Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift
Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift
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DOI：
10.1007/s11926-018-0784-7
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发表时间：
2018-12-01
影响因子：
5
通讯作者：
Boutin, Robert D.
中科院分区：
文献类型：
--
作者：
Lenchik, Leon;Weaver, Ashley A.;Boutin, Robert D.
综述目的：骨质疏松在风湿病患者中不成比例地常见。在过去的三十年里，骨质疏松症的诊断得益于强调使用双X射线吸收测量法(DXA)的成熟的实践指南。尽管有这些指南和DXA的广泛应用，但大约三分之二的符合条件的患者没有接受检测。改进骨质疏松症检测的一种策略是使用作为常规患者护理的一部分而获得的计算机断层扫描(CT)检查来“机会性地”筛查骨质疏松症，而不需要额外的费用或患者受到辐射照射。这篇综述考察了机会性CT在评估骨质疏松中的作用。最近的发现：最近的证据表明，使用CT机会性测量骨衰减(放射性密度)具有与DXA相当的敏感性。更重要的是，这种方法已被证明可以预测骨质疏松性骨折。总结：使用其他原因获得的CT来机会性筛查骨质疏松的范例转变有望显著改善患者的护理。
Purpose of Review: Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to "opportunistically" screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis.Recent Findings: Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures.Summary: The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.