1. Assessment of bone health in patients with prostate cancer using cancer staging computed tomography
- Author
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Mototaka Sato, Masafumi Kashii, Atsuki Matsukawa, Ryoya Mizuno, Mai Akiyama, Takashi Kamatani, Satoshi Kamido, Norichika Ueda, Jiro Nakayama, Norihide Tei, Hideki Yoshikawa, and Osamu Miyake
- Subjects
Male ,Endocrinology ,Absorptiometry, Photon ,Lumbar Vertebrae ,Bone Density ,Endocrinology, Diabetes and Metabolism ,Humans ,Prostatic Neoplasms ,Orthopedics and Sports Medicine ,General Medicine ,Tomography, X-Ray Computed ,Neoplasm Staging ,Retrospective Studies - Abstract
To evaluate the utility of vertebral Hounsfield unit (HU) values from computed tomography (CT) in cancer staging as a supplementary screening tool for bone health among prostate cancer (PCa) patients.T-scores of bone mineral density (BMD) in each lumbar vertebra (L1-L4) and hip for newly diagnosed PCa patients (N = 139) were measured using dual-energy X-ray absorptiometry (DXA). The degenerative changes in each lumbar vertebra were assessed, and the HU values of trabecular bone in axial CT images of each vertebral body (vertebral CT-HU value) were measured using staging CT.556 vertebrae were analyzed. 326 of 556 (59%) lumbar vertebrae had degenerative changes. The vertebral CT-HU value was positively correlated with the lumbar BMD T-score, with higher correlation coefficients observed in vertebrae without degenerative changes (r = 0.655, N = 230) when compared to vertebrae with degenerative changes (r = 0.575, N = 326). The thresholds matching BMD T-scores of - 2.0 and - 1.5 set by cancer treatment-induced bone loss guidelines were 95 HU and 105 HU, respectively. Based on the intervention threshold (lumbar BMD T-score - 1.5), 15.1% of PCa patients required osteoporosis treatment; and, this value increased to 30.9% when L1-L4 CT-HU thresholds that corresponded to BMD T-score - 1.5 were used.Lumbar BMD values from DXA may not reflect true bone health in PCa patients who often have lumbar degenerative diseases. Thresholds based on the vertebral CT-HU value can be used as a supplementary method to identify PCa patients who need anti-osteoporosis drugs.
- Published
- 2022