The British journal of radiology · 2026
Diagnostic ability of spectral CT-based vertebral hydroxyapatite concentration for bone mineral density assessment in patients with liver cirrhosis: evaluating in unenhanced, arterial, and portal venous phase after intravenous contrast administration.
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Cheng Xiaoyue, Ma Qiang, Hou Xinmeng, Zhao Chenglin, Yan Yuanyuan, Li Jianying, Yang Zhenghan
Аннотация
OBJECTIVES: To access the impact of intravenous contrast on the diagnostic efficacy of abdominal spectral CT-based vertebral hydroxyapatite (HAP) concentration measurement for bone mineral density (BMD) assessment in menopausal women, women undergoing menopausal transition, and men older than 50 years with liver cirrhosis.
METHODS: One hundred and seventy-two patients (mean age, 63.78 ± 7.20 years; range, 51-82 years) with liver cirrhosis enrolled in the study. These individuals underwent comprehensive abdominal spectral abdominal spectral CT scans, which included both unenhanced and contrast-enhanced arterial phase (AP) and portal venous phase (VP). Vertebral HAP concentration was quantified in the medullary compartment of vertebral body (L1-L3) using HAP-based material decomposition images. The receiver operating characteristic (ROC) curves were adapted to investigate the diagnostic efficacy of using unenhanced, AP and VP HAP concentrations for evaluating BMD validated by T-scores on dual-energy X-ray absorptiometry.
RESULTS: HAP values were significantly different among the 3 scan phases (all P < .05). By adjusting thresholds, high accuracies were obtained for detecting low bone mass (osteoporosis or osteopenia) with HAP measurements in all scan phases (all areas-under-ROC > 0.9). The data did not reveal a statistically significant disparity between the unenhanced and AP (P = .055) to detect low bone mass. The efficacies for detecting low bone mass had statistically significant reduction with HAP concentrations in VP (P = .012).
CONCLUSIONS: Vertebral HAP concentrations increased in AP and VP compared to unenhanced phase.
ADVANCES IN KNOWLEDGE: Adjusting thresholds higher in contrast-enhanced phases may maintain high detection efficacies for low bone mass.
METHODS: One hundred and seventy-two patients (mean age, 63.78 ± 7.20 years; range, 51-82 years) with liver cirrhosis enrolled in the study. These individuals underwent comprehensive abdominal spectral abdominal spectral CT scans, which included both unenhanced and contrast-enhanced arterial phase (AP) and portal venous phase (VP). Vertebral HAP concentration was quantified in the medullary compartment of vertebral body (L1-L3) using HAP-based material decomposition images. The receiver operating characteristic (ROC) curves were adapted to investigate the diagnostic efficacy of using unenhanced, AP and VP HAP concentrations for evaluating BMD validated by T-scores on dual-energy X-ray absorptiometry.
RESULTS: HAP values were significantly different among the 3 scan phases (all P < .05). By adjusting thresholds, high accuracies were obtained for detecting low bone mass (osteoporosis or osteopenia) with HAP measurements in all scan phases (all areas-under-ROC > 0.9). The data did not reveal a statistically significant disparity between the unenhanced and AP (P = .055) to detect low bone mass. The efficacies for detecting low bone mass had statistically significant reduction with HAP concentrations in VP (P = .012).
CONCLUSIONS: Vertebral HAP concentrations increased in AP and VP compared to unenhanced phase.
ADVANCES IN KNOWLEDGE: Adjusting thresholds higher in contrast-enhanced phases may maintain high detection efficacies for low bone mass.