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Erschienen in: Skeletal Radiology 6/2024

06.12.2023 | Scientific Article

Coronal plane in opportunistic screening of osteoporosis using computed tomography: comparison with axial and sagittal planes

verfasst von: Youngjune Kim, Changhyun Kim, Eugene Lee, Joon Woo Lee

Erschienen in: Skeletal Radiology | Ausgabe 6/2024

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Abstract

Objective

To compare the coronal plane with axial and sagittal planes in opportunistic screening of osteoporosis using computed tomography (CT).

Materials and methods

A total of 100 patients aged ≥ 50 years who underwent both lumbar spine CT and dual-energy X-ray absorptiometry within 3 months were included. Osteoporosis was diagnosed based on dual-energy X-ray absorptiometry results. The CT number was measured at the center of the vertebral body in coronal, axial, and sagittal planes. To compare the coronal plane with axial and sagittal planes in diagnosing osteoporosis, the areas under the receiver operating characteristic curve (AUC) were compared and intraclass correlation coefficient (ICC) was calculated. The optimal cutoff values were calculated using Youden’s index.

Results

The AUC of the coronal plane (0.80; 95% confidence interval [CI], 0.71–0.89) was not significantly different from that of the axial plane (0.78; 95% CI, 0.68–0.87; P = 0.39) and that of the sagittal plane (0.78; 95% CI, 0.69–0.87; P = 0.68). Excellent concordance rates were observed between coronal and axial planes with ICC of 0.95 (95% CI, 0.92–0.96) and between coronal and sagittal planes with ICC of 0.93 (95% CI, 0.85–0.96). The optimal cutoff values for the coronal, axial, and sagittal planes were 110, 112, and 112 HU, respectively.

