Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers
<i>Background and Objectives</i>: Women with gynecological cancers constitute a high-risk cohort for loss of bone density. International guidance stipulates women undergoing cancer treatments associated with bone loss should have a quantitative assessment of bone density. Access to Dual-...
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MDPI AG
2021-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/12/1386 |
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| author | Catherine Anne O’Gorman Sarah Milne Gerard Lambe Aleksandra Sobota Peter Beddy Noreen Gleeson |
| author_facet | Catherine Anne O’Gorman Sarah Milne Gerard Lambe Aleksandra Sobota Peter Beddy Noreen Gleeson |
| author_sort | Catherine Anne O’Gorman |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Women with gynecological cancers constitute a high-risk cohort for loss of bone density. International guidance stipulates women undergoing cancer treatments associated with bone loss should have a quantitative assessment of bone density. Access to Dual-energy X-ray Absorptiometry (DXA) is limited. This study aimed to assess the accuracy of opportunistic bone density measurement on staging computed tomography (CT) scans for gynaecological malignancies, in comparison to the gold standard DXA. <i>Materials and Methods</i>: Women with a staging CT scan of the abdomen and pelvis for a new diagnosis of gynecological cancer were recruited. DXA was performed within 6 weeks of treatment for gynaecological cancer. Lumbar bone density was measured by CT attenuation values, in Hounsfield units (HU), of the anterior trabecular region. Correlations between CT and DXA parameters were analysed. Receiver Operating Characteristic(ROC) curves for diagnosis of low bone density and osteoporosis were analysed. <i>Results:</i> Final cohort included 48 of 50 women recruited. There was good diagnostic accuracy for abnormal bone density and osteoporosis, with areas under the ROC curve at L1 of 0.77 (<i>p</i> = 0.002) and 0.80 (<i>p</i> = 0.020) respectively. CT-HU of 170–190 yielded sensitivities of 87–90%, positive predictive values of 75–84% and negative predictive values of 71–75% for the diagnosis of low bone mineral density. CT-HU of 90–110 yielded specificities of 85–93% for the diagnosis of osteoporosis. Moderate correlations were found between CT-HU and both DXA T-scores and diagnostic categories. <i>Conclusions:</i> This is the first study to assess the opportunistic application of CT in the assessment of bone health in women with gynaecological cancer, a cohort at high-risk of osteoporosis. The correlation between bone density assessment in CT-HU and DXA, and strong AUC values for the diagnosis of low bone density (0.77) and osteoporosis (0.80) support this pragmatic solution in resolving the care-gap in cancer treatment-induced bone loss, often associated with poor access to DXA. |
| first_indexed | 2024-03-10T03:35:53Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T03:35:53Z |
| publishDate | 2021-12-01 |
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| spelling | doaj.art-1b6d8b6007614020aaa29d0979ae7d0e2023-11-23T09:29:19ZengMDPI AGMedicina1010-660X1648-91442021-12-015712138610.3390/medicina57121386Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological CancersCatherine Anne O’Gorman0Sarah Milne1Gerard Lambe2Aleksandra Sobota3Peter Beddy4Noreen Gleeson5Trinity College Dublin, School of Medicine, Department of Obstetrics and Gynaecology, D02 PN40 Dublin, IrelandDepartment of Gynaecological Oncology, St James’s Hospital, D08 NHY1 Dublin, IrelandDepartment of Radiology, St James’s Hospital, D08 NHY1 Dublin, IrelandDepartment of Gynaecological Oncology, St James’s Hospital, D08 NHY1 Dublin, IrelandDepartment of Radiology, St James’s Hospital, D08 NHY1 Dublin, IrelandTrinity College Dublin, School of Medicine, Department of Obstetrics and Gynaecology, D02 PN40 Dublin, Ireland<i>Background and Objectives</i>: Women with gynecological cancers constitute a high-risk cohort for loss of bone density. International guidance stipulates women undergoing cancer treatments associated with bone loss should have a quantitative assessment of bone density. Access to Dual-energy X-ray Absorptiometry (DXA) is limited. This study aimed to assess the accuracy of opportunistic bone density measurement on staging computed tomography (CT) scans for gynaecological malignancies, in comparison to the gold standard DXA. <i>Materials and Methods</i>: Women with a staging CT scan of the abdomen and pelvis for a new diagnosis of gynecological cancer were recruited. DXA was performed within 6 weeks of treatment for gynaecological cancer. Lumbar bone density was measured by CT attenuation values, in Hounsfield units (HU), of the anterior trabecular region. Correlations between CT and DXA parameters were analysed. Receiver Operating Characteristic(ROC) curves for diagnosis of low bone density and osteoporosis were analysed. <i>Results:</i> Final cohort included 48 of 50 women recruited. There was good diagnostic accuracy for abnormal bone density and osteoporosis, with areas under the ROC curve at L1 of 0.77 (<i>p</i> = 0.002) and 0.80 (<i>p</i> = 0.020) respectively. CT-HU of 170–190 yielded sensitivities of 87–90%, positive predictive values of 75–84% and negative predictive values of 71–75% for the diagnosis of low bone mineral density. CT-HU of 90–110 yielded specificities of 85–93% for the diagnosis of osteoporosis. Moderate correlations were found between CT-HU and both DXA T-scores and diagnostic categories. <i>Conclusions:</i> This is the first study to assess the opportunistic application of CT in the assessment of bone health in women with gynaecological cancer, a cohort at high-risk of osteoporosis. The correlation between bone density assessment in CT-HU and DXA, and strong AUC values for the diagnosis of low bone density (0.77) and osteoporosis (0.80) support this pragmatic solution in resolving the care-gap in cancer treatment-induced bone loss, often associated with poor access to DXA.https://www.mdpi.com/1648-9144/57/12/1386oncologybone healthsurvivorshipcare-gaposteoporosis |
| spellingShingle | Catherine Anne O’Gorman Sarah Milne Gerard Lambe Aleksandra Sobota Peter Beddy Noreen Gleeson Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers Medicina oncology bone health survivorship care-gap osteoporosis |
| title | Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers |
| title_full | Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers |
| title_fullStr | Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers |
| title_full_unstemmed | Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers |
| title_short | Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers |
| title_sort | accuracy of opportunistic bone mineral density assessment on staging computed tomography for gynaecological cancers |
| topic | oncology bone health survivorship care-gap osteoporosis |
| url | https://www.mdpi.com/1648-9144/57/12/1386 |
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