ArticleEuropean radiology2021
Automatic opportunistic osteoporosis screening in routine CT: improved prediction of patients with prevalent vertebral fractures compared to DXA.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 2 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- 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
- Prevalence of osteoporosis in spinal surgery patients older than 50 years: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Artificial Intelligence for Clinical Decision Support in Rural Spine Care: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Opportunistic Screening for Low Bone Density Using Automated Vertebral Trabecular CT Attenuation from Low-Dose CT Acquired During FDG PET/CT: A Single-Center Retrospective Study.Tomography (Ann Arbor, Mich.) · 2026Article
- Ex vivo mechanical evaluation of anatomically and mechanically conforming patient-specific lumbar spinal fusion cages designed by full-scale topology optimization.North American Spine Society journal · 2026Article
- Radiation dose has no significant impact on CT-based bone mineral density measurements in a large-animal model.Scientific reports · 2026Article
- Advancing osteoporosis opportunistic screening: multicenter validation of a deep learning algorithm using abdominal CT scans.Abdominal radiology (New York) · 2026Article
- Current Status of AI-Assisted Screening for Opportunistic Osteoporosis.Current osteoporosis reports · 2026Review
- Artificial Intelligence in Rheumatology: From Algorithms to Clinical Impact in Osteoporosis and Chronic Inflammatory Rheumatic Diseases.Journal of clinical medicine · 2026Article
- Opportunistic osteoporosis screening in primary hyperparathyroidism using routine CT: validation of a standardized vertebral cBMD index.Frontiers in endocrinology · 2026Article
- Opportunistic Bone Health Assessment Using Contrast-Enhanced Abdominal CT: A DXA-Referenced Analysis in Liver Transplant Recipients.Diagnostics (Basel, Switzerland) · 2025Article
- Automated extraction of vertebral bone mineral density from imaging with various scan parameters: a cadaver study with correlation to quantitative computed tomography.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 · 2025Article
- Deep learning-driven incidental detection of vertebral fractures in cancer patients: advancing diagnostic precision and clinical management.La Radiologia medica · 2025Article
- Answer to the Letter to the Editor of X. Sun, et al. concerning "Automated extraction of vertebral bone mineral density from imaging with various scan parameters: A cadaver study with correlation to quantitative computed tomography" by C. Ramschütz et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09146-8).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 · 2025Article
- Opportunistic screening for osteoporosis: validation study for L1 bone density measurements using contrast-enhanced chest and abdominal CTs.Skeletal radiology · 2025Article
- Osteoporosis in Wilson's disease: A large cohort study highlighting age, sex and skeletal symptoms as key risk factors for clinical surveillance.Orphanet journal of rare diseases · 2025Article
- Opportunistic computed tomography (CT) assessment of osteoporosis in patients undergoing transcatheter aortic valve replacement (TAVR).Archives of osteoporosis · 2025Article
- Opportunistic screening for osteoporosis using artificial intelligence-based morphometric analysis of chest computed tomography images: a retrospective multi-center study in Russia leveraging the COVID-19 pandemic.Asian spine journal · 2025Article
- Improved radiological diagnosis of osteoporotic vertebral fragility fractures following UK-wide interventions and re-audit-can this be maintained and translated into clinical practice?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Automatic bone marrow segmentation for precise [Medical physics · 2025Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo compare spinal bone measures derived from automatic and manual assessment in routine CT with dual energy X-ray absorptiometry (DXA) in their association with prevalent osteoporotic vertebral fractures using our fully automated framework ( https://anduin.bonescreen.de ) to assess various bone measures in clinical CT.
methodsWe included 192 patients (141 women, 51 men; age 70.2 ± 9.7 years) who had lumbar DXA and CT available (within 1 year). Automatic assessment of spinal bone measures in CT included segmentation of vertebrae using a convolutional neural network (CNN), reduction to the vertebral body, and extraction of bone mineral content (BMC), trabecular and integral volumetric bone mineral density (vBMD), and CT-based areal BMD (aBMD) using asynchronous calibration. Moreover, trabecular bone was manually sampled (manual vBMD).
resultsA total of 148 patients (77%) had vertebral fractures and significantly lower values in all bone measures compared to patients without fractures (p ≤ 0.001). Except for BMC, all CT-based measures performed significantly better as predictors for vertebral fractures compared to DXA (e.g., AUC = 0.885 for trabecular vBMD and AUC = 0.86 for integral vBMD vs. AUC = 0.668 for DXA aBMD, respectively; both p < 0.001). Age- and sex-adjusted associations with fracture status were strongest for manual vBMD (OR = 7.3, [95%] CI 3.8-14.3) followed by automatically assessed trabecular vBMD (OR = 6.9, CI 3.5-13.4) and integral vBMD (OR = 4.3, CI 2.5-7.6). Diagnostic cutoffs of integral vBMD for osteoporosis (< 160 mg/cm
conclusionsFully automatic osteoporosis screening in routine CT of the spine is feasible. CT-based measures can better identify individuals with reduced bone mass who suffered from vertebral fractures than DXA. KEY POINTS: • Opportunistic osteoporosis screening of spinal bone measures derived from clinical routine CT is feasible in a fully automatic fashion using a deep learning-driven framework ( https://anduin.bonescreen.de ). • Manually sampled volumetric BMD (vBMD) and automatically assessed trabecular and integral vBMD were the best predictors for prevalent vertebral fractures. • Except for bone mineral content, all CT-based bone measures performed significantly better than DXA-based measures. • We introduce diagnostic thresholds of integral vBMD for osteoporosis (< 160 mg/cm
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.