TY - JOUR
T1 - Comprehensive assessment of osteoporosis and bone fragility with ct colonography
AU - Fidler, Jeff L.
AU - Murthy, Naveen S.
AU - Khosla, Sundeep
AU - Clarke, Bart L.
AU - Bruining, David H.
AU - Kopperdahl, David L.
AU - Lee, David C.
AU - Keaveny, Tony M.
N1 - Funding Information:
This research was supported by the National Institutes of Health (grant AR057616). Amgen, Eli Lilly, and Merck. The authors had control of the data and information submitted for publication, and, beyond O.N. Diagnostics, these study sponsors did not have a role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation of the manuscript. TMK is a consulting Chief Science Officer for and has stock ownership in O.N. Diagnostics. DLK and DCL are full-time employees of and have equity interests in O.N. Diagnostics. All other authors report no conflicts of interest. We would like to thank the following individuals at Mayo Clinic for their help: Elizabeth Atkinson, Assistant Professor of Biostatistics, who reviewed and assisted with addressing the statistical issues raised by the reviewers; Lifeng Yu, Ph.D., Associate Professor of Medical Physics, who assisted with calculating dose data for the CT colonography images; and Chi Ma, Ph.D., who also assisted with calculating dose data for the CT colonography images. J.L.F. Activities related to the present article: received a grant from O.N. Diagnostics. Activities not related to the present article: disclosed no relevant activities. Other activities: disclosed no relevant activities. N.S.M. disclosed no relevant activities. S.K. disclosed no relevant activities. B.L.C. Activities related to the present article: disclosed no relevant activities. Activities not related to the present article: received personal fees from Amgen and a grant from NPS Pharmaceuticals. Other activities: disclosed no relevant activities. D.H.B. disclosed no relevant activities. D.L.K. Activities related to the present article: grants from Amgen, Merck, Eli Lilly, and the National Institutes of Health. Activities not related to the present article: personal fees from O.N. Diagnostics. Other activities: patents pending and owns equity in O.N. Diagnostics. D.C.L. Activities related to the present article: grants from Amgen, Merck, Eli Lilly, and the National Institutes of Health. Activities not related to the present article: personal fees from O.N. Diagnostics. Other activities: disclosed no relevant activities. T.M.K. Activities related to the present article: grants from Amgen, Merck, Eli Lilly, and the National Institutes of Health. Activities not related to the present article: personal fees from Merck, Amgen, and Agnovos Healthcare. Other activities: patents pending, owns equity, and consulting Chief Science Officer at O.N. Diagnostics.
PY - 2016/1
Y1 - 2016/1
N2 - Purpose: To evaluate the ability of additional analysis of computed tomographic (CT) colonography images to provide a comprehensive osteoporosis assessment. Materials and Methods: This Health Insurance Portability and Accountability Act- compliant study was approved by our institutional review board with a waiver of informed consent. Diagnosis of osteoporosis and assessment of fracture risk were compared between biomechanical CT analysis and dual-energy x-ray absorptiometry (DXA) in 136 women (age range, 43-92 years), each of whom underwent CT colonography and DXA within a 6-month period (between January 2008 and April 2010). Blinded to the DXA data, biomechanical CT analysis was retrospectively applied to CT images by using phantomless calibration and finite element analysis to measure bone mineral density and bone strength at the hip and spine. Regression, Bland-Altman, and reclassification analyses and paired t tests were used to compare results. Results: For bone mineral density T scores at the femoral neck, biomechanical CT analysis was highly correlated (R2 = 0.84) with DXA, did not differ from DXA (P = .15, paired t test), and was able to identify osteoporosis (as defined by DXA), with 100% sensitivity in eight of eight patients (95% confidence interval [CI]: 67.6%, 100%) and 98.4% specificity in 126 of 128 patients (95% CI: 94.5%, 99.6%). Considering both the hip and spine, the classification of patients at high risk for fracture by biomechanical CT analysis-those with osteoporosis or "fragile bone strength"-agreed well against classifications for clinical osteoporosis by DXA (T score 22.5 at the hip or spine), with 82.8% sensitivity in 24 of 29 patients (95% CI: 65.4%, 92.4%) and 85.7% specificity in 66 of 77 patients (95% CI: 76.2%, 91.8%). Conclusion: Retrospective biomechanical CT analysis of CT colonography for colorectal cancer screening provides a comprehensive osteoporosis assessment without requiring changes in imaging protocols.
AB - Purpose: To evaluate the ability of additional analysis of computed tomographic (CT) colonography images to provide a comprehensive osteoporosis assessment. Materials and Methods: This Health Insurance Portability and Accountability Act- compliant study was approved by our institutional review board with a waiver of informed consent. Diagnosis of osteoporosis and assessment of fracture risk were compared between biomechanical CT analysis and dual-energy x-ray absorptiometry (DXA) in 136 women (age range, 43-92 years), each of whom underwent CT colonography and DXA within a 6-month period (between January 2008 and April 2010). Blinded to the DXA data, biomechanical CT analysis was retrospectively applied to CT images by using phantomless calibration and finite element analysis to measure bone mineral density and bone strength at the hip and spine. Regression, Bland-Altman, and reclassification analyses and paired t tests were used to compare results. Results: For bone mineral density T scores at the femoral neck, biomechanical CT analysis was highly correlated (R2 = 0.84) with DXA, did not differ from DXA (P = .15, paired t test), and was able to identify osteoporosis (as defined by DXA), with 100% sensitivity in eight of eight patients (95% confidence interval [CI]: 67.6%, 100%) and 98.4% specificity in 126 of 128 patients (95% CI: 94.5%, 99.6%). Considering both the hip and spine, the classification of patients at high risk for fracture by biomechanical CT analysis-those with osteoporosis or "fragile bone strength"-agreed well against classifications for clinical osteoporosis by DXA (T score 22.5 at the hip or spine), with 82.8% sensitivity in 24 of 29 patients (95% CI: 65.4%, 92.4%) and 85.7% specificity in 66 of 77 patients (95% CI: 76.2%, 91.8%). Conclusion: Retrospective biomechanical CT analysis of CT colonography for colorectal cancer screening provides a comprehensive osteoporosis assessment without requiring changes in imaging protocols.
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U2 - 10.1148/radiol.2015141984
DO - 10.1148/radiol.2015141984
M3 - Article
C2 - 26200602
AN - SCOPUS:84952879137
VL - 278
SP - 172
EP - 180
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 1
ER -