Automated extraction of vertebral bone mineral density from imaging with various scan parameters: a cadaver study with correlation to quantitative computed tomography.

PURPOSE: To investigate lumbar vertebral volumetric bone mineral density (vBMD) from ex vivo opportunistic multi-detector computed tomography (MDCT) scans using different protocols, and compare it to dedicated quantitative CT (QCT) values from the same specimens.

METHODS

Cadavers from two female donors (ages 62 and 68 years) were scanned (L1-L5) using six different MDCT protocols and one dedicated QCT scan. Opportunistic vBMD was extracted using an artificial intelligence-based algorithm. The vBMD measurements from the six MDCT protocols, which varied in peak tube voltage (80-140 kVp), tube load (72-200 mAs), slice thickness (0.75-1 mm), and/or slice increment (0.5-0.75 mm), were compared to those obtained from dedicated QCT.

RESULTS

A strong positive correlation was observed between vBMD from opportunistic MDCT and reference QCT (ρ = 0.869, p < 0.01). Agreement between vBMD measurements from MDCT protocols and the QCT reference standard according to the intraclass correlation coefficient (ICC) was 0.992 (95% confidence interval [CI]: 0.982-0.998). Bland-Altman analysis showed biases ranging from - 12.66 to 8.00 mg/cm³ across the six MDCT protocols, with all data points falling within the respective limits of agreement (LOA) for both cadavers.

CONCLUSION

Opportunistic vBMD measurements of lumbar vertebrae demonstrated reliable consistency ex vivo across various scan parameters when compared to dedicated QCT.