Correlation between Forearm Bone Mineral Density Measured by Dual Energy X-ray Absorptiometry and Hounsfield Units Value Measured by CT in Lumbar Spine

Abstract

Background Our aim was to determine if the dual-energy X-ray absorptiometry (DXA)-measured forearm bone mineral density (BMD) correlates with the Hounsfield unit (HU) values obtained from computed tomography (CT).

Methods A retrospective analysis of 164 patients with degenerative diseases of the lumbar spine was performed. DXA was used to measure the BMD and T-scores of each patient’s forearm. Lumbar CT was used to measure the CT HU values in three axial images of the L1–L4 vertebral bodies, and the average was calculated. According to the preoperative DXA T-score, they were divided into a normal group, an osteopenia group, and an osteoporosis group. Pearson’s correlation coefficient was used to analyze the correlations of CT HU values in L1–L4 with BMD and T-scores in the corresponding vertebral body. The receiver operating characteristic curve (ROC) was used to determine the CT HU thresholds between osteoporosis and non-osteoporosis groups.

Results Forearm BMD was moderately correlated with L1–L4 CT HU values (0.4 < R² < 0.6), and the correlation coefficients (R²) were 0.552, 0.578, 0.582, and 0.577, respectively (all p < 0.001). Forearm T-scores were moderately correlated with L1–L4 CT HU values (0.4 < R² < 0.6), and the correlation coefficients (R²) were 0.595, 0.609, 0.605, and 0.605, respectively (all p < 0.001). The thresholds of L1–L4 between the osteoporosis group (t ≤ -2.5) and the non-osteoporosis group (t > −2.5) were 110.0 HU (sensitivity 74% and specificity 76%), 112.5 HU (sensitivity 67% and 83% specificity), 92.4 HU (81% sensitivity and 70% specificity), and 98.7 HU (74% sensitivity and 78% specificity), respectively.

Conclusions Based on the moderate positive correlation between forearm DXA-measured BMD and HU values, forearm DXA provides a theoretical basis for evaluating lumbar vertebral bone mass. Preoperative forearm DXA may be useful in the formulation of surgical plans and the prevention of postoperative complications in patients with lumbar degenerative diseases.

Zusammenfassung

Hintergrund Unser Ziel war es, festzustellen, ob die Knochenmineraldichte (BMD) des Unterarms, gemessen mit der Dual-Röntgen-Absorptiometrie (DXA), mit den Werten der Hounsfield-Einheit (HU) aus der Computertomografie (CT) korreliert.

Methoden Es wurde eine retrospektive Analyse von 164 Patienten mit degenerativen Erkrankungen der Lendenwirbelsäule durchgeführt. DXA wurde verwendet, um BMD und T-Wert des Unterarms jedes Patienten zu messen. Lumbale CT wurde verwendet, um die CT-HU-Werte der L1–L4-Wirbelkörper in drei axialen Bildern zu messen, und der Durchschnitt wurde berechnet. Gemäß dem präoperativen DXA-T-Wert wurden die Patienten in eine Normalgruppe, eine Osteopenie-Gruppe und eine Osteoporose-Gruppe eingeteilt. Der Korrelationskoeffizient nach Pearson wurde verwendet, um die Korrelationen der CT-HU-Werte in L1–L4 mit BMD und T-Werten in den entsprechenden Wirbelkörpern zu analysieren. Die Receiver Operating Characteristic-Kurve (ROC-Kurve) wurde verwendet, um die CT-HU-Schwellenwerte zwischen Osteoporose- und Nicht-Osteoporose-Gruppen zu bestimmen.

Ergebnisse Die Unterarm-BMD korrelierte moderat mit L1–L4-CT-HU-Werten (0,4 < R² < 0,6), und die Korrelationskoeffizienten (R²) betrugen 0,552, 0,578, 0,582 bzw. 0,577 (alle p < 0,001). Die Unterarm-T-Werte korrelierten moderat mit den L1–L4-CT-HU-Werten (0,4 < R² < 0,6) und die Korrelationskoeffizienten (R²) betrugen 0,595, 0,609, 0,605 bzw. 0,605 (alle p < 0,001). Die Schwellenwerte von L1–L4 zwischen der Osteoporose-Gruppe (t ≤ –2,5) und der Nicht-Osteoporose-Gruppe (t > −2,5) betrugen 110,0 HU (Sensitivität 74% und Spezifität76%), 112,5 HU (Sensitivität 67% und 83% Spezifität), 92,4 HU (81% Sensitivität und 70% Spezifität) bzw. 98,7 HU (74% Sensitivität und 78% Spezifität).

Schlussfolgerung Aufgrund der moderaten positiven Korrelation zwischen den mit der Unterarm-DXA gemessenen BMD und HU-Werten bietet die Unterarm-DXA eine theoretische Grundlage für die Bewertung der Knochenmasse der Lendenwirbelsäule. Daher kann die präoperative Unterarm-DXA bei der Formulierung von Operationsplänen und der Prävention postoperativer Komplikationen bei Patienten mit lumbalen degenerativen Erkrankungen nützlich sein.

Keywords

osteoporosis - CT Hounsfield unit value · - dual-energy X-ray absorptiometry - forearm - lumbar degenerative disease

Schlüsselwörter

Osteoporose - CT Hounsfield-Einheitswert - Dual-Energy-Röntgen-Absorptiometrie - Unterarm - lumbale degenerative Erkrankung

Publication History

Received: 19 May 2022

Accepted after revision: 21 November 2022

Article published online:
31 January 2023

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