Conclusion

The coronal plane does not significantly differ from axial and sagittal planes in opportunistic screening of osteoporosis. Thus, the coronal plane as well as axial and sagittal planes can be used interchangeably in measuring bone mineral density using CT.
Literatur
1.
Zurück zum Zitat Sarafrazi N, Wambogo EA, Shepherd JA. Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief. 2021;405:1–8. Sarafrazi N, Wambogo EA, Shepherd JA. Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief. 2021;405:1–8.
2.
Zurück zum Zitat Cauley JA. Osteoporosis: fracture epidemiology update 2016. Curr Opin Rheumatol. 2017;29(2):150–6.CrossRefPubMed Cauley JA. Osteoporosis: fracture epidemiology update 2016. Curr Opin Rheumatol. 2017;29(2):150–6.CrossRefPubMed
3.
Zurück zum Zitat Pickhardt PJ, Pooler BD, Lauder T, del Rio AM, Bruce RJ, Binkley N. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med. 2013;158(8):588–95.CrossRefPubMedPubMedCentral Pickhardt PJ, Pooler BD, Lauder T, del Rio AM, Bruce RJ, Binkley N. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med. 2013;158(8):588–95.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Buckens CF, Dijkhuis G, de Keizer B, Verhaar HJ, de Jong PA. Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. Eur Radiol. 2015;25(7):2074–9.CrossRefPubMed Buckens CF, Dijkhuis G, de Keizer B, Verhaar HJ, de Jong PA. Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. Eur Radiol. 2015;25(7):2074–9.CrossRefPubMed
5.
Zurück zum Zitat Li YL, Wong KH, Law MW, Fang BX, Lau VW, Vardhanabuti VV, et al. Opportunistic screening for osteoporosis in abdominal computed tomography for Chinese population. Arch Osteoporos. 2018;13(1):76.CrossRefPubMed Li YL, Wong KH, Law MW, Fang BX, Lau VW, Vardhanabuti VV, et al. Opportunistic screening for osteoporosis in abdominal computed tomography for Chinese population. Arch Osteoporos. 2018;13(1):76.CrossRefPubMed
6.
Zurück zum Zitat Alacreu E, Moratal D, Arana E. Opportunistic screening for osteoporosis by routine CT in Southern Europe. Osteoporos Int. 2017;28(3):983–90.CrossRefPubMed Alacreu E, Moratal D, Arana E. Opportunistic screening for osteoporosis by routine CT in Southern Europe. Osteoporos Int. 2017;28(3):983–90.CrossRefPubMed
7.
Zurück zum Zitat Vadera S, Osborne T, Shah V, Stephenson JA. Opportunistic screening for osteoporosis by abdominal CT in a British population. Insights Imaging. 2023;14(1):57.CrossRefPubMedPubMedCentral Vadera S, Osborne T, Shah V, Stephenson JA. Opportunistic screening for osteoporosis by abdominal CT in a British population. Insights Imaging. 2023;14(1):57.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Abbouchie H, Raju N, Lamanna A, Chiang C, Kutaiba N. Screening for osteoporosis using L1 vertebral density on abdominal CT in an Australian population. Clin Radiol. 2022;77(7):e540–8.CrossRefPubMed Abbouchie H, Raju N, Lamanna A, Chiang C, Kutaiba N. Screening for osteoporosis using L1 vertebral density on abdominal CT in an Australian population. Clin Radiol. 2022;77(7):e540–8.CrossRefPubMed
9.
Zurück zum Zitat Loffler MT, Jacob A, Scharr A, Sollmann N, Burian E, El Husseini M, et al. Automatic opportunistic osteoporosis screening in routine CT: improved prediction of patients with prevalent vertebral fractures compared to DXA. Eur Radiol. 2021;31(8):6069–77.CrossRefPubMedPubMedCentral Loffler MT, Jacob A, Scharr A, Sollmann N, Burian E, El Husseini M, et al. Automatic opportunistic osteoporosis screening in routine CT: improved prediction of patients with prevalent vertebral fractures compared to DXA. Eur Radiol. 2021;31(8):6069–77.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Graffy PM, Lee SJ, Ziemlewicz TJ, Pickhardt PJ. Prevalence of vertebral compression fractures on routine CT scans according to L1 trabecular attenuation: determining relevant thresholds for opportunistic osteoporosis screening. AJR Am J Roentgenol. 2017;209(3):491–6.CrossRefPubMed Graffy PM, Lee SJ, Ziemlewicz TJ, Pickhardt PJ. Prevalence of vertebral compression fractures on routine CT scans according to L1 trabecular attenuation: determining relevant thresholds for opportunistic osteoporosis screening. AJR Am J Roentgenol. 2017;209(3):491–6.CrossRefPubMed
11.
Zurück zum Zitat Carberry GA, Pooler BD, Binkley N, Lauder TB, Bruce RJ, Pickhardt PJ. Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology. 2013;268(1):120–6.CrossRefPubMed Carberry GA, Pooler BD, Binkley N, Lauder TB, Bruce RJ, Pickhardt PJ. Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology. 2013;268(1):120–6.CrossRefPubMed
12.
Zurück zum Zitat Lee SJ, Pickhardt PJ. Opportunistic screening for osteoporosis using body CT scans obtained for other indications: the UW experience. Clinic Rev Bone Miner Metab. 2017;15:128–37.CrossRef Lee SJ, Pickhardt PJ. Opportunistic screening for osteoporosis using body CT scans obtained for other indications: the UW experience. Clinic Rev Bone Miner Metab. 2017;15:128–37.CrossRef
13.
Zurück zum Zitat Lee SJ, Binkley N, Lubner MG, Bruce RJ, Ziemlewicz TJ, Pickhardt PJ. Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density. Osteoporos Int. 2016;27(3):1131–6.CrossRefPubMed Lee SJ, Binkley N, Lubner MG, Bruce RJ, Ziemlewicz TJ, Pickhardt PJ. Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density. Osteoporos Int. 2016;27(3):1131–6.CrossRefPubMed
