Quantitative CT Detects Undiagnosed Low Bone Mineral Density in Oncologic Patients Imaged With 18F-FDG PET/CT.
Quantitative CT Detects Undiagnosed Low Bone Mineral Density in Oncologic Patients Imaged With 18F-FDG PET/CT.
复制标题
DOI：
10.1097/rlu.0000000000003416
复制
发表时间：
2021-01
影响因子：
10.6
通讯作者：
Öz OK
中科院分区：
文献类型：
--
作者：
Kay FU;Ho V;Dosunmu EB;Chhabra A;Brown K;Duan X;Öz OK
我们评估了接受 F-18-FDG-PET/CT 的肿瘤患者中低骨密度 (BMD) 的患病率。对2015年10月至2016年5月期间在单中心接受F-18-FDG-PET/CT的100例患者进行回顾性分析。定量计算机断层扫描（QCT）用于评估腰椎（BMDQCT）和股骨颈（BMDCTXA）的BMD。 SUVmax用于评估骨髓的代谢活性。使用股骨颈 BMDCTXA 和 FRAX® 算法计算骨质疏松相关骨折的风险，并将其与 L1 (L1HU) 骨小梁的 CT 衰减测量结果进行比较。 ≥ 50 岁的患者中分别有 16%/46% 存在骨质疏松/骨质减少。骨髓 SUVmax 与腰椎 BMD 相关（ρ=0.36，p<0.001）。年龄增加和低骨髓 SUVmax 与腰椎低 BMDQCT 相关（均 p<0.001），而年龄增加、女性性别和低骨髓 SUVmax 与股骨颈低 BMDCTXA 相关（分别为 p<0.001、p<0.001、p=0.01）。 L1HU 检测骨质疏松相关骨折风险增加的曲线下面积为 0.95（95% 置信区间，CI=0.90–0.99），最佳阈值为 125.8 HU（95%CI=115.7–144.9），灵敏度为 100%（95%CI=0.92–1.00），特异性为 0.90 (95%CI=0.76–0.97)，准确度为 0.91 (95%CI=0.79–0.97)。低 BMD 在接受 F-18-FDG-PET/CT 的肿瘤患者中很常见。骨髓的 F-18-FDG 亲和力降低与 BMD 降低相关，验证了骨质疏松症和骨髓脂肪之间的联系。 L1HU 可能是一种简单而准确的方法，可使用 PET/CT 数据检测有骨质疏松相关骨折风险的患者。
We assessed the prevalence of low bone mineral density (BMD) in oncologic patients undergoing F-18-FDG-PET/CT. Retrospective analysis of 100 patients who underwent F-18-FDG-PET/CT at a single center from October 2015 till May 2016. Quantitative computed tomography (QCT) was used to assess BMD at the lumbar spine (BMDQCT) and femoral necks (BMDCTXA). SUVmax was used to evaluate metabolic activity of the bone marrow. Risk of osteoporosis-related fractures was calculated with femoral neck BMDCTXA and the FRAX® algorithm, which was compared against measurements of CT attenuation of the trabecular bone at L1 (L1HU). Osteoporosis/osteopenia were respectively present in 16%/46% of patients ≥ 50 years old. Bone marrow SUVmax was correlated with BMD at the lumbar spine (ρ=0.36, p<0.001). Increased age and low marrow SUVmax were associated with low BMDQCT at the lumbar spine (both p<0.001), while increased age, female sex, and low marrow SUVmax were associated with low BMDCTXA at the femoral necks (p<0.001, p<0.001, p=0.01, respectively). L1HU had an area under the curve of 0.95 (95% confidence interval, CI=0.90–0.99) for detecting increased risk for osteoporosis-related fracture, with best threshold of 125.8 HU (95%CI=115.7–144.9) yielding sensitivity of 100% (95%CI=0.92–1.00), specificity of 0.90 (95%CI=0.76–0.97), and accuracy of 0.91 (95%CI=0.79–0.97). Low BMD is frequent in oncologic patients undergoing F-18-FDG-PET/CT. Decreased F-18-FDG avidity of the bone marrow correlates with decreased BMD, validating the link between osteoporosis and bone marrow fat. L1HU could be a simple and accurate approach for detecting patients at risk for osteoporosis-related fractures using PET/CT data.