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?
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?
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DOI：
10.1007/s00330-017-4904-y
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发表时间：
2017-12
影响因子：
5.9
通讯作者：
Baum T
中科院分区：
文献类型：
--
作者：
Mei K;Kopp FK;Bippus R;Köhler T;Schwaiger BJ;Gersing AS;Fehringer A;Sauter A;Münzel D;Pfeiffer F;Rummeny EJ;Kirschke JS;Noël PB;Baum T
使用多层螺旋CT（MDCT）诊断骨质疏松症仅限于相对较高的辐射暴露。我们研究了模拟超低剂量方案对体内骨矿物质密度（BMD）和定量骨小梁评估的影响。获得了机构审查委员会的批准。12例接受常规胸部和腹部MDCT检查的腰椎骨折受试者和12例年龄和性别匹配的对照受试者入选（平均有效剂量：10 mSv）。通过模拟较低的管电流和原始剂量的50%、25%和10%的稀疏采样实现超低辐射检查。在T10-L5中提取BMD和松质骨参数。除稀疏采样数据中的BMD测量值外，超低剂量数据导出的所有参数的绝对值与原始剂量图像导出的参数的绝对值之间存在显著差异（p<0.05）。骨折组的BMD、表观骨分数和骨小梁厚度仍低于无骨折组（p<0.05）。在超低剂量扫描中，骨密度和微结构参数能够区分有无椎骨骨折的受试者，提示骨质疏松症诊断是可行的。但是，绝对值与原始值不同。来自稀疏采样的BMD似乎更稳健。在未来的临床应用中应考虑参数的剂量依赖性。 · BMD和定量骨参数可在超低剂量体内MDCT扫描中评估。 ·当应用稀疏采样时，骨矿物质密度没有显著变化。 ·定量骨小梁微观结构测量对剂量减少敏感。 ·即使在原始剂量的10%下也可以区分骨质疏松受试者。 ·在比较定量骨参数时，应考虑辐射暴露。 本文的在线版本（doi：10.1007/s 00330 -017-4904-y）包含补充材料，可供授权用户使用。
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. 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. 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). 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. • 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. The online version of this article (doi:10.1007/s00330-017-4904-y) contains supplementary material, which is available to authorized users.
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影响因子：
2.1
作者：
Pan X;Sidky EY;Vannier M
通讯作者：
Vannier M
影响因子：
5
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Noel, Peter B.;Fingerle, Alexander A.;Dobritz, Martin
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Dobritz, Martin
影响因子：
3.3
作者：
Bauma, Thomas;Mueller, Dirk;Bauer, Jan S.
通讯作者：
Bauer, Jan S.
影响因子：
6.2
作者：
Burge, Russel;Dawson-Hughes, Bess;Tosteson, Anna
通讯作者：
Tosteson, Anna
影响因子：
4
作者：
Baum, T.;Carballido-Gamio, J.;Huber, M. B.;Mueller, D.;Monetti, R.;Raeth, C.;Eckstein, F.;Lochmueller, E. M.;Majumdar, S.;Rummeny, E. J.;Link, T. M.;Bauer, J. S.
通讯作者：
Bauer, J. S.