A comparison of spinal quantitative computed tomography with dual energy X-ray absorptiometry in European women with vertebral and nonvertebral fractures

Abstract

Quantitative computed tomography (QCT) was compared to dual X-ray absorptiometry (DXA) measured in the lumbar spine of 508 European women defined as normal without fracture (NoF), or osteoporotic (OP), with either vertebral fracture (VF), or peripheral fracture (PF). The correlations between QCT and DXA BMD measurements were significantly different in normal and in osteoporotic patients, indicating that the two exams do not measure the same bone aspects. According to ROC curves results, QCT Z-scores separate OP from NoF with better sensitivity than all other measurements. A threshold to differentiate OP from NoF was chosen at Z-score = -1 for DXA-BMD and -1.5 for QCT-BMD. VF patients showed a highly significant decrease in BMD by DXA or QCT. PF patients revealed measurements lower than those of normal subjects but greater than those of VF, calling into question the idea of a diffuse osteoporosis causing nonvertebral fractures that is measurable by spinal DXA or QCT. DXA is weakly dependent upon age, and T-score or Z-score are equivalent for evaluating osteoporosis. QCT depends greatly upon age, and Z-score appears to be more efficient.

En bloc spondylectomy reconstructions in a biomechanical in-vitro study

“…Determination of BMD showed an average of 87.9 (±20.8) mg/cm 3 . Average BMD at the mentioned average age at death lies in the range of the second standard deviation below average controls [6] and is-concerning to the WHO definition-nonosteoporotic. Spinal specimens with structural disorders, posttraumatic abnormalities and deformities or previous spinal surgery were excluded.…”

Bone Mineral Density Values Derived from Routine Lumbar Spine Multidetector Row CT Predict Osteoporotic Vertebral Fractures and Screw Loosening

“…7,9,10 However, while acquiring data for this study, we have seen that qCT validity highly depends on the technician performing the analysis. In qCT, there is only basic morphologic information provided by the sagittal topogram; therefore, pathologies such as fractures or hemangiomas may not be detected.…”

“…5,6 There are several diagnostic techniques available for measuring BMD, such as dualenergy x-ray absorptiometry or quantitative CT (qCT). 5,[7][8][9][10][11] All established methods are associated with additional radiation exposure to the patient (eg, up to 360 Sv in qCT) 12 and additional expenses.…”

Vertebroplasty with self-locking hexagonal metal implants shows comparable primary and secondary stiffness to PMMA cement augmentation techniques in a biomechanical vertebral compression fracture model

“…Mean trabecular BMD was 85.2 mg/cm 3 (SD 20.0). Reference values for QCT BMD are reported in the literature with 96.6 and 68.6 mg/cm 3 for the age groups of 60-69 and 70-79 years, respectively [2]. Specimens were evenly distributed among three groups according to age, spinal level and BMD.…”