CT Derived Hounsfield Unit: An Easy Way to Determine Osteoporosis and Radiation Related Fracture Risk in Irradiated Patients

Yaprak, Gökhan; Gemici, Cengiz; Seseogullari, Ozgur Ozan; Karabag, Irem S; Çini, Nilsu

doi:10.3389/fonc.2020.00742

Cited by 16 publications

(17 citation statements)

References 32 publications

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“…The bone density is high, usually 300~3000HU [18]. Many studies have shown a good correlation between HU value and T score [8][9][10][18][19][20].Similarly, the M-score was the rst MRI-based observation to use adipose tissue with high T1 signal and to assess fat in ltration in cancellous bone by measuring T1 signal in the vertebral body [21].Other study has con rmed this approach and provided evidence for the use of m-scores to assess bone quality [22].However, M-Score is of limited utility because it requires measurements to be taken using the same MRI machine.Using the principle of M-score and avoiding its defects, VBQ score was developed [11]. VBQ score was standardized with L3 space CSF SI as a reference value and could be compared between patients with different MRI machines.…”

Section: Discussionmentioning

confidence: 99%

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Zhu

Tong

et al. 2022

Preprint

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Background: Computed tomography Hounsfield unit (HU) and magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score are both alternative tool to the dual energy x-ray absorptiometry(DEXA) scan T-score to quantify the bone quality. However, it is not known which method more accurately reflects vertebral bone mineral density. Purpose: To evaluate the best method for evaluating vertebral bone mineral density in patients undergoing lumbar spine surgery.Methods: Eighty-five patients who had at most two vertebrae with severe degeneration at L1–L4 were retrospectively reviewed.HU value was measured by axial CT image, VBQ score was calculated by T1-weighted lumbar MRI image, and L1-L4 T-score and bone mineral density (BMD) were measured by DEXA.The correlation of the vertebral HU value and VBQ score to the T-score was analyzed.Results: There were 52 female and 33 male patients. The average age was 57.18±9.65 years . HU values had a positive correlation with BMD and T-score. The correlation coefficients between HU and T-score was 0.751(<0.001) for L1; 0.699(<0.001) for L2; 0.618(<0.001) for L3; 0.543(<0.001) for L4; and 0.677(<0.001) for L1-4.However,VBQ score had a negative correlation with BMD and T-score. The correlation coefficients between VBQ score and T-score was -0.231(<0.05) for L1; -0.246(<0.05) for L2; -0.268(<0.05) for L3; -0.252(<0.05) for L4; and -0.346(<0.01) for L1-4. The correlation coefficients of HU value at L1–L4 were higher than the correlation coefficients of VBQ score . Conclusions: HU value was a better predictor of vertebral bone mineral density than VBQ score in patients with lumbar degenerative disease.

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Section: Discussionmentioning

confidence: 99%

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Zhu

Tong

et al. 2022

Preprint

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“…This process is performed at the L1-L4 vertebral levels and an average obtained (Figure 3). Yaprak et al 14 demonstrated a significant correlation between low HU values and a diagnosis of osteoporosis and suggested a cutoff of less than 100 HU for diagnosis.…”

Section: Quantitative Ct Scan and Hounsfield Unitsmentioning

confidence: 99%

Bone Quality in Spinal Surgery: Evaluation, Implications, and Treatments

Raad,

Satin,

Derman

2024

Contemporary Spine Surgery

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Bone mineral density (BMD) is generally defined as the concentration or density of bone minerals in bone tissue. It is an indicator of bone quality and is used in the diagnosis of osteopenia or osteoporosis. Poor bone quality has been demonstrated to be associated with significantly higher risk of fragility fractures including those of the hip, distal radius, and spine. It is important for spinal surgeons to understand the implications of BMD on outcomes after spinal surgery, learn the various methods to evaluate it, and be aware of treatment options in the perioperative period.

