Exploring bone density analysis on routine CT scans as a tool for opportunistic osteoporosis screening

• Published in: Scientific reports 2024-08, Vol.14 (1), p.18359-7, Article 18359
• Main Authors: du Fossé, Nadia A., Grootjans, Willem, Navas, Ana, Appelman-Dijkstra, Natasha M., Elzo Kraemer, Carlos V., van Westerloo, David J., de Jonge, Evert
• Format: Article
• Language: English
• Subjects: 631/443/63; 631/443/811; Aged; Aged, 80 and over; Bone Density; Chest; Computed tomography; Correlation coefficient; COVID-19; COVID-19 - diagnostic imaging; COVID-19 - epidemiology; Female; Humanities and Social Sciences; Humans; Intensive care; Intensive Care Units; Long bone; Male; Mass Screening - methods; Medical imaging; Middle Aged; multidisciplinary; Netherlands - epidemiology; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - diagnostic imaging; Retrospective Studies; SARS-CoV-2 - isolation & purification; Science; Science (multidisciplinary); Thoracic Vertebrae - diagnostic imaging; Thorax; Tomography, X-Ray Computed - methods; Vertebrae
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-69397-1

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