Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Schreiber, Joseph J.; Gausden, Elizabeth B.; Anderson, Paul A.; Carlson, Michelle G.; Weiland, Andrew J.

doi:10.2106/jbjs.n.01230

Cited by 50 publications

(35 citation statements)

References 23 publications

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“…However, this method of correlating HU with DEXA scores has been shown to be reliable. 7,8 Our distal radius and capitate bone density findings are comparable to those of Schreiber et al 8 Additionally, Todisco et al in 2005 19 showed that bone mineral density on CT scan directly correlated to bone volume on histomorphometry. Norton in 2001 20 showed that HU correlated with bone quality, and Ahlo in 1998 21 showed a significant correlation between HU and trabecular bone mineral density.…”

Section: Concentric Shellssupporting

confidence: 81%

“…3). Hounsfield units (HUs) were then measured in each region of the scaphoid to evaluate bone density using the method previously described by Schreiber et al 7,8 Bone density of the scaphoid proximal and distal poles, the distal radius, and the capitate was measured by averaging three axial sections proximal to the physeal scar in the distal radius and three cross sections in the carpal bones as described by Schreiber et al 7,8 Cortical regions were included in these measurements.…”

Section: Methodsmentioning

confidence: 99%

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Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement

et al. 2017

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Ideal internal fixation of the scaphoid relies on adequate bone stock for screw purchase; so, knowledge of regional bone density of the scaphoid is crucial. The purpose of this study was to evaluate regional variations in scaphoid bone density. Three-dimensional CT models of fractured scaphoids were created and sectioned into proximal/distal segments and then into quadrants (volar/dorsal/radial/ulnar). Concentric shells in the proximal and distal pole were constructed in 2-mm increments moving from exterior to interior. Bone density was measured in Hounsfield units (HU). Bone density of the distal scaphoid (453.2 ± 70.8 HU) was less than the proximal scaphoid (619.8 ± 124.2 HU). There was no difference in bone density between the four quadrants in either pole. In both the poles, the first subchondral shell was the densest. In both the proximal and distal poles, bone density decreased significantly in all three deeper shells. The proximal scaphoid had a greater density than the distal scaphoid. Within the poles, there was no difference in bone density between the quadrants. The subchondral 2-mm shell had the greatest density. Bone density dropped off significantly between the first and second shell in both the proximal and distal scaphoids. In scaphoid fracture ORIF, optimal screw placement engages the subchondral 2-mm shell, especially in the distal pole, which has an overall lower bone density, and the second shell has only two-third the density of the first shell.

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Section: Concentric Shellssupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement

et al. 2017

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“…Previous studies have demonstrated that CT attenuation correlates with dual X-ray absorptiometry (DEXA) and that HU can serve as a surrogate measure for bone density, though it does not directly measure bone mineral content. (17,(21)(22)(23)(24)(25)(26)(27)(28)(29) In our study, we found age-related global bone density loss as measured by mean HU, which affected the CP as well as other craniofacial bones. This age-related bone loss appears to occur diffusely throughout the CP, however, this may be more profound in the middle CP, as compared to the posterior region.…”

Section: Discussionsupporting

confidence: 47%

Radiologic changes in the aging nasal cavity

Ganjaei¹,

Soler²,

Mappus³

et al. 2019

Rhin

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Background: With an aging population, it is important to understand age-related anatomic changes in the nasal cavity and cribriform plate (CP) that may have clinical implications. Methodology: Computed tomography (CT) scans obtained for non-rhinologic conditions were divided into a young cohort (N=35, 18-34 years old) and an old cohort (N=32, 80-99 years old). Intranasal airspace volumes and bony anatomy of the CP were manually segmented using OsiriX software. The CP was assessed for mean Hounsfield Units (HU) and percentage of olfactory foramina. Deformation based morphometry (DBM) was then performed on the same cohort and correlated with manual measurements. Results: Individual nasal cavity volumes increased 17-75% with age (p<0.05 for most volumes). Regression analysis of all scans revealed age to be the predominant variable influencing intranasal volume differences when controlling for sex and head size (p<0.05). Mean HU of the CP negatively correlated with age (r=−0.391, p <0.001). No age-related differences in bone stenosis of olfactory foramina were identified. Automated DBM measurements of intranasal volumes, as well as CP and zygoma mean HU correlated with manual measurements (r>0.8, p<0.001). Conclusion: Older subjects have a global increase in intranasal volumes and diffuse bone density loss in the CP. The clinical impact of age-related anatomic changes in the nasal cavity and CP requires further investigation.

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“…DXA has been widely used for the diagnosis of osteoporosis. However, previous studies indicate that the majority of patients at high-risk of osteoporosis have not been adequately evaluated for BMD [ 13 , 14 ]. Therefore, various alternative tools for osteoporosis screening have been suggested.…”

Section: Discussionmentioning

confidence: 99%

Opportunistic osteoporosis screening via the measurement of frontal skull Hounsfield units derived from brain computed tomography images

Won

Kim

et al. 2018

PLoS ONE

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Background and purposeOsteoporosis is one of the most common chronic metabolic diseases, but detection and treatment rates are low. The aim of the current study was to evaluate the correlation between frontal skull Hounsfield unit (HU) values from brain computed tomography (CT) scans and T-scores of the lumbar spine and femoral neck from dual-energy X-ray absorptiometry (DXA) scans.MethodsPatients with < 1 year between brain CT and DXA scans were included in the study. The average frontal skull HU value used for analysis was defined as the average of four HU values of the frontal bone. A receiver operating characteristic curve was generated, and area under the curve (AUC) was used to determine the HU values of the frontal skull for predicting osteoporosis. The frontal skull HU value with the highest sensitivity and specificity was considered the optimal cutoff value.ResultsIn total, 899 patients who underwent both brain CT and DXA scans at a single institution were enrolled. Average skull HU values differed significantly among patients in different bone mineral density categories (p < 0.001). There was a positive correlation between skull HU value and T-score (β = 105.06, p < 0.001, R2 = 0.343). The mean HU value in subjects with osteoporosis was 515, and the optimal cutoff value for the prediction of osteoporosis was 610 HU (AUC = 0.775, 95% CI 0.744–0.806, p < 0.001).ConclusionsClinical brain CT scans can assist in the detection of osteoporosis, and patients with an HU value < 610 as determined via brain CT may be considered for further evaluation for possible osteoporosis.

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Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Cited by 50 publications

References 23 publications

Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement

Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement

Radiologic changes in the aging nasal cavity

Opportunistic osteoporosis screening via the measurement of frontal skull Hounsfield units derived from brain computed tomography images

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