ArticleQuantitative imaging in medicine and surgery2023
Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography.
Article in Quantitative imaging in medicine and surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- A Novel Dual-Energy X-Ray Absorptiometry Protocol for the Proximal Humerus Reveals a Fatty Infiltration Dependent Reduction in Bone Mineral Density.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026Article
- Comparative Assessment of Proximal Humeral Bone Density Using CT Osteoabsorptiometry, Bone Microarchitecture Analysis, and a HU-Based Calibration Method: A CT and Micro-CT Study in Elderly Body Donors (65-86 Years).Diagnostics (Basel, Switzerland) · 2026Article
- Proximal humerus fractures in the elderly work up, classifications and fracture biomechanics.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Review
- Correlation between vertebral bone mineral density and multi-level virtual non-calcium imaging parameters from dual-layer spectral detector computed tomography.Quantitative imaging in medicine and surgery · 2024Article
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Abstract
Background: The proximal humerus is a common site of osteoporotic fractures, and bone quality is a predictor of surgical reduction quality. Dual-energy computed tomography (DECT) is assuming an increasingly important role in the quantification of bone mineral density (BMD) due it is ability to perform three-material decomposition. We aimed to analyze the bone quality and distribution of the proximal humerus with DECT quantitatively. Methods: Sixty-five consecutive patients (average age 49.5±15.2 years; male: female ratio 32:33) without proximal humerus fractures who had undergone DECT were retrospectively selected. The humeral head was divided into 4 regions on a cross section in the medial plane between the greater tuberosity and the surgical neck. The quantitative parameters, including virtual noncalcium (VNCa) value, computed tomography value of calcium (CaCT), computed tomography value of mixed-energy images (regular CT value) (rCT), and relative calcium density (rCaD), were measured. The correlations between the quantitative parameters and age and body mass index (BMI) were analyzed, and the correlations of age, sex, BMI, region of the humeral head, and VNCa value on CaCT were evaluated. Results: The differences in CaCT, rCT, and rCaD between the 4 regions of proximal humerus were statistically significant (P<0.001), while the difference in VNCa values was not (P=0.688). The calcium concentration (CaCT and rCaD) was the densest in the posteromedial zone. The differences of CaCT, rCT, and rCaD between males and females in the 4 regions of proximal humerus were statistically significant (P<0.05), while those of the posterolateral zone were not (rCT; P>0.05). The differences in VNCa values between males and females were also not significant (P>0.05). Multivariable linear regression analysis indicated that sex, age, BMI, regions, and VNCa were significant (P<0.05) predictors of the CaCT value. Conclusions: The concentration of calcium was the densest in the posteromedial region of proximal humerus, and the VNCa value of DECT may be used for quantifying the BMD of the proximal humerus.
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