Opportunistic thoracic CT scan over bone densitometry in CF care: Is it possible to screen for osteoporosis using a CT scan?

INTRODUCTION

Cystic fibrosis (CF) is an autosomal recessive disease that alters ionic transport in the body's secretions, including those of the lung mucosa, and is the most common hereditary respiratory disease in the Western world. One of the causes of morbidity and decreased quality of life in patients with CF is osteoporosis, which is currently assessed by bone densitometry.

METHODS

bi-centric, cross-sectional, retrospective study, reviewing data contained in the medical records of patients with cystic fibrosis participants who were treated at 2 CF reference centers, and reanalysis of chest tomography scans performed annually during checkup, in comparison with their bone densitometry measurements from the same period.

RESULTS

A total of 73 CF patients were evaluated. Patients with DXA-defined osteoporosis showed significantly lower HU values. Using 215HU as the cutoff, we obtained 83% sensitivity and 68% specificity for osteoporosis. Area under the ROC curve was 0.86 using analyses of T10 to T12 vertebrae.

CONCLUSIONS

Chest computed tomography may serve as an opportunistic screening for identifying patients with cystic fibrosis at increased risk of low bone mineral density, particularly when CT examinations are already being performed for other clinical reasons.