A Statistical Approach Regarding the Diagnosis of Osteoporosis and Osteopenia From DXA: Are We Underdiagnosing Osteoporosis?

Abstract

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Support vector machines are superior to principal components analysis for selecting the optimal bones’ CT attenuations for opportunistic screening for osteoporosis using CT scans of the foot or ankle

“…However, prior studies have shown that the calcaneus is a reasonable bone to use for screening for osteoporosis using ultrasound and quantitative CT [ 18 ]. Prior reports showed that the BMD measurements at different osseous sites were highly correlated [ 27 , 28 ], which would support our finding that the attenuations at different osseous sites are highly correlated. A prior study also showed that the TBS provides complementary information to DXA BMD measurements for prediction of fracture risk [ 29 ].…”

Machine Learning for Opportunistic Screening for Osteoporosis and Osteopenia Using Knee CT Scans

“…9,14,17,41,42 The spine and hips may be involved by degenerative changes or bony metastases that may affect the BMD of the bones. 2,[8][9][10]48 Our results show that opportunistic knee CT scans can be used in patients with degenerative changes of the knee.…”

“…2 The BMD T-score at the femoral neck is thought to be more reliable because BMD T-scores at the lumbar spine and total hip can be affected by degenerative changes of the spine and hip. 2,8–10…”

“…Low bone mineral density (BMD) is an indolent, pernicious, senescent process that results in osteopenia and eventually osteoporosis. 1,2 Low BMD is the result of bone loss that begins in the fourth decade of life, and progressively increases with age, slightly faster in women than men after menopause. 3–5 Low BMD is thought to be related insufficient peak bone mass in the third decade of life, excessive bone resorption, or inadequate formation of new bone during remodelling.…”

“…6 The World Health Organization (WHO) classification defines normal BMD as a minimum T-score ≥ À1; osteopenia as a minimum T-score between À1 and À2.5; osteoporosis as a minimum Tscore ≤ À2.5; and severe osteoporosis as a minimum Tscore ≤ À2.5 and a history of fracture. 2 The BMD T-score at the femoral neck is thought to be more reliable because BMD T-scores at the lumbar spine and total hip can be affected by degenerative changes of the spine and hip. 2,[8][9][10] Most patients who suffer frailty fractures are osteopenic rather than osteoporotic, 11,12 so the Fracture Risk Assessment Tool (FRAX) scores have been used to identify patients with osteopenia who are also at increased risk for fractures.…”