Prospective validation of a rapid CT-based bone mineral density screening method using colored spinal images
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Prospective validation of a rapid CT‑based bone mineral density screening method using colored spinal images Elliot Varney1 · Asser Abou Elkassem2 · Majid Khan3 · Ellen Parker1 · Todd Nichols1 · David Joyner1 · Seth T. Lirette4 · Candace Howard‑Claudio1 · Andrew D. Smith2 Received: 19 July 2020 / Revised: 18 September 2020 / Accepted: 27 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To prospectively validate a method to accurately and rapidly differentiate normal from abnormal spinal bone mineral density (BMD) using colored abdominal CT images. Methods For this prospective observational study, 196 asymptomatic women ≥ 50 years of age presenting for screening mammograms underwent routine nonenhanced CT imaging of the abdomen. The CT images were processed with software designed to generate sagittal colored images with green vertebral trabecular bone indicating normal BMD and red indicating abnormal BMD (low BMD or osteoporosis). Four radiologists evaluated L1/L2 BMD on sagittal images using visual assessment of grayscale images, quantitative measurements of mean vertebral attenuation, and visual assessment of colored images. Mean BMD values at L1/L2 using quantitative CT with a phantom served as the reference standard. The average accuracy and time of interpretation were calculated. Inter-observer agreement was assessed using intraclass correlation coefficient (ICC). Results Mean attenuation at L1/L2 was highly correlated with mean BMD (r = 0.96/0.91, p
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