Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening
Abstract Background Quantitative computed tomography (QCT)-based lumbar bone mineral density (LBMD) has been used to diagnose osteoporosis. This study explored the value of lower thoracic BMD (TBMD) in diagnosing osteoporosis in older adults during CT lung cancer screening. Methods This study includ...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-04737-4 |
| _version_ | 1797266619332820992 |
|---|---|
| author | Nandong Hu Miaomiao Wang Meng Yang Xin Chen Jiangchuan Wang Chao Xie Bin Zhang Zhongqiu Wang Xiao Chen |
| author_facet | Nandong Hu Miaomiao Wang Meng Yang Xin Chen Jiangchuan Wang Chao Xie Bin Zhang Zhongqiu Wang Xiao Chen |
| author_sort | Nandong Hu |
| collection | DOAJ |
| description | Abstract Background Quantitative computed tomography (QCT)-based lumbar bone mineral density (LBMD) has been used to diagnose osteoporosis. This study explored the value of lower thoracic BMD (TBMD) in diagnosing osteoporosis in older adults during CT lung cancer screening. Methods This study included 751 subjects who underwent QCT scans with both LBMD and TBMD. 141 of them was selected for a validation. Osteoporosis was diagnosed based on LBMD using the ACR criteria (gold standard). TBMD thresholds were obtained using receiver operating characteristic curve. TBMD was also translated into LBMD (TTBMD) and osteoporosis was defined based on TTBMD using ACR criteria. The performance of TBMD and TTBMD in identifying osteoporosis was determined by Kappa test. The associations between TBMD- and TTBMD-based osteoporosis and fracture were tested in 227 subjects with followed up status of spine fracture. Results The performance of TBMD in identifying osteoporosis was low (kappa = 0.66) if using the ACR criteria. Two thresholds of TBMD for identifying osteopenia (128 mg/cm3) and osteoporosis (91 mg/cm3) were obtained with areas under the curve of 0.97 and 0.99, respectively. The performance of the identification of osteoporosis/osteopenia using the two thresholds or TTBMD both had good agreement with the gold standard (kappa = 0.78, 0.86). Similar results were observed in validation population. Osteoporosis identified using the thresholds (adjusted hazard ratio (HR) = 18.72, 95% confidence interval (CI): 5.13–68.36) or TTBMD (adjusted HR = 10.28, 95% CI: 4.22–25.08) were also associated with fractures. Conclusion Calculating the threshold of TBMD or normalizing TBMD to LBMD are both useful in identifying osteoporosis in older adults during CT lung cancer screening. |
| first_indexed | 2024-04-25T01:03:34Z |
| format | Article |
| id | doaj.art-2f7e63ba72ee4216b1c7ead3ddfeca0f |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-25T01:03:34Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-2f7e63ba72ee4216b1c7ead3ddfeca0f2024-03-10T12:21:37ZengBMCBMC Geriatrics1471-23182024-03-012411910.1186/s12877-024-04737-4Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screeningNandong Hu0Miaomiao Wang1Meng Yang2Xin Chen3Jiangchuan Wang4Chao Xie5Bin Zhang6Zhongqiu Wang7Xiao Chen8Department of Radiology, the Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Radiology, the Affiliated Hospital of Nanjing University of Chinese MedicineBengbu Medical CollegeDepartment of Radiology, Shanghai Longhua HospitalDepartment of Radiology, the Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Orthopaedics, University of Rochester School of MedicineDepartment of Thoracic surgery, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Radiology, the Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Radiology, the Affiliated Hospital of Nanjing University of Chinese MedicineAbstract Background Quantitative computed tomography (QCT)-based lumbar bone mineral density (LBMD) has been used to diagnose osteoporosis. This study explored the value of lower thoracic BMD (TBMD) in diagnosing osteoporosis in older adults during CT lung cancer screening. Methods This study included 751 subjects who underwent QCT scans with both LBMD and TBMD. 141 of them was selected for a validation. Osteoporosis was diagnosed based on LBMD using the ACR criteria (gold standard). TBMD thresholds were obtained using receiver operating characteristic curve. TBMD was also translated into LBMD (TTBMD) and osteoporosis was defined based on TTBMD using ACR criteria. The performance of TBMD and TTBMD in identifying osteoporosis was determined by Kappa test. The associations between TBMD- and TTBMD-based osteoporosis and fracture were tested in 227 subjects with followed up status of spine fracture. Results The performance of TBMD in identifying osteoporosis was low (kappa = 0.66) if using the ACR criteria. Two thresholds of TBMD for identifying osteopenia (128 mg/cm3) and osteoporosis (91 mg/cm3) were obtained with areas under the curve of 0.97 and 0.99, respectively. The performance of the identification of osteoporosis/osteopenia using the two thresholds or TTBMD both had good agreement with the gold standard (kappa = 0.78, 0.86). Similar results were observed in validation population. Osteoporosis identified using the thresholds (adjusted hazard ratio (HR) = 18.72, 95% confidence interval (CI): 5.13–68.36) or TTBMD (adjusted HR = 10.28, 95% CI: 4.22–25.08) were also associated with fractures. Conclusion Calculating the threshold of TBMD or normalizing TBMD to LBMD are both useful in identifying osteoporosis in older adults during CT lung cancer screening.https://doi.org/10.1186/s12877-024-04737-4Quantitative computed tomographyThoracic vertebral bone mineral densityOsteoporosisComputed tomographyLung cancer |
| spellingShingle | Nandong Hu Miaomiao Wang Meng Yang Xin Chen Jiangchuan Wang Chao Xie Bin Zhang Zhongqiu Wang Xiao Chen Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening BMC Geriatrics Quantitative computed tomography Thoracic vertebral bone mineral density Osteoporosis Computed tomography Lung cancer |
| title | Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening |
| title_full | Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening |
| title_fullStr | Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening |
| title_full_unstemmed | Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening |
| title_short | Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening |
| title_sort | bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during ct lung cancer screening |
| topic | Quantitative computed tomography Thoracic vertebral bone mineral density Osteoporosis Computed tomography Lung cancer |
| url | https://doi.org/10.1186/s12877-024-04737-4 |
| work_keys_str_mv | AT nandonghu bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT miaomiaowang bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT mengyang bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT xinchen bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT jiangchuanwang bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT chaoxie bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT binzhang bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT zhongqiuwang bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening AT xiaochen bonemineraldensityinlowerthoracicvertebraforosteoporosisdiagnosisinolderadultsduringctlungcancerscreening |