Bone mineral density measurements derived from dual-layer spectral CT enable opportunistic screening for osteoporosis
Open accessAbstract
OBJECTIVE: To investigate the in vivo applicability of non-contrast-enhanced hydroxyapatite (HA)-specific bone mineral density (BMD) measurements based on dual-layer CT (DLCT). METHODS: A spine phantom containing three artificial vertebral bodies with known HA densities was measured to obtain spectral data using DLCT and quantitative CT (QCT), simulating different patient positions and grades of obesity. BMD was calculated from virtual monoenergetic images at 50 and 200 keV. HA-specific BMD values of 174 vertebrae in 33 patients (66 ± 18 years; 33% women) were determined in non-contrast routine DLCT and compared with corresponding QCT-based BMD values. RESULTS: Examining the phantom, HA-specific BMD measurements were on a par with QCT measurements. In vivo measurements revealed strong correlations between DLCT and QCT (r = 0.987 [95% confidence interval, 0.963-1.000]; p < 0.001) and substantial agreement in a Bland-Altman plot. CONCLUSION: DLCT-based HA-specific BMD measurements were comparable with QCT measurements in in vivo analyses. This suggests that opportunistic DLCT-based BMD measurements are an alternative to QCT, without requiring phantoms and specific protocols. KEY POINTS: • DLCT-based hydroxyapatite-specific BMD measurements show a substantial agreement with QCT-based BMD measurements in vivo. • DLCT-based hydroxyapatite-specific measurements are on a par with QCT in spine phantom measurements. • Opportunistic DLCT-based BMD measurements may be a feasible alternative for QCT, without requiring dedicated examination protocols or a phantom.
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These findings are in line with previous reports using quantitative CT, dual-energy CT, and dual-energy CT-based localizer radiographs.
“These findings are in line with previous reports using quantitative CT,18 dual-energy CT,18–20 and dual-energy CT–based localizer radiographs.10”
From In Vivo Bone Mineral Density Assessment With Spectral Localizer Radiographs From Photon-Counting Detector CT (2025) · cites this paper as [19]
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- Authors
- Roski, F., Hammel, J., Mei, K., Baum, T., Kirschke, J. S., Laugerette, A., Kopp, F. K., Bodden, J., Pfeiffer, D., Pfeiffer, F., Rummeny, E. J., Noël, P. B., Gersing, A. S., & Schwaiger, B. J.
- Affiliations
- TUM Klinikum (DE)
- Technical University of Munich (DE)
- Corresponding author
- Roski, Ferdinand
- ORCID
- Venue
- European Radiology
- Published
- 2019-05-21
- Volume
- 29
- Issue
- 11
- Pages
- 6355-6363
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- PMC
- PMC6795615
- OpenAlex
- W2944864407
- Cited by
- 70
- References
- 34
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 8 · 2023: 18 · 2022: 9 · 2021: 12 · 2020: 11 · 2019: 1 · 2018: 1
- FWCI
- 8.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Radiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion, other-oa)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Funders
- European Research Council (ERC-StG-2014 637164, H2020, AdG 695045)
- Deutsche Forschungsgemeinschaft (Gottfried Wilhelm Leibniz program)
- Bundesministerium für Bildung und Forschung (13GW0072C)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Physical Sciences › Engineering › Biomedical Engineering › Advanced X-ray and CT Imaging
- Physical Sciences › Engineering › Biomedical Engineering › Medical Imaging and Analysis
- Keywords
- bone mineral density, dual-layer spectral CT, osteoporosis screening, opportunistic screening, spine phantom, vertebral body, obesity, virtual monoenergetic images
- MeSH terms
- Adult, Algorithms, Female, Humans, Male, Mass Screening, Middle Aged, Osteoporosis, Spine, Tomography, X-Ray Computed, Absorptiometry, Photon, Bone Density, Phantoms, Imaging
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