Comparisons of Hounsfield units and volumetric bone density in discriminating vertebral fractures on lumbar CT scans

• Published in: British journal of radiology 2024-05, Vol.97 (1157), p.1003-1009
• Main Authors: Zhou, Fengyun, Zhang, Wenshuang, Geng, Jian, Liu, Yandong, Yuan, Yi, Ma, Kangkang, Cheng, Zitong, Huang, Pengju, Cheng, Xiaoguang, Wang, Ling, Liu, Yajun
• Format: Article
• Language: English
• Subjects: Aged; Bone Density; Case-Control Studies; Female; Humans; Lumbar Vertebrae - diagnostic imaging; Male; Middle Aged; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Spinal Fractures - diagnostic imaging; Tomography, X-Ray Computed - methods
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1093/bjr/tqae053

To compare the performance of areal Hounsfield units (aHUs), volumetric Hounsfield units (vHUs), and volumetric bone mineral density (vBMD) by quantitative CT (QCT) in discriminating vertebral fractures (VFs) risk. We retrospectively included CT scans of the lumbar spine 101 VFs cases (60 women, mean age: 64 ± 4 years; 41 men, mean age: 73 ± 10 years) and sex- and age-matched 101 control subjects (60 women, mean age: 64 ± 4 years; 41 men, mean age: 72 ± 7 years). In order to assess the discriminatory capability of aHU, vHU, and vBMD measurements at the L1 and L2 levels in identifying VFs, we conducted binary logistic regression and receiver operating characteristic (ROC) curve analyses in men and women. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. In both men and women with and without VFs, aHU, vHU, and vBMD were highly correlated with each other (r2 from 0.832 to 0.957, all P