L1 vertebral density on CT is just too variable with completely different scanning protocols to be a helpful screening device for osteoporosis in on a regular basis apply.
Br J Radiol. 2018 Apr;91(1084):20170395
Authors: Gerety EL, Bearcroft PW
OBJECTIVE: To find out whether or not a single L1 density threshold can be utilized to display all sufferers present process CT at a busy tertiary referral centre for these liable to osteoporosis.
METHODS: 200 sufferers, who had been randomly chosen for an audit of CT reporting of incidental vertebral fractures, had their L1 density measured on 864 routine CT examinations. These had been carried out with quite a lot of kVp and intravenous (i.v.) distinction protocols, reflecting the big selection of imaging indications.
RESULTS: L1 density measured on thick axial, skinny axial or sagittal photos had a wonderful intraclass correlation coefficient (zero.996). For a similar sufferers imaged twice inside 6 months, there was imply intraexamination L1 density distinction of 27.5 HU. Variability as a consequence of i.v. distinction medium administration resulted in a imply distinction of 24.5 HU. Imply distinction as a consequence of acquisition kVp was 24.1 HU. As soon as matched for intercourse, age, kVp and that i.v. distinction, there was a major distinction between the L1 density in sufferers with vertebral fractures in comparison with these with out fractures (imply 30.19 HU).
CONCLUSION: There may be important variability within the L1 vertebral physique CT density as a consequence of variations in acquisition variables equivalent to kVp and timing post-i.v. distinction medium. Advances in information: Earlier research recommended that L1 CT density could possibly be used to display for osteoporosis. The present examine cautions that it’s not doable to outline a single L1 density threshold for screening, as a result of variety of variables inside a variety of scanning protocols for various imaging indications in on a regular basis apply.
PMID: 29308913 [PubMed – indexed for MEDLINE]