Timothy J. Ziemlewicz MD, Presenter: Nothing to Disclose

Alan D. Brett PhD, Abstract Co-Author: Employee, Mindways Software, Inc

Keenan Brown, Abstract Co-Author: Employee, Mindways Software, Inc Stockholder, Mindways Software, Inc

Perry J. Pickhardt MD, Abstract Co-Author: Co-founder, VirtuoCTC, LLC Stockholder, Cellectar Biosciences, Inc

For patients undergoing CT colonography, an opportunity exists for concurrent osteoporosis screening without additional radiation exposure or patient time using proximal femur quantitative CT (QCT) “CTXA”. Previous studies demonstrated equivalence between CTXA and DXA for femoral neck BMD evaluation. This study aims to evaluate the addition of CTXA reporting to a CT colonography program.

This cohort included 77 female and 59 male adults (mean age, 60.3±7.7 years; range, 50-85 years) who underwent routine CT colonography at 120kVp (GE Healthcare, Waukesha, WI) between March 2013 and March 2014 with calibration phantom on the table at the time of the scan. Areal BMD in g/cm2 of the femoral neck was measured on the CT series using QCT Pro Version 5.1 (Mindways Software, Austin, TX) with synchronous phantom calibration. QCT T-scores were derived using manufacturer’s female reference data. Chart review was performed to evaluate if the patient was eligible for screening according to the USPSTF recommendations, had undergone prior BMD testing, and to determine if results of QCT changed patient management.

Overall, 67.6% (92/136) of patients from the cohort had not previously undergone BMD screening and 23.9 % (22/92) of these patients were eligible for screening according to the USPSTF recommendations. T-scores within the osteopenic and osteoporotic were detected in 30.9% (42/136) and 4.4% (6/136) of patients respectively. Of these patients with low bone mineral density, 77.1% (37/48) had not previously undergone screening or were due for follow-up BMD testing. The reported T-score altered management in 6 patients with low bone mineral density.

In this cohort, adding BMD evaluation of the femoral neck to CT colonography allowed osteoporosis screening in patients who were eligible and had not previously undergone screening. A large proportion of patients with low bone mineral density identified had not previously undergone screening. This add-on, which does not change workflow,  stands to add value to CT colonography examinations for both patients and referring providers.

Maximizing value from the imaging currently being performed is crucial in the current era of healthcare reform. We demonstrate the ability to combine screening for both colon cancer/polyps and osteoporosis.

Ziemlewicz, T, Brett, A, Brown, K, Pickhardt, P, Opportunistic Osteoporosis Screening: Addition of QCT BMD Measurement to CT Colonography Fits a Clinical Need.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019171.html