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Assessing Lumbar Vertebral Bone Quality: A Methodological Evaluation Of CT And MRI As Alternatives To Traditional DEXA London Spine

This article investigates the impact of different assessment methods on the measurement of vertebral bone quality. The study includes 427 candidates for lumbar disc replacement who underwent lumbar DEXA and MRI and/or CT scans. CT measurements were highly correlated with each other, and sagittal measurements were highly correlated with axial measurements. CT values were also correlated with DEXA. However, no MRI vertebral bone quality (VBQ) values were highly correlated with DEXA, indicating that MRI may be less reliable for osteoporosis/osteopenia screening. The article suggests that CT produces values more closely related to DEXA and that there is no benefit to measuring multiple images for each vertebral body in CT scans. The authors conclude that standardization of methods is needed to maximize the utility of assessing bone quality from existing images. Keywords for the article include CT, DEXA, MRI, and Methodology

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Published article

CT produced values more closely related to DEXA, while MRI was less reliable for osteoporosis/osteopenia screening. On CT, there was no benefit to making multiple measurements for each vertebral body to calculate a composite. Measuring sagittal CT images produced values similar to axial and required less time. While assessing bone quality from existing images rather than getting an additional DEXA scan is appealing, the methods of measuring these images needs standardization to…

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Abstract Purpose: The purpose of this study was to investigate the impact of various methods on the assessment of vertebral bone quality. Methods: A consecutive series of 427 candidates for lumbar disc replacement with lumbar DEXA and MRI and/or CT scans were included. Two measurement techniques were used on CTs-a sagittal and axial. From axial,

Abstract

Purpose: The purpose of this study was to investigate the impact of various methods on the assessment of vertebral bone quality.

Methods: A consecutive series of 427 candidates for lumbar disc replacement with lumbar DEXA and MRI and/or CT scans were included. Two measurement techniques were used on CTs-a sagittal and axial. From axial images, the upper, mid, and lower portions of each vertebral body were measured. Four MRI vertebral bone quality (VBQ) calculations were generated using separate equations.

Results: All CT measures were highly correlated with each other, regardless of measurement or calculation method (range 0.925-0.995). Sagittal measurements were highly correlated with axial (r = 0.928, p < 0.001). CT values were correlated with DEXA (range 0.446-0.534). There was no benefit to measuring multiple axial images of each vertebral body vs. just midbody (r = 0.441 and 0.455, respectively). No MRI VBQ values were highly correlated with DEXA (r = - 0.103, p = 0.045). In receiver operating curve analysis, the area under the curve ranged from 0.539 to 0.558, indicating poor ability of VBQ to identify osteoporosis/osteopenia.

CT produced values more closely related to DEXA, while MRI was less reliable for osteoporosis/osteopenia screening. On CT, there was no benefit to making multiple measurements for each vertebral body to calculate a composite. Measuring sagittal CT images produced values similar to axial and required less time. While assessing bone quality from existing images rather than getting an additional DEXA scan is appealing, the methods of measuring these images needs standardization to maximize their utility.

Keywords: CT; DEXA; MRI; Methodology.

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Assessing lumbar vertebral bone quality: a methodological evaluation of CT and MRI as alternatives to traditional DEXA

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Abstract Purpose: The purpose of this study was to investigate the impact of various methods on the assessment of vertebral bone quality. Methods: A consecutive series of 427 candidates for lumbar disc replacement with lumbar DEXA and MRI and/or CT scans were included. Two measurement techniques were used on CTs-a sagittal and axial. From axial

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