Improved prediction of incident vertebral fractures using opportunistic QCT compared to DXA

• DOI: 10.1007/s00330-019-06018-w
• Publication Date: 2019-02-21T05:03:11Z
• Authors: Maximilian T. Löf...; Alina Jacob; Alexander Valenti...; Anna Rienmüller; Claus Zimmer; Yu-Mi Ryang; Thomas Baum; Jan S. Kirschke
• Keywords: Neuroradiology; Interventional radiology

To compare opportunistic quantitative CT (QCT) with dual energy X-ray absorptiometry (DXA) in their ability to predict incident vertebral fractures. We included 84 patients aged 50 years and older, who had routine including the lumbar spine DXA within a 12-month period (baseline) as well follow-up imaging after at least 12 months or sustained an fracture documented earlier. Patients bone disorders aside from osteoporosis were excluded. Fracture status trabecular mineral density (BMD) retrospectively evaluated baseline was reassessed follow-up. BMDQCT assessed by QCT asynchronous calibration of multiple MDCT scanners. Sixteen fractures showing lower mean than without (p = 0.001). For risk fractures, hazard ratio increased per SD (4.07; 95% CI, 1.98–8.38), adjusting for age, sex, prevalent (2.54; 1.09–5.90). DXA, statistically significant increase relative decrease T-score only observed age sex adjustment (1.57; 1.04–2.38). The predictability good (AUC 0.76; 0.64–0.89) non-significant T-scores. Asynchronously calibrated scanners showed long-term stability (linear drift ranging − 0.55 2.29 HU year). Opportunistic screening mainly neurosurgical oncologic performed indications other densitometry allows better assessment imminent dedicated DXA. • predicts osteoporotic reference standard patients. More every second patient (56%) misdiagnosed not having according Standard ACR QCT-cutoff values (< 80 mg/cm 3 ) osteopenia (≤ 120 can also be applied scanner independently QCT.