1. Exploring bone density analysis on routine CT scans as a tool for opportunistic osteoporosis screening.
- Author
-
du Fossé NA, Grootjans W, Navas A, Appelman-Dijkstra NM, Elzo Kraemer CV, van Westerloo DJ, and de Jonge E
- Subjects
- Humans, Female, Male, Aged, Retrospective Studies, Middle Aged, Intensive Care Units, Netherlands epidemiology, Mass Screening methods, Thoracic Vertebrae diagnostic imaging, SARS-CoV-2 isolation & purification, Aged, 80 and over, Osteoporosis diagnostic imaging, Osteoporosis diagnosis, Bone Density, Tomography, X-Ray Computed methods, COVID-19 diagnostic imaging, COVID-19 epidemiology
- Abstract
The primary aim of this study was to evaluate computed tomography (CT)-based bone density analysis at the level of thoracic vertebra 12 (Th12) as a screening method for decreased bone density in patients admitted to the intensive care unit (ICU). Interobserver variability was analyzed. Secondary aims were to assess the prevalence of CT-based low bone density upon ICU admission in a cohort of COVID-19 patients and to assess the potential effect of long-term ICU stay on bone density in these patients. Retrospective single-center cohort study. ICU of the Leiden University Medical Center (LUMC), the Netherlands. Patients admitted to the ICU of the LUMC between March 1st, 2020 and February 1st, 2022 with a diagnosis of COVID-19, and a length of ICU stay of ≥ 21 days. In the included patients both baseline chest CT scans (obtained upon ICU admission) and follow-up chest CT scans (obtained ≥ 21 days after ICU admission) were available for analysis. A total of 118 CT scans in 38 patients were analyzed. There was a good interobserver variability, with an overall mean absolute difference (between measurements of three observers) of 9.7 Hounsfield Units (HU) and an intraclass correlation coefficient (ICC) of 0.93 (95% CI 0.88-0.96). The effect of intravenous contrast administration on bone density measurements was small (+ 7.5 HU (95% CI 3.4-11.5 HU)) higher in contrast enhanced CT images compared to non contrast enhanced CT images). Thirty-seven percent of patients had a bone density < 140 HU, suggestive of osteoporosis. No significant difference was found between bone density upon ICU admission and bone density at follow-up (≥ 21 days after ICU admission). Vertebral CT-based bone density analysis using routine CT scans is an easily applicable method to identify ICU patients with decreased bone density, which could enable enrollment in osteoporosis prevention programs. A high prevalence of low bone density was found in our cohort of ICU patients. There were no changes observed in bone density between baseline and follow-up measurements., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF