ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Optimizing region of interest size and placement for clinical opportunistic CT trabecular bone Hounsfield unit measurements.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 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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Who cites it
3 citing papers in PubMed.
- Multilevel Lumbar CT Attenuation Beyond L1: Comparison with QCT-Derived Volumetric Bone Mineral Density and Prevalent Fragility Fracture Status in a Diagnostic Referral Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Diagnostic performance of lumbar computed tomography Hounsfield unit thresholds for osteoporosis and osteopenia: 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 · 2026Review
- Systemic bone loss measured by routine CT is associated with increased pain, postural decompensation, and survival in multiple myeloma.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 · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
purposeNo formal guidance exists regarding optimal opportunistic computed tomography (CT) region of interest (ROI) size or placement to clinically obtain bone Hounsfield unit (HU) data. Using clinical CT scans, this study evaluated ROI size/placement and assessed HU reproducibility.
methodsThree non-radiologists independently identified the L1 and L4 vertebral body centroid and then placed varying size circular ROIs on axial and sagittal images of 30 clinical CT scans. A 200-mm
resultsVertebral body centroid placement was nearly identical between readers (ICC > 0.99). Intra- and inter-observer reliability was excellent for all ROI sizes on both projections (ICC > 0.95). Statistically, but not clinically, significant differences, less than 8 HU, were present between various sized ROIs at L1, with no difference at L4. Axial HU was generally higher than sagittal for all ROI sizes at L1 and L4 by ~ 5-12 HU. In the precision cohort, L1 and L4 HU %CV was 4.8-7.9% yielding least significant change values of 10-16 HU.
conclusionsNon-radiologists can reliably identify the vertebral body centroid and measure HU. For clinical use, we recommend a 200-mm
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