Abstract
Purpose
This study aimed to apply a newly developed semi-automatic phantom-less QCT (PL-QCT) to measure proximal humerus trabecular bone density based on chest CT and verify its accuracy and precision.
Methods
Subcutaneous fat of the shoulder joint and trapezius muscle were used as calibration references for PL-QCT BMD measurement. A self-developed algorithm based on a convolution map was utilized in PL-QCT for semi-automatic BMD measurements. CT values of ROIs used in PL-QCT measurements were directly used for phantom-based quantitative computed tomography (PB-QCT) BMD assessment. The study included 376 proximal humerus for comparison between PB-QCT and PL-QCT. Two sports medicine doctors measured the proximal humerus with PB-QCT and PL-QCT without knowing each other’s results. Among them, 100 proximal humerus were included in the inter-operative and intra-operative BMD measurements for evaluating the repeatability and reproducibility of PL-QCT and PB-QCT.
Results
A total of 188 patients with 376 shoulders were involved in this study. The consistency analysis indicated that the average bias between proximal humerus BMDs measured by PB-QCT and PL-QCT was 1.0 mg/cc (agreement range – 9.4 to 11.4; P > 0.05, no significant difference). Regression analysis between PB-QCT and PL-QCT indicated a good correlation (R-square is 0.9723). Short-term repeatability and reproducibility of proximal humerus BMDs measured by PB-QCT (CV: 5.10% and 3.41%) were slightly better than those of PL-QCT (CV: 6.17% and 5.64%).
Conclusions
We evaluated the bone quality of the proximal humeral using chest CT through the semi-automatic PL-QCT system for the first time. Comparison between it and PB-QCT indicated that it could be a reliable shoulder BMD assessment tool with acceptable accuracy and precision.
Summary
This study developed and verify a semi-automatic PL-QCT for assessment of proximal humeral bone density based on CT to assist in the assessment of proximal humeral osteoporosis and development of individualized treatment plans for shoulders.
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Data availability
The data presented in this study are available on request from the corresponding author. The data are not publicly available due to the restriction of IRB.
Change history
01 April 2024
A Correction to this paper has been published: https://doi.org/10.1007/s00198-024-07064-x
Abbreviations
- BMD:
-
Bone mineral density
- vBMD:
-
Volumetric bone mineral density
- DXA:
-
Dual-energy X-ray absorptiometry
- QCT:
-
Quantitative computed tomography
- PB-QCT:
-
Phantom-based quantitative computed tomography
- PL-QCT:
-
Phantom-less quantitative computed tomography
- LDCT:
-
Low-dose chest computed tomography
- ROI:
-
Region of interest
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Funding
This research was funded by The National Natural Science Foundation of China (U21A20390), the Special Foundation for Science and Technology Innovation of Jilin (20200201566JC, 20230204075YY), the Health Service Capacity Building Projects of Jilin Province (05KA001026009002), Graduate Innovation Program of Jilin University (No. 2023CX122), the 2023 Science and Technology Project of Jilin Provincial Department of Education (JJKH20231226KJ), and Jilin Province Natural Science Foundation (20190201218JC).
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The original online version of this article was revised: In this article the affiliation details for Yuan-Zhi Weng and Chi Ma were incorrectly given as 'Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun 130041, Jilin Province, China' but should have been 'Orthopaedic and Traumatology, The University of Hong Kong, Hong Kong, People’s Republic of China'.
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Guo, DM., Weng, YZ., Yu, ZH. et al. Semi-automatic proximal humeral trabecular bone density assessment tool: technique application and clinical validation. Osteoporos Int 35, 1049–1059 (2024). https://doi.org/10.1007/s00198-024-07047-y
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DOI: https://doi.org/10.1007/s00198-024-07047-y