Abstract
In 174 adults presenting with backache, bone densitometry was performed on the lumbar spine, both femoral necks, and one femoral shaft employing dual energy photon absorptiometry (DPA); in 112 of these, densitometry was under-taken on L4 using single energy quantitative computer assisted tomography (CT). Radiographs of the spine were obtained in all patients and those with known or suspected malignant disease were excluded. The subjects were divided into two groups according to the presence (n=128) or absence (n=44) of signs of vertebral collapse or compression.
The predictive value of the densitometric results for the presence of vertebral fractures was calculated and used as an estimate of fracture risk. While CT showed somewhat higher predictive values than DPA of the spine or combinations of DPA results from spine and femoral necks, the difference was not significant. It is concluded that with both CT and DPA the probability of the presence or absence of fracture can be raised to 75–80% when the probability prior to the investigation is 50% and when the threshold values of the measurements are chosen so that their sensitivity and specificity are about equal.
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Cann CE, Genant HK (1980) Precise measurement of vertebral mineral content using computed tomography. J Comput Assist Tomogr 4:493
Cann CE, Genant HK, Kolb, FO, Ettinger B (1985) Quantitative computed tomography for prediction of vertebral fracture risk. Bone 6:1
Genant HK, Cann CE, Boyd DP, Kolb FO, Ettinger B, Gordan GS (1983) Quantitative computed tomography for vertebral, mineral determination. In: Fram B, Potts JT Jr (eds) Clinical disorders of bone and mineral metabolism. Excerpta Medica, Amsterdam Oxford Princeton, p 40
Genant HK, Cann CE, Ettinger B, Gordan GS, Kolb FO, Reiser U, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (1984) Quantitative computed tomography for spinal mineral assessment. In: Christiansen C, Arnaud CD (eds) Osteoporosis. Proceedings of the Copenhagen International Symposium on Osteoporosis. Glostrup Hospital, Denmark, p 65
Genant HK, Powell MR, Cann CE, Stebler B, Rutt BK, Richardson ML, Kolb FO (1984) Comparison of methods for in vivo spinal mineral measurement. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proceedings of the Copenhagen International Symposium on Osteoporosis. Glostrup Hospital, Denmark, p 97
Isherwood I, Rutherford RA, Pullan BR, Adams PH (1976) Bone mineral estimation by computer-assisted transverse axial tomography. Lancet 2:712
Lavel-Jeantet M, Laval-Jeantet AM, Lamarque JL, Demoulin B (1979) Evaluation de la mineralisation osseuse vertebrale par tomographie computerisée. Etude experimentale. J Radiol 60:87
Kaplan FS, Katz M, Axel L, Haddad J, Fallon M, Simpson E, Dalinka M (1984) The clinical value of quantitative computed tomographic assessment of lumbar trabecular bone mineral density in the osteopenic patient. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proceedings of the Copenhagen International Symposium on Osteoporosis. Glostrup Hospital, Denmark, p 87
Krølner B, Pors Nielsen S (1980) Measurement of bone mineral content (BMC) of the lumbar spine I. Theory and application of a new two-dimensional dual photon attenuation method. Scand J Clin Lab Invest 40:653
Krølner B, Pors Nielsen S, Lund B, Lund BJ, Sørensen OH, Uhrenholdt A (1980) Measurement of bone mineral content (BMC) of the lumbar spine II. Correlation between forearm BMC and lumbar BMC. Scand J Clin Lab Invest 40:665
Krølner B, Pors Nielsen S (1982) Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci 62:329
Madsen M (1976) Vertebral and peripheral bone mineral content by photon absorptiometry. Invest Radiol 12:185
Mazess RB (1983) Errors in measuring trabecular bone by computed tomography due to marrow and bone composition. Calcif Tissue Int 35:148
Ott SM, Chesnut CH III, Hanson JA, Kilcoyne RF, Murano R, Lewellen ThK (1984) In: Christiansen C, Arnaud CB, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proceedings of the Copenhagen International Symposium on Osteoporosis. Glostrup Hospital, Denmark, p 93
Powell MR, Kolb FO, Genant HK, Cann CE, Stebler BG (1983). Comparison of dual photon absorptiometry and quantitative computed tomography of the lumbar spine in the same subjects. In: Frame B, Potts JT Jr (eds) Clinical disorders of bone and mineral metabolism. Excerpta Medica, Amsterdam Oxford Princeton, p 58
Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton JC III (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging. Relationship to spinal osteoporosis. J Clin Invest 67:328
Roos BW, Skoldhorn H (1974) Dual photon absorptiometry in lumbar vertebra. Acta Radiol (Stockh) 13:269
Schaadt O, Bohr H (1982) Bone mineral by dial photon absorptiometry. Accurcy-precision-sites of measurement. In: Dequeker J, Johnston CC Jr (eds) Non-invasive bone measurements: methodological problems. IRL Press, Oxford Washington DC
Wahner HW, Dunn WL, Offord KP, Riggs BL (1983) Dual photon absorptiometry: clinical considerations. In: Frame B, Potts JT Jr (eds) Clinical disorders of bone and mineral metabolism. Excerpta Medica, Amsterdam, Oxford Princeton, p 34
Wahner HW, Dunn WL, Riggs BL (1984) Assessment of bone mineral part 1. J Nucl Med 25:1134
Wahner HW, Dunn WL, Riggs BL (1984) Assessment of bone mineral part 2. J Nucl Med 25:1241
Wilson CR, Madsen M (1976) Dichromatic absorptiometry of vertebral bone mineral content. Invest Radiol 12:180
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Raymakers, J.A., Hoekstra, O., van Putten, J. et al. Fracture prevalence and bone mineral mass in osteoporosis measured with computed tomography and dual energy photon absorptiometry. Skeletal Radiol 15, 191–197 (1986). https://doi.org/10.1007/BF00354059
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DOI: https://doi.org/10.1007/BF00354059