Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men
Objective: The objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. Methods: A total of 313 males older than 60 years, who underwent both spinal QCT and lumba...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-07-01
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| Series: | Journal of Orthopaedic Translation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214031X18300925 |
| _version_ | 1818198276569038848 |
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| author | Xiao-ming Xu Na Li Kai Li Xiao-Yu Li Ping Zhang Yan-jiao Xuan Xiao-guang Cheng |
| author_facet | Xiao-ming Xu Na Li Kai Li Xiao-Yu Li Ping Zhang Yan-jiao Xuan Xiao-guang Cheng |
| author_sort | Xiao-ming Xu |
| collection | DOAJ |
| description | Objective: The objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. Methods: A total of 313 males older than 60 years, who underwent both spinal QCT and lumbar spine and hip DXA in our department, were included. The diagnostic criteria established by the World Health Organisation in 1994 were used for DXA to diagnose osteoporosis, and the criteria recommended by the International Society of Clinical Densitometry were used for QCT. The osteoporosis detection rate by the two techniques was calculated, and the difference was compared. The minor discordance was considered present when the different diagnostic classes between the two techniques were adjacent. Major discordance was present when the diagnosis by one technique was osteoporosis and the other was normal. The computed tomography images were reviewed by radiologists to assess whether vertebral fracture, aorta calcification or degeneration was present. Results: In the 313 participants (mean age, 79.6 ± 7.2 years), the osteoporosis detection rate was 10.9% for DXA (lumbar spine and hip) and 45.1% for QCT, a significant difference (p < 0.001). The major discordance, minor discordance and concordance of diagnosis between the two techniques were seen in 8.3%, 50.8% and 40.9%, respectively. QCT detected osteoporosis better than DXA. The causes of this discordance were degeneration of spine, abdominal aorta calcification and vertebral fractures. Conclusion: Our study demonstrated that discordance was common when using QCT and DXA to diagnose osteoporosis and that spinal degeneration, aorta calcification and fracture obscure the bone mineral density measurement of spine by DXA. QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. The translational potential of this article: This study investigated the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. The results demonstrated that QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. This work may help clinicians make an appropriate choice of technique for the accurate diagnosis of osteoporosis and identify the patients at high risk of osteoporosis who should be treated early to prevent fractures. This may influence the therapeutic plan and the overall prognosis of patients. Keywords: Bone mineral density, Dual X-ray absorptiometry, Osteoporosis, Quantitative computed tomography |
| first_indexed | 2024-12-12T02:03:18Z |
| format | Article |
| id | doaj.art-c821e7f3a76941cb9dc7441a096d132e |
| institution | Directory Open Access Journal |
| issn | 2214-031X |
| language | English |
| last_indexed | 2024-12-12T02:03:18Z |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Translation |
| spelling | doaj.art-c821e7f3a76941cb9dc7441a096d132e2022-12-22T00:42:07ZengElsevierJournal of Orthopaedic Translation2214-031X2019-07-01185964Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly menXiao-ming Xu0Na Li1Kai Li2Xiao-Yu Li3Ping Zhang4Yan-jiao Xuan5Xiao-guang Cheng6Department of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, ChinaDepartment of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, ChinaDepartment of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, ChinaDepartment of Geriatric, Beijing Jishuitan Hospital, ChinaDepartment of Geriatric, Beijing Jishuitan Hospital, ChinaDepartment of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, ChinaDepartment of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, China; Corresponding author.Objective: The objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. Methods: A total of 313 males older than 60 years, who underwent both spinal QCT and lumbar spine and hip DXA in our department, were included. The diagnostic criteria established by the World Health Organisation in 1994 were used for DXA to diagnose osteoporosis, and the criteria recommended by the International Society of Clinical Densitometry were used for QCT. The osteoporosis detection rate by the two techniques was calculated, and the difference was compared. The minor discordance was considered present when the different diagnostic classes between the two techniques were adjacent. Major discordance was present when the diagnosis by one technique was osteoporosis and the other was normal. The computed tomography images were reviewed by radiologists to assess whether vertebral fracture, aorta calcification or degeneration was present. Results: In the 313 participants (mean age, 79.6 ± 7.2 years), the osteoporosis detection rate was 10.9% for DXA (lumbar spine and hip) and 45.1% for QCT, a significant difference (p < 0.001). The major discordance, minor discordance and concordance of diagnosis between the two techniques were seen in 8.3%, 50.8% and 40.9%, respectively. QCT detected osteoporosis better than DXA. The causes of this discordance were degeneration of spine, abdominal aorta calcification and vertebral fractures. Conclusion: Our study demonstrated that discordance was common when using QCT and DXA to diagnose osteoporosis and that spinal degeneration, aorta calcification and fracture obscure the bone mineral density measurement of spine by DXA. QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. The translational potential of this article: This study investigated the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. The results demonstrated that QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. This work may help clinicians make an appropriate choice of technique for the accurate diagnosis of osteoporosis and identify the patients at high risk of osteoporosis who should be treated early to prevent fractures. This may influence the therapeutic plan and the overall prognosis of patients. Keywords: Bone mineral density, Dual X-ray absorptiometry, Osteoporosis, Quantitative computed tomographyhttp://www.sciencedirect.com/science/article/pii/S2214031X18300925 |
| spellingShingle | Xiao-ming Xu Na Li Kai Li Xiao-Yu Li Ping Zhang Yan-jiao Xuan Xiao-guang Cheng Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men Journal of Orthopaedic Translation |
| title | Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men |
| title_full | Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men |
| title_fullStr | Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men |
| title_full_unstemmed | Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men |
| title_short | Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men |
| title_sort | discordance in diagnosis of osteoporosis by quantitative computed tomography and dual energy x ray absorptiometry in chinese elderly men |
| url | http://www.sciencedirect.com/science/article/pii/S2214031X18300925 |
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