X-ray-based quantitative osteoporosis imaging at the spine

AbstractOsteoporosis is a metabolic bone disease with a high prevalence that affects the population worldwide, particularly the elderly. It is often due to fractures associated with bone fragility that the diagnosis of osteoporosis becomes clinically evident. However, early diagnosis would be necessary to initiate therapy and to prevent occurrence of further fractures, thus reducing morbidity and mortality. X-ray-based imaging plays a key role for fracture risk assessment and monitoring of osteoporosis. Whereas over decades dual-energy X-ray absorptiometry (DXA) has been the main method used and still reflects the reference standard, another modality reemerges with quantitative computed tomography (QCT) because of its three-dimensional advantages and the opportunistic exploitation of routine CT scans. Against this background, this article intends to review and evaluate recent advances in the field of X-ray-based quantitative imaging of osteoporosis at the spine. First, standard DXA with the recent addition of trabecular bone score (TBS) is presented. Secondly, standard QCT, dual-energy BMD quantification, and opportunistic BMD screening in non-dedicated CT exams are discussed. Lastly, finite element analysis and microstructural parameter analysis are reviewed.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research

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Abstract OBJECTIVE: The goal of this study was to compare different recognized definitions of osteoporosis in patients with degenerative lumbar spine pathology undergoing elective spinal fusion surgery to determine which patient population should be considered for preoperative optimization. METHODS: A retrospective review of patients in whom lumbar spine surgery was planned at 2 academic medical centers was performed, and the rate of osteoporosis was compared based on different recognized definitions. Assessments were made based on dual-energy x-ray absorptiometry (DXA), CT Hounsfield units (HU), trabecular b...
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Using an artificial intelligence (AI) deep convolutional neural network to...Read more on AuntMinnie.comRelated Reading: AI enables screening of fracture risk from CT scans 3D printing cuts hip fracture repair time, blood loss 3D DEXA enhances hip fracture risk prediction USPSTF reaffirms osteoporosis screening
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
ConclusionsThe study identified that entropy and uniformity are a relevant parameters data in bone fragility assessment in acromegalic patients.
Source: Endocrine - Category: Endocrinology Source Type: research
AbstractThe surgeon general of the USA defines osteoporosis as “a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture.” Measuring bone strength,Biomechanical Computed Tomography analysis  (BCT), namely, finite element analysis of a patient’s clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied “opportunistically” to most existing CT scans that include the spine or hip re...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Conclusions: As NaF PET/CT becomes more popular in evaluating skeletal calcium metabolism (as shown by the measurement of osteoporosis), advancing technology such as total-body PET/CT scanners should be used to take complete advantage of this imaging modality. We believe that future, well-powered studies are needed to prove this prediction, and detail the far-reaching benefits today-body PET/CT scanners can have for osteoporotic patients.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Poster Session I Source Type: research
46Objectives: Traditionally, obesity is believed to be protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity increases the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a possible underlying mechanism for the development of obesity-related osteoporosis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the predictive role of VAT metabolic activity evaluated by 18F-FD...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Spotlights in Endocrinology Source Type: research
AbstractPurpose of ReviewThis review discusses imaging modalities for fracture repair assessment, with an emphasis on pragmatic clinical and translational use, best practices for implementation, and challenges and opportunities for continuing research.Recent FindingsSemiquantitative radiographic union scoring remains the clinical gold standard, but has questionable reliability as a surrogate indicator of structural bone healing, particularly in early-stage, complex, or compromised healing scenarios. Alternatively, computed tomography (CT) scanning enables quantitative assessment of callus morphometry and mechanics through ...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research
Study Design. Retrospective analysis. Objective. To investigate the prevalence of osteoporosis (OP) in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD). Summary of Background Data. OP is related to many complications after lumbar fusion for patients with LDD. There are sparse data on the prevalence of OP among this specific population. Moreover, LDD can falsely elevate the bone mineral density measured by dual energy x-ray absorptiometry (DXA), leading to unreliable diagnostic results. Computed tomography (CT) Hounsfield unit (HU) values can help identify osteoporotic patients undetected by ...
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
This study aimed to determine the relationship of PMI to clinical parameters including bone mineral density (BMD) in candidates for lung transplantation.MethodsA retrospective review of transplant candidates at a single center was performed. Demographic, anthropomorphic, and clinical data were recorded. Pectoralis muscle area (PMA) was determined on an axial slice from a chest CT. PMI was calculated as the PMA divided by height squared. BMD was obtained from routine dual-energy X-ray absorptiometry (DXA) scan.ResultsIn 226 included patients, mean PMI was 8.2  ± 3.0 cm2/m2 in males and 6.1  ...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractSummaryWe performed a prospective study using both FRAX and computed tomography to screen for osteoporosis in men undergoing radiation for prostate cancer. We found that implementing routine computed tomography (CT)-based screening was feasible in the setting of a prospective study, but the yield of osteoporosis identification was low in this population.PurposeMen with prostate cancer (PCa) are at increased risk of hip fracture for multiple reasons. Estimation of hip fracture risk with the FRAX tool is currently recommended, but FRAX alone may not identify a portion of men with osteoporosis. We hypothesized that ad...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
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