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. 2023 Sep 21;24(1):747.
doi: 10.1186/s12891-023-06888-8.

Combinations of two imaging parameters to improve bone mineral density (BMD) assessment in patients with lumbar degenerative diseases

Wenshuai Li #  1   2 , Houze Zhu #  1   2 , Hongsen Tian  1   2 , Tong Tong  1   2 , Zijian Hua  1   2 , Xuan Zhao  1   2 , Yong Shen  1   2 , Linfeng Wang  3   4
Affiliations

Combinations of two imaging parameters to improve bone mineral density (BMD) assessment in patients with lumbar degenerative diseases

Wenshuai Li et al. BMC Musculoskelet Disord. .

Abstract

Purpose: To explore whether combining the Hounsfield unit (HU) values and vertebral bone quality (VBQ) scores can improve the BMD assessment in patients with lumbar degenerative diseases.

Methods: The HU values were measured by CT image, and VBQ scores were calculated by lumbar MRI image. The correlations of the opportunistic imaging parameters to the lowest T-scores were analyzed. Receiver-operating characteristic curve (ROC) analysis was used to evaluate the accuracy in detecting osteoporosis. Finally, the specificity and sensitivity of different combined methods of the HU values and VBQ scores in the diagnosis of osteoporosis were compared.

Results: Patients with osteoporosis had the lowest HU values and the highest VBQ scores. The correlation coefficients between the VBQ scores and the T-scores were smaller than HU values (L1 HU value: 0.702; average HU value:0.700; L1 VBQ score: -0.413; VBQ score: -0.386). The areas under the curve (AUCs) of the HU values were greater than those of the VBQ scores, and the AUCs of the L1 VBQ score were similar to the VBQ score (L1 HU value: 0.850; average HU value:0.857; L1 VBQ score: 0.704; VBQ score: 0.673). When combining the two imaging parameters in series, the specificity of the detection of osteoporosis was improved (L1 HU value and L1 VBQ score: 87.3%; Average HU value and VBQ score: 85.9%). When combining the two imaging parameters in parallel, the sensitivity of the detection of osteoporosis was improved (L1 HU value or L1 VBQ score: 88.1%; Average HU value or VBQ score: 91.5%).

Conclusions: Combinations of the HU values and VBQ scores could improve the diagnostic performance of osteoporosis. In addition, considering the same diagnostic performance but easier measurement, parameters at the single-segment level were recommended to assist in the diagnosis of osteoporosis.

Keywords: Hounsfield units; Lumbar degenerative disease; Osteoporosis; Vertebral bone quality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
HU values determined using region of interest (ROI) were shown. Figure 1 A shows the axial plane of ROI in the L1-L4. Figure 1B shows PACS software automatically calculates the HU values
Fig. 2
Fig. 2
Non − contrast-enhanced T1-weighted MRI image shows the determination of signal intensity (SI) of L1-L4 and SI of cerebrospinal fluid (CSF) at the L1 level and L3 level using regions of interest (ROIs)
Fig. 3
Fig. 3
The distribution of HU values and VBQ scores in different BMD was shown. The line in the box plot represents the median, and the top to bottom of the box is the range of quartiles
Fig. 4
Fig. 4
Receiver-operating characteristic curve (ROC) analysis was used to evaluate the performance of HU value and VBQ score in distinguishing osteoporosis
See this image and copyright information in PMC

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