ArticleInvestigative radiology2025
In Vivo Bone Mineral Density Assessment With Spectral Localizer Radiographs From Photon-Counting Detector CT: Prospective Comparison With DXA.
Article in Investigative radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Image-quality optimization for late iodine enhancement with photon-counting CT: impact of spectral analysis and reconstruction parameters.La Radiologia medica · 2026Article
- Dual-view scout scans with deep learning for ultra-low dose attenuation correction in PET.Medical physics · 2026Article
- ESR Innovation in Focus: photon-counting detector CT.European radiology · 2026Article
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to determine in a prospective patient study the accuracy of areal bone mineral density (aBMD) measurements with spectral localizer radiographs obtained with a clinical photon-counting detector computed tomography (PCD-CT) scanner in comparison with dual-energy x-ray absorptiometry (DXA).
methodsIn this institutional review board-approved, prospective study, 41 patients (15 females, 26 males; mean age 61.3 years, age range 35-78 years) underwent PCD-CT of the abdomen with a spectral localizer radiograph (tube voltage 140 kVp, tube current 30 mA) and DXA within a median of 45 days. aBMD values were derived for lumbar vertebrae L1-L4 from both methods and were compared with linear regression, Pearson correlation, intraclass correlation coefficients (ICCs), and Bland-Altman plots. T-scores were calculated on a patient level and were compared between methods.
resultsDXA and spectral localizer radiographs showed strong correlation in aBMD measurements ( R = 0.97, P < 0.001) and patient level T-scores ( R = 0.99, P < 0.001). There was a strong agreement between aBMD from both methods (ICC, 0.96; 95% CI, 0.94-0.97). Bland-Altman analysis revealed a very small mean difference in aBMD between methods (mean absolute error 0.019 g/cm 2 ) with narrow limits of agreement (-0.083 g/cm 2 to 0.121 g/cm 2 ). Similarly, there were small differences in regard to the T-score (mean absolute error 0.156) with narrow limits of agreement (-0.422 to 0.734) between methods. ICCs indicated an excellent agreement between T-scores from DXA and spectral localizer radiographs (ICC, 0.98; 95% confidence interval, 0.95-0.99).
conclusionsOur prospective patient study indicates that spectral localizer radiographs obtained with a clinical PCD-CT system enable accurate quantification of the lumbar bone areal mineral density. This opens up the opportunity for opportunistic screening of osteoporosis in patients who undergo CT for other indications.
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