Automatic phantom-less QCT system with high precision of BMD measurement for osteoporosis screening: Technique optimisation and clinical validation,Journal of Orthopaedic Translation

当前位置： X-MOL 学术 › J. Orthop. Translat. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Automatic phantom-less QCT system with high precision of BMD measurement for osteoporosis screening: Technique optimisation and clinical validation
Journal of Orthopaedic Translation ( IF 6.6 ) Pub Date : 2022-02-05 , DOI: 10.1016/j.jot.2021.11.008
Zhuo-Jie Liu ₁ , Cheng Zhang _{2,

3} , Chi Ma _{2,

3} , Huan Qi _{2,

3} , Ze-Hong Yang ₄ , Hao-Yu Wu ₁ , Ke-Di Yang _{2,

3} , Jun-Yu Lin _{2,

3} , Tak-Man Wong _{2,

3} , Zhao-Yang Li ₅ , Chun-Hai Li ₁ , Yue Ding ₁

Affiliation

Background

Currently dual-energy X-ray absorptiometry (DXA) and phantom-based quantitative computed tomography (PB-QCT) have been utilized to diagnose osteoporosis widely in clinical practice. While traditional phantom-less QCT (PL-QCT) is limited by the precision of manual calibration using body tissues, such as fat and muscle.

Objective

The aim of this study is to validate the accuracy and precision of one newly-developed automatic PL-QCT system to measure spinal bone mineral density (BMD) and diagnose osteoporosis.

Methods

A total of 36 patients were enrolled for comparison of BMD measurement between DXA and QCT. CT images of 63 patients were analyzed by both PB-QCT and newly developed automatic PL-QCT system, then the BMD results generated by the automatic PL-QCT were utilized to diagnose osteoporosis. The diagnostic outcomes were compared with that of DXA and PB-QCT to assess the performance of the new system.

Results

BMD test results showed that the automatic PL-QCT system had higher precision than previous studies performed with QCT, while maintaining similar capability to diagnose osteoporosis as DXA and PB-QCT. Area under curve (AUC) result of PL-QCT was larger than 0.8 for predicting spine DXA T-score in receiver operating characteristic (ROC) analysis. Pearson correlation analysis (r = 0.99) showed strong linear correlation and Bland-Altman analysis (bias = 3.0mg/cc) indicated little difference between the two methods. The precision result (CV = 0.89%) represented good reproducibility of the new system.

Conclusion

The traditional PL-QCT system has relatively low reproducibility due to the manual selection of the region of interest (ROI) of body tissues. Automatic selection of ROI in this new system makes the BMD testing more convenient and improves precision significantly. Compared with traditional BMD measurement methods, the automatic PL-QCT system had higher precision in accurate diagnosis of osteoporosis with great potential in translational research and wide clinical application.

Translational potential statement

With high accuracy and precision, the automatic PL-QCT system could serve as an opportunistic screening tool for osteoporosis patients in the future. It could also facilitate related researches by providing more reliable data collection, both retrospectively and longitudinally.

中文翻译：

用于骨质疏松症筛查的高精度 BMD 测量的自动无模型 QCT 系统：技术优化和临床验证

背景

目前，双能 X 线骨密度仪 (DXA) 和基于体模的定量计算机断层扫描 (PB-QCT) 已在临床实践中广泛用于诊断骨质疏松症。而传统的无模型 QCT (PL-QCT) 受到使用身体组织（例如脂肪和肌肉）进行手动校准的精度的限制。

客观的

本研究的目的是验证一种新开发的自动 PL-QCT 系统测量脊柱骨矿物质密度 (BMD) 和诊断骨质疏松症的准确性和精密度。

方法

共有 36 名患者被纳入比较 DXA 和 QCT 之间的 BMD 测量值。通过PB-QCT和新开发的自动PL-QCT系统对63例患者的CT图像进行分析，然后利用自动PL-QCT产生的BMD结果诊断骨质疏松症。将诊断结果与 DXA 和 PB-QCT 进行比较，以评估新系统的性能。

结果

BMD 测试结果表明，自动 PL-QCT 系统比以前使用 QCT 进行的研究具有更高的精度，同时保持与 DXA 和 PB-QCT 相似的诊断骨质疏松症的能力。PL-QCT 的曲线下面积 (AUC) 结果大于 0.8，用于预测接受者操作特征 (ROC) 分析中的脊柱 DXA T 分数。Pearson 相关分析 (r = 0.99) 显示出很强的线性相关性，Bland-Altman 分析 (偏差 = 3.0mg/cc) 表明两种方法之间几乎没有差异。精密度结果（CV = 0.89%）代表了新系统的良好重现性。