Efficacy of Hounsfield Units Measured by Lumbar Computer Tomography on Bone Density Assessment: A Systematic Review

• Type: Another Publication in an International Scientific Journal
• Date: 2022

Authors

Pinto, EM (Author) Other; Neves, JR (Author) FMUP; Teixeira, A (Author) Other; Frada, R (Author) Other; Atilano, P (Author) Other; Oliveira, F (Author) Other; Veigas, T (Author) Other; Miranda, A (Author) Other

Journal

Title: Spine

Vol. 47

Pages: 702-710

ISSN: 0362-2436

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 25 Citations

Other information

Authenticus ID: P-00V-JEH

DOI: 10.1097/brs.0000000000004211

Abstract (EN): Study Design. Systematic review. Objective. This work aimed to compare the Hounsfield units (HU) value obtained from computed tomography and the t score of dual-energy x-ray absorptiometry (DXA) in the prediction of the lumbar spine bone mineral density (BMD). Summary of Background Data. Several reports have found a correlation between HU and BMD values based on DXA. Using HUs to infer bone quality has a thorough clinical relevance as it could triage patients at risk for osteoporotic and fragility fractures or modify surgical indications. Methods. A systematic review in Cochrane Library, Medline, Scopus and Web of Science was performed, using the following query: hounsfield units AND (osteoporosis OR spine OR bone mineral density OR dual x-ray absorptiometry). We included 18 cohort studies that compared HU value obtained from computed tomography and t score of DXA for predicting regional BMD. Results. A total of 18 studies were included, enrolling 5307 patients. The HU measurement was most frequently made at L1 (N = 3; 18.8%). The mean HU values differentiated based on BMD measured through DXA were reported in seven studies, with values from 54.7 to 130 for osteoporotic, 78.8 to 146 for osteopenic, and from 120.8 to 230 in normal patients. Eight studies identified thresholds for diagnosing osteoporosis through receiver-operating characteristic (ROC) curves, with values ranging from 0.66 to 0.96. Medium HU values reported as diagnostic of osteoporosis ranged between 110 and 150, after exclusion of the two papers presenting outlier values. We infer an HU interval value of 90.9 to 138.7 (95% CI, P < 0.001) for the diagnosis osteoporosis. Conclusions. Present data evidence favorable results regarding the possibility of establishing a threshold value for osteoporosis diagnosis from CT measurements of HU. Prospective large-scale studies are needed to more robustly infer the possibility of quantifying BMD based on CT as a screening test and infer a prognostic value of the CT-based evaluation.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9