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Opportunistic osteoporosis screening using chest CT with artificial intelligence

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Abstract

Summary

Osteoporosis has a high incidence and a low detection rate. If it is not detected in time, it will cause osteoporotic fracture and other serious consequences. This study showed that the attenuation values of vertebrae on chest CT could be used for opportunistic screening of osteoporosis. This will be beneficial to improve the detection rate of osteoporosis and reduce the incidence of adverse events caused by osteoporosis.

Introduction

To explore the value of the attenuation values of all thoracic vertebrae and the first lumbar vertebra measured by artificial intelligence on non-enhanced chest CT to do osteoporosis screening.

Methods

On base of images of chest CT, using artificial intelligence (AI) to measure the attenuation values (HU) of all thoracic and the first vertebrae of patients who underwent CT examination for lung cancer screening and dual-energy X-ray absorptiometry (DXA) examination during the same period. The patients were divided into three groups: normal group, osteopenia group, and osteoporosis group according to the results of DXA. Clinical baseline data and attenuation values were compared among the three groups. The correlation between attenuation values and BMD values was analyzed, and the predictive ability and diagnostic efficacy of attenuation values of thoracic and first lumbar vertebrae on osteopenia or osteoporosis risk were further evaluated.

Results

CT values of each thoracic vertebrae and the first lumbar vertebrae decreased with age, especially in menopausal women and presented high predictive ability and diagnostic efficacy for osteopenia or osteoporosis. After clinical data correction, with every 10 HU increase of CT values, the risk of osteopenia or osteoporosis decreased by 32 ~ 44% and 61 ~ 80%, respectively. And the combined diagnostic efficacy of all thoracic vertebrae was higher than that of a single vertebra. The AUC of recognizing osteopenia or osteoporosis from normal group was 0.831and 0.972, respectively.

Conclusions

The routine chest CT with AI is of great value in opportunistic screening for osteopenia or osteoporosis, which can quickly screen the population at high risk of osteoporosis without increasing radiation dose, thus reducing the incidence of osteoporotic fracture.

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Data availability

All materials were made publicly available at the HARVARD Dataverse and can be accessed at https://doi.org/10.7910/DVN/WDKMAA.

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Acknowledgements

Thanks to everyone who contributed to this research.

Funding

The study was supported by the National Natural Science Foundation of China (Grant No.81571373, No.81601217, No.82001491), Natural Science Foundation of Hubei Province of China (Grant No. 2017CFB627), Health Commission of Hubei Province scientific research project (WJ2021M247) and Scientific Research Fund of Wuhan Union Hospital (Grant No. 2019).

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Author notes

  1. Jinrong Yang and Man Liao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, Hubei Province, China

    Jinrong Yang, Leqing Chen, Yingying Ji, Yao Xiao, Wenliang Fan, Zhuang Nie & Fan Yang

  2. Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, Hubei Province, China

    Man Liao, Yaoling Wang, Linfeng He, Ruiyun Wang & Benling Qi

  3. Siemens Healthineers Digital Technology (Shanghai) Co., Ltd, No. 278, Zhouzhu Road, Nanhui, Shanghai, China

    Yichen Lu

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  1. Jinrong Yang
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Correspondence to Benling Qi or Fan Yang.

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Yang, J., Liao, M., Wang, Y. et al. Opportunistic osteoporosis screening using chest CT with artificial intelligence. Osteoporos Int 33, 2547–2561 (2022). https://doi.org/10.1007/s00198-022-06491-y

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