Evidence map›Paper›PMID 42442757›Full record

ArticleBone & joint research2026

Comparisons of phantom-based and phantomless QCT bone mineral density for predicting subsequent fractures.

Jian Geng, Zitong Cheng, Yandong Liu, Dongfeng Xu, Wenshuang Zhang, Yi Yuan, Bo Hu, Jing Zheng, Ling Wang, Chunhua Mai and 1 more

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Article in Bone & joint research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Jian GengDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0002-3248-1094
Zitong ChengDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0009-0008-9442-1805
Yandong LiuDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0002-4752-9484
Dongfeng XuDepartment of Medical Imaging, Dongguan Hospital of Traditional Chinese Medicine, Beijing, China.ORCID 0009-0001-4496-3672
Wenshuang ZhangDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0002-9291-2538
Yi YuanDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0001-8058-8534
Bo HuDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0003-0943-5206
Jing ZhengDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0009-0000-2759-4943
Ling WangDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0002-5129-4999
Chunhua MaiDepartment of Medical Imaging, Dongguan Hospital of Traditional Chinese Medicine, Beijing, China.ORCID 0009-0002-1733-6937
Xiaoguang ChengDepartment of Radiology, Beijing Jishuitan Hospital, Affiliated to Capital Medical University, National Orthopedics Medical Center, Beijing, China.ORCID 0000-0002-4596-8248

Funding

Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research InstitutesBeijing Natural Science FoundationBeijing Physician Scientist Training ProjectNational Key R&D Program of ChinaNational Natural Science Foundation of China
6 · The paper itself

Abstract

Aims: This study aimed to compare the agreement between phantom-based (PB-QCT) and phantomless (PL-QCT) quantitative CT bone mineral density (BMD) measurements, and their predictive utility for subsequent fractures in postmenopausal women following percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs). Methods: In this prospective cohort study, 185 OVCF patients underwent lumbar CT with synchronous phantom calibration. BMD was measured via PB-QCT, PL-QCT (using subcutaneous adipose tissue (SAT), psoas muscle, or dual-tissue calibration), and vertebral Hounsfield units (vHU). Agreement was assessed via Bland-Altman analysis, and fracture prediction via Cox regression. Results: Dual-tissue PL-QCT showed the highest agreement with PB-QCT (absolute bias: 0.04 to 2.18 mg/cm³). However, PB-QCT demonstrated superior predictive power: per 1-SD decrease, it predicted 20% to 22% increased risk of spinal fractures (adjusted HR = 1.21, p = 0.032) and any-site fractures (HR = 1.20, p = 0.043), maintaining significance after multivariable adjustment. Conclusion: Despite high agreement - especially between PB-QCT and dual-tissue PL-QCT - PB-QCT demonstrated modest but consistent advantages in predicting subsequent fractures over PL-QCT and vHU. These results reinforce the essential role of standardized phantom calibration for accurate fracture risk stratification in post-PKP patients, while also supporting the potential use of PL-QCT and vHU as opportunistic screening tools in settings where phantom calibration is not feasible.

Identifiers

PMID42442757
PMCPMC13364345

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