14.
Zurück zum Zitat Snider KT, Kribs JW, Snider EJ, Degenhardt BF, Bukowski A, Johnson JC. Reliability of Tuffier’s line as an anatomic landmark. Spine (Phila Pa 1976). 2008;33(6):E161-165.CrossRefPubMed Snider KT, Kribs JW, Snider EJ, Degenhardt BF, Bukowski A, Johnson JC. Reliability of Tuffier’s line as an anatomic landmark. Spine (Phila Pa 1976). 2008;33(6):E161-165.CrossRefPubMed
15.
Zurück zum Zitat DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.CrossRefPubMed DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.CrossRefPubMed
16.
Zurück zum Zitat Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63.CrossRefPubMedPubMedCentral Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. 5th ed. Boston: Houghton Mifflin; 2003. Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. 5th ed. Boston: Houghton Mifflin; 2003.
18.
Zurück zum Zitat Morris CA, Cabral D, Cheng H, Katz JN, Finkelstein JS, Avorn J, et al. Patterns of bone mineral density testing: current guidelines, testing rates, and interventions. J Gen Intern Med. 2004;19(7):783–90.CrossRefPubMedPubMedCentral Morris CA, Cabral D, Cheng H, Katz JN, Finkelstein JS, Avorn J, et al. Patterns of bone mineral density testing: current guidelines, testing rates, and interventions. J Gen Intern Med. 2004;19(7):783–90.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Amarnath AL, Franks P, Robbins JA, Xing G, Fenton JJ. Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study. J Gen Intern Med. 2015;30(12):1733–40.CrossRefPubMedPubMedCentral Amarnath AL, Franks P, Robbins JA, Xing G, Fenton JJ. Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study. J Gen Intern Med. 2015;30(12):1733–40.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Zhu Y, Triphuridet N, Yip R, Becker BJ, Wang Y, Yankelevitz DF, et al. Opportunistic CT screening of osteoporosis on thoracic and lumbar spine: a meta-analysis. Clin Imaging. 2021;80:382–90.CrossRefPubMed Zhu Y, Triphuridet N, Yip R, Becker BJ, Wang Y, Yankelevitz DF, et al. Opportunistic CT screening of osteoporosis on thoracic and lumbar spine: a meta-analysis. Clin Imaging. 2021;80:382–90.CrossRefPubMed
22.
Zurück zum Zitat Pickhardt PJ, Lauder T, Pooler BD, Munoz Del Rio A, Rosas H, Bruce RJ, et al. Effect of IV contrast on lumbar trabecular attenuation at routine abdominal CT: correlation with DXA and implications for opportunistic osteoporosis screening. Osteoporos Int. 2016;27(1):147–52.CrossRefPubMed Pickhardt PJ, Lauder T, Pooler BD, Munoz Del Rio A, Rosas H, Bruce RJ, et al. Effect of IV contrast on lumbar trabecular attenuation at routine abdominal CT: correlation with DXA and implications for opportunistic osteoporosis screening. Osteoporos Int. 2016;27(1):147–52.CrossRefPubMed
23.
Zurück zum Zitat Fang J, Franconeri A, Boos J, Nimhuircheartaigh J, Zhang Z, Brook A, et al. Opportunistic bone density measurement on abdomen and pelvis computed tomography to predict fracture risk in women aged 50 to 64 years without osteoporosis risk factors. J Comput Assist Tomogr. 2018;42(5):798–806.CrossRefPubMed Fang J, Franconeri A, Boos J, Nimhuircheartaigh J, Zhang Z, Brook A, et al. Opportunistic bone density measurement on abdomen and pelvis computed tomography to predict fracture risk in women aged 50 to 64 years without osteoporosis risk factors. J Comput Assist Tomogr. 2018;42(5):798–806.CrossRefPubMed
24.
Zurück zum Zitat Pompe E, Willemink MJ, Dijkhuis GR, Verhaar HJ, Mohamed Hoesein FA, de Jong PA. Intravenous contrast injection significantly affects bone mineral density measured on CT. Eur Radiol. 2015;25(2):283–9.CrossRefPubMed Pompe E, Willemink MJ, Dijkhuis GR, Verhaar HJ, Mohamed Hoesein FA, de Jong PA. Intravenous contrast injection significantly affects bone mineral density measured on CT. Eur Radiol. 2015;25(2):283–9.CrossRefPubMed
25.
Zurück zum Zitat Brunnquell CL, Winsor C, Aaltonen HL, Telfer S. Sources of error in bone mineral density estimates from quantitative CT. Eur J Radiol. 2021;144:110001.CrossRefPubMed Brunnquell CL, Winsor C, Aaltonen HL, Telfer S. Sources of error in bone mineral density estimates from quantitative CT. Eur J Radiol. 2021;144:110001.CrossRefPubMed
26.
Zurück zum Zitat Ahmad A, Crawford CH, Glassman SD, 2nd JRD, Gum JL, Carreon LY. Correlation between bone density measurements on CT or MRI versus DEXA scan: a systematic review. N Am Spine Soc J. 2023;14:100204. Ahmad A, Crawford CH, Glassman SD, 2nd JRD, Gum JL, Carreon LY. Correlation between bone density measurements on CT or MRI versus DEXA scan: a systematic review. N Am Spine Soc J. 2023;14:100204.
Metadaten
Titel
Coronal plane in opportunistic screening of osteoporosis using computed tomography: comparison with axial and sagittal planes
verfasst von
Youngjune Kim
Changhyun Kim
Eugene Lee
Joon Woo Lee
Publikationsdatum
06.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2024
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-023-04525-y

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