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“…It has recently been shown that patients with decreased BMD and osteoporosis may be identified based on CT-derived bony HU determinations [25,26]. Osteopenia is defined as values of 100-160 HU, whereas values < 100 are considered osteoporotic [25][26][27][28]. The risk of osteoporotic vertebral fractures (OVFs) is increased in patients at HU < 160 [28,29].…”

Section: Introductionmentioning

confidence: 99%

“…Osteopenia is defined as values of 100-160 HU, whereas values < 100 are considered osteoporotic [25][26][27][28]. The risk of osteoporotic vertebral fractures (OVFs) is increased in patients at HU < 160 [28,29]. Obesity and adipose tissue are linked to sarcopenic fatty muscle degeneration and bone health through various pathways [30].…”

Section: Introductionmentioning

confidence: 99%

Impact of Sarcopenia and Bone Mineral Density on Implant Failure after Dorsal Instrumentation in Patients with Osteoporotic Vertebral Fractures

et al. 2022

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Background and Objectives: Age-related loss of bone and muscle mass are signs of frailty and are associated with an increased risk of falls and consecutive vertebral fractures. Management often necessitates fusion surgery. We determined the impacts of sarcopenia and bone density on implant failures (IFs) and complications in patients with spondylodesis due to osteoporotic vertebral fractures (OVFs). Materials and Methods: Patients diagnosed with an OVF according to the osteoporotic fracture classification (OF) undergoing spinal instrumentation surgery between 2011 and 2020 were included in our study. The skeletal muscle area (SMA) was measured at the third lumbar vertebra (L3) level using axial CT images. SMA z-scores were calculated for the optimal height and body mass index (BMI) adjustment (zSMAHT). The loss of muscle function was assessed via measurement of myosteatosis (skeletal muscle radiodensity, SMD) using axial CT scans. The bone mineral density (BMD) was determined at L3 in Hounsfield units (HU). Results: A total of 68 patients with OVFs underwent instrumentation in 244 segments (mean age 73.7 ± 7.9 years, 60.3% female). The median time of follow-up was 14.1 ± 15.5 months. Sarcopenia was detected in 28 patients (47.1%), myosteatosis in 45 patients (66.2%), and osteoporosis in 49 patients (72%). The presence of sarcopenia was independent of chronological age (p = 0.77) but correlated with BMI (p = 0.005). The zSMAHT was significantly lower in patients suffering from an IF (p = 0.0092). Sarcopenia (OR 4.511, 95% CI 1.459–13.04, p = 0.0092) and osteoporosis (OR 9.50, 95% CI 1.497 to 104.7, p = 0.014) increased the likelihood of an IF. Using multivariate analysis revealed that the zSMAHT (p = 0.0057) and BMD (p = 0.0041) were significantly related to IF occurrence. Conclusion: Herein, we established sarcopenic obesity as the main determinant for the occurrence of an IF after instrumentation for OVF. To a lesser degree, osteoporosis was associated with impaired implant longevity. Therefore, measuring the SMA and BMD using an axial CT of the lumbar spine might help to prevent an IF in spinal fusion surgery via early detection and treatment of sarcopenia and osteoporosis.

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CT Derived Hounsfield Unit: An Easy Way to Determine Osteoporosis and Radiation Related Fracture Risk in Irradiated Patients

Abstract: Background: We aimed to evaluate osteoporosis, bone mineral density, and fracture risk in irradiated patients by computerized tomography derived Hounsfield Units (HUs) calculated from radiation treatment planning system.

Cited by 16 publications

References 32 publications

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Hounsfield Units Value is a Better Predictor of Bone Mineral Density Than the Vertebral Bone Quality Score of Magnetic Resonance Imaging in Patients with Lumbar Degenerative Diseases

Bone Quality in Spinal Surgery: Evaluation, Implications, and Treatments

Impact of Sarcopenia and Bone Mineral Density on Implant Failure after Dorsal Instrumentation in Patients with Osteoporotic Vertebral Fractures

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