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European Radiology
Published in: European Radiology 12/2017

Open Access 01-12-2017 | Computed Tomography

Is multidetector CT-based bone mineral density and quantitative bone microstructure assessment at the spine still feasible using ultra-low tube current and sparse sampling?

Authors: Kai Mei, Felix K. Kopp, Rolf Bippus, Thomas Köhler, Benedikt J. Schwaiger, Alexandra S. Gersing, Andreas Fehringer, Andreas Sauter, Daniela Münzel, Franz Pfeiffer, Ernst J. Rummeny, Jan S. Kirschke, Peter B. Noël, Thomas Baum

Published in: European Radiology | Issue 12/2017

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Abstract

Objective

Osteoporosis diagnosis using multidetector CT (MDCT) is limited to relatively high radiation exposure. We investigated the effect of simulated ultra-low-dose protocols on in-vivo bone mineral density (BMD) and quantitative trabecular bone assessment.

Materials and methods

Institutional review board approval was obtained. Twelve subjects with osteoporotic vertebral fractures and 12 age- and gender-matched controls undergoing routine thoracic and abdominal MDCT were included (average effective dose: 10 mSv). Ultra-low radiation examinations were achieved by simulating lower tube currents and sparse samplings at 50%, 25% and 10% of the original dose. BMD and trabecular bone parameters were extracted in T10–L5.

Results

Except for BMD measurements in sparse sampling data, absolute values of all parameters derived from ultra-low-dose data were significantly different from those derived from original dose images (p<0.05). BMD, apparent bone fraction and trabecular thickness were still consistently lower in subjects with than in those without fractures (p<0.05).

Conclusion

In ultra-low-dose scans, BMD and microstructure parameters were able to differentiate subjects with and without vertebral fractures, suggesting osteoporosis diagnosis is feasible. However, absolute values differed from original values. BMD from sparse sampling appeared to be more robust. This dose-dependency of parameters should be considered for future clinical use.

Key Points

• BMD and quantitative bone parameters are assessable in ultra-low-dose in vivo MDCT scans.
• Bone mineral density does not change significantly when sparse sampling is applied.
• Quantitative trabecular bone microstructure measurements are sensitive to dose reduction.
• Osteoporosis subjects could be differentiated even at 10% of original dose.
• Radiation exposure should be considered when comparing quantitative bone parameters.
Appendix
Available only for authorised users
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Metadata
Title
Is multidetector CT-based bone mineral density and quantitative bone microstructure assessment at the spine still feasible using ultra-low tube current and sparse sampling?
Authors
Kai Mei
Felix K. Kopp
Rolf Bippus
Thomas Köhler
Benedikt J. Schwaiger
Alexandra S. Gersing
Andreas Fehringer
Andreas Sauter
Daniela Münzel
Franz Pfeiffer
Ernst J. Rummeny
Jan S. Kirschke
Peter B. Noël
Thomas Baum
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4904-y

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