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Feasibility of opportunistic osteoporosis screening in routine contrast-enhanced multi detector computed tomography (MDCT) using texture analysis



This study investigated the feasibility of opportunistic osteoporosis screening in routine contrast-enhanced MDCT exams using texture analysis. The results showed an acceptable reproducibility of texture features, and these features could discriminate healthy/osteoporotic fracture cohort with an accuracy of 83%.


This aim of this study is to investigate the feasibility of opportunistic osteoporosis screening in routine contrast-enhanced MDCT exams using texture analysis.


We performed texture analysis at the spine in routine MDCT exams and investigated the effect of intravenous contrast medium (IVCM) (n = 7), slice thickness (n = 7), the long-term reproducibility (n = 9), and the ability to differentiate healthy/osteoporotic fracture cohort (n = 9 age and gender matched pairs). Eight texture features were extracted using gray level co-occurrence matrix (GLCM). The independent sample t test was used to rank the features of healthy/fracture cohort and classification was performed using support vector machine (SVM).


The results revealed significant correlations between texture parameters derived from MDCT scans with and without IVCM (r up to 0.91) slice thickness of 1 mm versus 2 and 3 mm (r up to 0.96) and scan-rescan (r up to 0.59). The performance of the SVM classifier was evaluated using 10-fold cross-validation and revealed an average classification accuracy of 83%.


Opportunistic osteoporosis screening at the spine using specific texture parameters (energy, entropy, and homogeneity) and SVM can be performed in routine contrast-enhanced MDCT exams.

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This work was supported by the Deutsche Forschungsgemeinschaft DFG BA 4906/2-1 (Thomas Baum) and Singapore University of Technology and Design (SUTD) Start-up Research Grant SRG EPD 2015 093 (Karupppasamy Subburaj). The funding agencies had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

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Correspondence to K. Subburaj.

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Mookiah, M.R.K., Rohrmeier, A., Dieckmeyer, M. et al. Feasibility of opportunistic osteoporosis screening in routine contrast-enhanced multi detector computed tomography (MDCT) using texture analysis. Osteoporos Int 29, 825–835 (2018).

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  • Opportunistic osteoporosis screening
  • Spine
  • Texture analysis
  • Trabecular bone microstructure