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Opportunistic osteoporosis screening using chest CT with artificial intelligence
Osteoporosis International ( IF 4 ) Pub Date : 2022-08-06 , DOI: 10.1007/s00198-022-06491-y
Jinrong Yang 1 , Man Liao 2 , Yaoling Wang 2 , Leqing Chen 1 , Linfeng He 2 , Yingying Ji 1 , Yao Xiao 1 , Yichen Lu 3 , Wenliang Fan 1 , Zhuang Nie 1 , Ruiyun Wang 2 , Benling Qi 2 , Fan Yang 1
Affiliation  

Summary

Osteoporosis has a high incidence and a low detection rate. If it is not detected in time, it will cause osteoporotic fracture and other serious consequences. This study showed that the attenuation values of vertebrae on chest CT could be used for opportunistic screening of osteoporosis. This will be beneficial to improve the detection rate of osteoporosis and reduce the incidence of adverse events caused by osteoporosis.

Introduction

To explore the value of the attenuation values of all thoracic vertebrae and the first lumbar vertebra measured by artificial intelligence on non-enhanced chest CT to do osteoporosis screening.

Methods

On base of images of chest CT, using artificial intelligence (AI) to measure the attenuation values (HU) of all thoracic and the first vertebrae of patients who underwent CT examination for lung cancer screening and dual-energy X-ray absorptiometry (DXA) examination during the same period. The patients were divided into three groups: normal group, osteopenia group, and osteoporosis group according to the results of DXA. Clinical baseline data and attenuation values were compared among the three groups. The correlation between attenuation values and BMD values was analyzed, and the predictive ability and diagnostic efficacy of attenuation values of thoracic and first lumbar vertebrae on osteopenia or osteoporosis risk were further evaluated.

Results

CT values of each thoracic vertebrae and the first lumbar vertebrae decreased with age, especially in menopausal women and presented high predictive ability and diagnostic efficacy for osteopenia or osteoporosis. After clinical data correction, with every 10 HU increase of CT values, the risk of osteopenia or osteoporosis decreased by 32 ~ 44% and 61 ~ 80%, respectively. And the combined diagnostic efficacy of all thoracic vertebrae was higher than that of a single vertebra. The AUC of recognizing osteopenia or osteoporosis from normal group was 0.831and 0.972, respectively.

Conclusions

The routine chest CT with AI is of great value in opportunistic screening for osteopenia or osteoporosis, which can quickly screen the population at high risk of osteoporosis without increasing radiation dose, thus reducing the incidence of osteoporotic fracture.



中文翻译:

使用人工智能胸部 CT 进行机会性骨质疏松症筛查

概括

骨质疏松症发病率高,检出率低。如果不及时发现,会造成骨质疏松性骨折等严重后果。本研究表明,胸部CT上椎体的衰减值可用于骨质疏松症的机会性筛查。这将有利于提高骨质疏松症的检出率,降低骨质疏松症引起的不良事件发生率。

介绍

探讨人工智能在非增强胸部CT上测量的所有胸椎和第一腰椎的衰减值在骨质疏松筛查中的价值。

方法

以胸部CT图像为基础,利用人工智能(AI)测量肺癌筛查CT检查和双能X线骨密度仪(DXA)患者所有胸椎和第一椎骨的衰减值(HU)同期考试。根据DXA结果将患者分为三组:正常组、骨量减少组和骨质疏松组。比较三组的临床基线数据和衰减值。分析衰减值与BMD值的相关性,进一步评价胸椎和第一腰椎衰减值对骨质减少或骨质疏松风险的预测能力和诊断效能。

结果

每个胸椎和第一腰椎的 CT 值随着年龄的增长而降低,特别是在绝经期妇女中,对骨质减少或骨质疏松症具有很高的预测能力和诊断效能。临床数据校正后,CT值每增加10 HU,骨质减少或骨质疏松的风险分别降低32~44%和61~80%。且所有胸椎的综合诊断效能高于单一椎体。正常组识别骨质减少或骨质疏松的AUC分别为0.831和0.972。

结论

常规胸部CT联合AI对骨质减少或骨质疏松的机会性筛查具有重要价值,可在不增加辐射剂量的情况下快速筛查骨质疏松高危人群,从而降低骨质疏松性骨折的发生率。

更新日期:2022-08-07
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