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Cited by 50Bone health and osteoporosis researchAdvanced X-ray and CT ImagingRadiation Dose and Imaging

Bone Mineral Density Estimations From Routine Multidetector Computed Tomography: A Comparative Study of Contrast and Calibration Effects

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Kaesmacher, Johannes, Liebl, Hans, Baum, Thomas, Kirschke, Jan Stefan·2017·Journal of Computer Assisted Tomography
DOI 10.1097/rct.0000000000000518PMC PMC5359785
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Abstract

INTRODUCTION: Phantom-based (synchronous and asynchronous) and phantomless (internal tissue calibration based) assessment of bone mineral density (BMD) in routine MDCT (multidetector computed tomography) examinations potentially allows for diagnosis of osteoporosis. Although recent studies investigated the effects of contrast-medium application on phantom-calibrated BMD measurements, it remains uncertain to what extent internal tissue-calibrated BMD measurements are also susceptible to contrast-medium associated density variation. The present study is the first to systemically evaluate BMD variations related to contrast application comparing different calibration techniques. PURPOSE: To compare predicative performance of different calibration techniques for BMD measurements obtained from triphasic contrast-enhanced MDCT. MATERIALS AND METHODS: Bone mineral density was measured on nonenhanced (NE), arterial (AR) and portal-venous (PV) contrast phase MDCT images of 46 patients using synchronous (SYNC) and asynchronous (ASYNC) phantom calibration as well as internal calibration (IC). Quantitative computed tomography (QCT) served as criterion standard. Density variations were analyzed for each contrast phase and calibration technique, and respective linear fitting was performed. RESULTS: Both asynchronous calibration-derived BMD values (NE-ASYNC) and values estimated using IC (NE-IC) on NE MDCT images did reasonably well in predicting QCT BMD (root-mean-square deviation, 8.0% and 7.8%, respectively). Average NE-IC BMD was 2.7% lower when compared with QCT (P = 0.017), whereas no difference could be found for NE-ASYNC (P = 0.957). All average BMD estimates derived from contrast-enhanced scans differed significantly from QCT BMD (all P < 0.005) and led to notable systemic BMD biases (mean difference at least > 6.0 mg/mL). All regression fits revealed a consistent linear dependency (R range, 0.861-0.963). Overall accuracy and goodness of fit tended to decrease from AR to PV contrast phase. Highest precision and best linear fit could be reached using a synchronously scanned phantom (root-mean-square deviation, 9.4% for AR and 14.4% for PV). Both ASYNC and IC estimations performed comparably accurate and precise. CONCLUSIONS: Our data suggest that internal calibration driven BMD measurements derived from contrast-enhanced MDCT need the same amount of post hoc contrast-effect adjustment as measurements using phantom calibration. Adjustment using linear correction equations can correct for systematic bias of bone density variations related to contrast application, irrespective of the calibration technique used.

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Authors
Kaesmacher, J., Liebl, H., Baum, T., & Kirschke, J. S.
Affiliations
TUM Klinikum (DE)
Corresponding author
Kaesmacher, Johannes
ORCID
Venue
Journal of Computer Assisted Tomography
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017
Volume
41
Issue
2
Pages
217-223
ISSN
0363-8715 (ISSN-L)
DOI
10.1097/rct.0000000000000518
PMC
PMC5359785
OpenAlex
W2542118749
Cited by
50
References
0
Citations by year
2026: 4 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 4
FWCI
4.47
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Journal of Computer Assisted Tomography (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • BORIS (University Library Bern) (submittedVersion, cc-by-nc-nd)
  • mediaTUM (Technical University of Munich) (submittedVersion)
  • Open Access CRIS of the University of Bern
Funders
  • Deutsche Forschungsgemeinschaft (4906/1-1, BA 4906/1-1, BA 4085/2-, DFG BA 4085/2-1 and BA 4906/1-1, BA 4085/2-1)
  • H2020 European Research Council (637164)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Physical Sciences › Engineering › Biomedical Engineering › Advanced X-ray and CT Imaging
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
Keywords
bone mineral density, multidetector computed tomography, phantom calibration, osteoporosis diagnosis, quantitative computed tomography
MeSH terms
Calibration, Contrast Media, Female, Humans, Male, Middle Aged, Osteoporosis, Radiographic Image Enhancement, Bone Density, Phantoms, Imaging, Multidetector Computed Tomography

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