767) for L-DXA, 0.717 (95% CI 0.637–0.796) for FN-DXA and 0.712 (95% CI 0.633–0.792) for TH-DXA (Figure).

CT attenuation values of trabeculae measured on clinical abdominal CT correlated BMD by DXA. CT attenuation measurements, especially in vertebrae, had greater discriminatory ability for vertebral fracture than DXA.

CT attenuation measurements of tabecurae can provide valuable data for identifying individuals at risk for fracture who would require osteoporosis treatment, with no additional radiation or costs. 

Nishida, A, Ito, M, Uetani, M, Shimamoto, A, Kido, Y, Clinical Abdominal CT Can Effectively Predict the Risk for Osteoporotic Vertebral Fracture.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026534.html Accessed September 18, 2025