ArticleFrontiers in endocrinology2022
Level-Specific Volumetric BMD Threshold Values for the Prediction of Incident Vertebral Fractures Using Opportunistic QCT: A Case-Control Study.
Article in Frontiers in endocrinology, 2022. 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, 39 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
- Per-Vertebra Prediction of Future Osteoporotic Fractures from Routine Computed Tomography Using a Two-Stage Machine Learning Framework.Medicina (Kaunas, Lithuania) · 2026Article
- An osteoporotic bone model: developing and validating an ex-vivo bone demineralization protocol.JBMR plus · 2026Article
- Differences in lumbar spine bone mineral density measured by quantitative computed tomography and dual-energy X-ray absorptiometry: an age- and sex-specific analysis.Journal of orthopaedic surgery and research · 2026Article
- Age-related bone loss in mouse lumbar vertebrae is affected by region, sex, and level: Implications for spinal loading and analysis methods.Bone reports · 2025Article
- Article
- Assessing the Impact of Reduced L1 Bone Density on Surgical Stabilisation of Rib Fractures in Elderly Patients: A Study on Fracture Nonunion Rates, Analgesia Usage and Hospital Length of Stay.Journal of medical imaging and radiation oncology · 2025Article
- Gender- and Age-Associated Variations in the Prevalence of Atelectasis, Effusion, and Nodules on Chest Radiographs: A Large-Scale Analysis Using the NIH ChestX-Ray8.Diagnostics (Basel, Switzerland) · 2025Article
- Thoracic vertebral bone mineral density measured by quantitative computed tomography is associated with fracture risk in lung cancer screening populations: a prospective cohort study.Frontiers in endocrinology · 2025Article
- Using QCT for the prediction of spontaneous age- and gender-specific thoracolumbar vertebral fractures and accompanying distant vertebral fractures.BMC musculoskeletal disorders · 2024Article
- Opportunistic Screening of Bone Fragility Using Computed Tomography.Seminars in musculoskeletal radiology · 2024Review
- The role of sarcopenia in fragility fractures of the pelvis - is sarcopenia an underestimated risk factor?BMC geriatrics · 2024Article
- Comparisons of Hounsfield units and volumetric bone density in discriminating vertebral fractures on lumbar CT scans.The British journal of radiology · 2024Article
- Computer Vision in Osteoporotic Vertebral Fracture Risk Prediction: A Systematic Review.Neurospine · 2023Article
- Preoperative Prediction of New Vertebral Fractures after Vertebral Augmentation with a Radiomics Nomogram.Diagnostics (Basel, Switzerland) · 2023Article
- Long-term reproducibility of opportunistically assessed vertebral bone mineral density and texture features in routine clinical multi-detector computed tomography using an automated segmentation framework.Quantitative imaging in medicine and surgery · 2023Article
- Advances in Osteoporosis Therapy: Focus on Osteoanabolic Agents, Secondary Fracture Prevention, and Perioperative Bone Health.Current osteoporosis reports · 2023Review
- Automated Opportunistic Trabecular Volumetric Bone Mineral Density Extraction Outperforms Manual Measurements for the Prediction of Vertebral Fractures in Routine CT.Diagnostics (Basel, Switzerland) · 2023Article
- Quantitative CT screening improved lumbar BMD evaluation in older patients compared to dual-energy X-ray absorptiometry.BMC geriatrics · 2023Article
- Opportunistic Screening Techniques for Analysis of CT Scans.Current osteoporosis reports · 2023Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To establish and evaluate the diagnostic accuracy of volumetric bone mineral density (vBMD) threshold values at different spinal levels, derived from opportunistic quantitative computed tomography (QCT), for the prediction of incident vertebral fractures (VF). Materials and Methods: In this case-control study, 35 incident VF cases (23 women, 12 men; mean age: 67 years) and 70 sex- and age-matched controls were included, based on routine multi detector CT (MDCT) scans of the thoracolumbar spine. Trabecular vBMD was measured from routine baseline CT scans of the thoracolumbar spine using an automated pipeline including vertebral segmentation, asynchronous calibration for HU-to-vBMD conversion, and correction of intravenous contrast medium (https://anduin.bonescreen.de). Threshold values at T1-L5 were calculated for the optimal operating point according to the Youden index and for fixed sensitivities (60 - 85%) in receiver operating characteristic (ROC) curves. Results: vBMD at each single level of the thoracolumbar spine was significantly associated with incident VFs (odds ratio per SD decrease [OR], 95% confidence interval [CI] at T1-T4: 3.28, 1.66-6.49; at T5-T8: 3.28, 1.72-6.26; at T9-T12: 3.37, 1.78-6.36; and at L1-L4: 3.98, 1.97-8.06), independent of adjustment for age, sex, and prevalent VF. AUC showed no significant difference between vertebral levels and was highest at the thoracolumbar junction (AUC = 0.75, 95%-CI = 0.63 - 0.85 for T11-L2). Optimal threshold values increased from lumbar (L1-L4: 52.0 mg/cm³) to upper thoracic spine (T1-T4: 69.3 mg/cm³). At T11-L2, T12-L3 and L1-L4, a threshold of 80.0 mg/cm³ showed sensitivities of 85 - 88%, and specificities of 41 - 49%. To achieve comparable sensitivity (85%) at more superior spinal levels, resulting thresholds were higher: 114.1 mg/cm³ (T1-T4), 92.0 mg/cm³ (T5-T8), 88.2 mg/cm³ (T9-T12). Conclusions: At all levels of the thoracolumbar spine, lower vBMD was associated with incident VFs in an elderly, predominantly oncologic patient population. Automated opportunistic osteoporosis screening of vBMD along the entire thoracolumbar spine allows for risk assessment of imminent VFs. We propose level-specific vBMD threshold at the thoracolumbar spine to identify individuals at high fracture risk.
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