ArticlePloS one2020
Opportunistic use of chest CT for screening osteoporosis and predicting the risk of incidental fracture in breast cancer patients: A retrospective longitudinal study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- CT image-based biomarkers for opportunistic screening of osteoporotic fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Article
- Evaluating Bone Mass with Opportunistic Chest CT: T8 as the Optimal Vertebral Level.Calcified tissue international · 2025Article
- Deep learning-driven incidental detection of vertebral fractures in cancer patients: advancing diagnostic precision and clinical management.La Radiologia medica · 2025Article
- Diagnostic efficiency of chest CT for opportunistic screening for osteoporosis and low BMD in postmenopausal women.Scientific reports · 2025Article
- A CT-based radiomic model for predicting vertebral fractures in older patients with type 2 diabetes mellitus: A longitudinal study.Journal of endocrinological investigation · 2025Article
- Assessing bone quality in hounsfield units using computed tomography: what value should be used to classify bone as normal or osteoporotic?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Review
- PET/CT for the Opportunistic Screening of Osteoporosis and Fractures in Cancer Patients.Current osteoporosis reports · 2024Review
- Long-term effects of COVID-19 infection on bone mineral density.Journal of global health · 2024Article
- Development and validation of a predictive model for vertebral fracture risk in osteoporosis patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- A computed tomography radiomics-based model for predicting osteoporosis after breast cancer treatment.Physical and engineering sciences in medicine · 2024Article
- Effect of osteosarcopenia on feeding status in hospitalized patients with suspected dysphagia.PloS one · 2024Article
- Artificial Intelligence Applications for Osteoporosis Classification Using Computed Tomography.Bioengineering (Basel, Switzerland) · 2023Review
- Addressing Challenges of Opportunistic Computed Tomography Bone Mineral Density Analysis.Diagnostics (Basel, Switzerland) · 2023Review
- Correlation between bone density measurements on CT or MRI versus DEXA scan: A systematic review.North American Spine Society journal · 2023Article
- Role of Machine Learning-Based CT Body Composition in Risk Prediction and Prognostication: Current State and Future Directions.Diagnostics (Basel, Switzerland) · 2023Review
- Opportunistic Screening Techniques for Analysis of CT Scans.Current osteoporosis reports · 2023Review
- Longitudinal Association between L1 Trabecular Attenuation from Chest Computed Tomography (CT) and Bone Mineral Density from Dualenergy X-ray Absorptiometry (DXA).Current medical imaging · 2023Article
- Correlation of bone density measured on CT chest with the severity of COVID-19 infection: A retrospective study.PloS one · 2023Article
- Machine Learning for Opportunistic Screening for Osteoporosis from CT Scans of the Wrist and Forearm.Diagnostics (Basel, Switzerland) · 2022Article
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7 authors.
Funding
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Abstract
This study aimed to investigate the diagnostic performance of chest computed tomography (CT) for opportunistic screening and longitudinal follow-up of osteoporosis in breast cancer patients, compared to dual-energy X-ray absorptiometry (DXA). The association between L1 vertebral attenuation on chest CT and incidental fracture was also evaluated. We retrospectively reviewed 414 consecutive breast cancer patients who underwent both non-enhanced chest CT and DXA within a 3-month interval and had at least two DXA and two chest CT examinations over more than 1 year. The attenuation value of the L1 trabecular bone was measured on an axial CT image and compared to the corresponding DXA T-score. The diagnostic performance of L1 vertebral attenuation on CT for osteoporosis was calculated at different thresholds (90 HU, 100 HU, 110 HU), and the correlation between L1 vertebral attenuation values and DXA T-scores was statistically analyzed. Overall fracture-free survival was estimated and compared with the threshold of 90 HU on CT and -2.5 T-score on DXA. Of 414 patients (median age, 53.0 years), 88 (21.3%) had either vertebral or non-vertebral fractures. The median follow-up duration between initial and final DXA was 902.9 days. There was a moderate correlation between L1 vertebral attenuation value and DXA T-score (ρ = 0.684, CI 0.653-0.712). Fracture-free survival was significantly lower in patients with attenuation values ≤90 HU on CT and T-scores ≤-2.5 on DXA (P < .001). Multivariate analysis revealed that attenuation values ≤90 HU on CT (P < .001), T-scores ≤-2.5 on DXA (P = .003), and age ≥65 years (P = .03) were independent significant prognostic factors associated with overall fracture-free survival. The sensitivities and specificities of L1 attenuation value were 54.9% and 85.8% at 90-HU threshold, 74.0% and78.4% at 100-HU threshold, and 83.9% and 70.1% at 110-HU threshold, respectively. In conclusion, CT can be used for predicting osteoporosis and discriminating incidental fracture risk in breast cancer patients.
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