Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis – a highly sensitive and specific technique: An observational study

Abstract

With the aging of the population in our society, osteoporosis (OP) has become one of the chronic diseases that seriously threaten the physical health of the elderly, leading to a heavy burden on healthcare. In recent years, with the continuous development of dual-energy CT (DECT) technology, quantitative measurements of DECT parameters, which is highly sensitive to OP, provides accurate results, is convenient and cost-effective, and is expected to be widely used in bone density testing. This study was aimed to explore the value of quantitative measurements of DECT parameters in diagnosing OP, in order to better guide clinical judgments and treatment. A total of 187 patients who underwent dual-energy X-ray and DECT examinations at Tianjin hospital between January 2022 and June 2023 were included as participants in this study. The bone mineral density (BMD) values of the lumbar spine (L1–L4) were determined using dual-energy X-ray absorptiometry. Simultaneously, CT scans of the lumbar spine (L1–L4) were conducted to measure the CT values of contrast media (CM), mixed-energy image CT values (regular CT value [rCT]), calcium concentration (CaD), as well as fat fraction (FF). Pearson correlation analysis was used to examine the relationship between the quantitative measurements of L1 to L4 vertebral bodies obtained from DECT and BMD. The values of CM, rCT, and CaD in the OP group were all lower than those in the non-OP group with statistical significance (P < .001). Conversely, the fat fraction parameter value in the OP group was significantly higher in contrast with the non-OP group (P = .004); there was a positive correlation between CM, rCT, CaD, and BMD values (R = 0.579, P < .001; R = 0.604, P < .001; R = 0.563, P < .001); CM, rCT, and CaD had high diagnostic value for OP, as evidenced by AUCs of 0.935 (95% CI: 0.900–0.971), 0.956 (95% CI: 0.925–0.987), and 0.926 (95% CI: 0.858–0.954), respectively, all with P values < .001. Quantitative measurement of DECT parameters showed a high sensitivity as well as a high specificity in the diagnosis of OP. It is also highly feasible and holds significant clinical diagnostic value, making it a suitable candidate for widespread application.