Comparison of two asynchronous QCT methods

Rationale. Quantitative CT (QCT) bone densitometry with asynchronous calibration not require a phantom during the scan procedure. Based on calibration data it converts X-ray density in HU to bone mineral density (BMD). Given the large number of CT studies performed on patients at risk of osteoporosis, there is a need for a hands-on method capable of assessing BMD in a short period of time without tailored software or protocols.

Goal. To develop a method for QCT bone densitometry using an PHK (PHantom Kalium), to compare the volume BMD measurements with the QCT data with asynchronous calibration provided by software from a reputable developer.

Methods. The studies were performed at 64-slice CT unit with body scanning parameters. The BMD was measured using two techniques: 1) QCT with asynchronous calibration using software from a reputable developer; 2) QCT using a PHK phantom (QCT-PHK). For convert the HU to BMD values, we scanned the PHK phantom and calculate correction factor. Phantom contains “vertebrae” filled with potassium hydrogen phosphate in different concentrations. In both methods, the BMD values measured for LI–II, and sometimes for ThXII, LIII.

Results. The study enrolled 65 subjects (11 male and 54 female patients); median age 69.0 years. A comparison of the vertebrae BMD measured by QCT and QCT-PHK revealed a significant linear Pearson correlation r = 0.977 (p < 0.05). The Bland–Altman analysis demonstrated a lack of relationship between the difference in measurements and the average BMD and a systematic BMD; bias of +4.50 mg/ml in QCT vs. QCT-PHK. Differences in the division into groups osteoporosis / osteopenia / norm according to the ACR criteria for the two methods were not significant.

Conclusion. The developed asynchronous QCT-PHK method measure BMD comparable to the widely used QCT with asynchronous calibration. This method can be used for opportunistic screening for osteoporosis.

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