What question did this study set out to answer?

To compare the diagnostic performance of vertebral Hounsfield unit attenuation against FRAX and Garvan fracture risk calculators in identifying low bone mineral density and vertebral compression fractures among lung cancer screening participants.

July 24, 2023British Journal of RadiologyOpen Access

Vertebral CT attenuation outperforms standard clinical fracture risk prediction tools in detecting osteoporotic disease in lung cancer screening participants

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Authors

KDKatrina DahlThe University of Queensland RORachael O’RourkeThe University of Queensland AWAnne WilliamsonUniversity of Maryland, Baltimore

Discussion

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Implication

Cohort study reveals vertebral CT attenuation outperforms standard fracture risk tools in lung cancer screening participants, indicating an efficient way to detect osteoporosis opportunistically.

Key Points

To compare the diagnostic performance of vertebral Hounsfield unit attenuation against FRAX and Garvan fracture risk calculators in identifying low bone mineral density and vertebral compression fractures among lung cancer screening participants.
Analyzed baseline chest CT scans from 535 participants at a single site of the International Lung Screen Trial.
Assessed bone mineral density via vertebral Hounsfield unit (VHU) attenuation (<110 HU) and quantitative CT (<120 mg/cm³), alongside semi-quantitative scoring of prevalent vertebral fractures.
Calculated 10-year FRAX and Garvan fracture risk scores incorporating femoral neck DXA T-scores in a subset (n=64) and evaluated discriminatory accuracy using area under receiver-operating characteristic curves (AUC).
Among 535 participants, 41% had low VHU-BMD, 56% had low QCT-BMD, and 10% had ≥1 vertebral fracture with ≥25% height loss; VHU showed 94% specificity and 70% sensitivity for identifying low QCT-BMD.
VHU was significantly superior to risk tools in detecting low QCT-BMD across the full cohort (AUC: VHU 0.94 vs FRAX 0.67, Garvan 0.64; p < 0.05) and within the DXA subset (AUC: VHU 0.99 vs FRAX T-score 0.71, Garvan T-score 0.71; p < 0.05).
VHU was non-inferior to risk calculators using T-scores for discriminating prevalent vertebral fractures (AUC: VHU 0.65 vs FRAX T-score 0.53, Garvan T-score 0.61).

Cite This Study

Dahl et al. (2023) studied this question.

synapsesocial.com/papers/6aa800afff0084718cb188a8 https://doi.org/10.1259/bjr.20220992

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Implication

Cohort study reveals vertebral CT attenuation outperforms standard fracture risk tools in lung cancer screening participants, indicating an efficient way to detect osteoporosis opportunistically.

Vertebral CT attenuation outperforms standard clinical fracture risk prediction tools in detecting osteoporotic disease in lung cancer screening participants

Discussion

Member takes

Implication

Key Points

Cite This Study

Vertebral CT attenuation outperforms standard clinical fracture risk prediction tools in detecting osteoporotic disease in lung cancer screening participants

Discussion

Member takes

Implication

Key Points

Cite This Study

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