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Low-dose CT identifies osteoporosis in cancer screenings

by John R. Fischer, Senior Reporter | November 09, 2020
CT X-Ray
Osteoporosis can be identified in low dose CT screenings for lung cancer and other conditions
Low-dose CT scans may help identify signs for osteoporosis more easily when used in screenings for cancer and other diseases.

That’s what researchers at the Peking University School of Medicine in China found while analyzing data from more than 69 thousand patients who underwent LDCT imaging for lung cancer. Osteoporosis was identified in patients who may otherwise have gone undiagnosed with the condition, according to lead researcher Dr. Wei Tian.

"Our large scale, multicenter study of bone density measured from routine LDCT scans demonstrated the great potential of using LDCT for the opportunistic screening of osteoporosis as an alternative to standard DXA (dual-energy X-ray absorptiometry) scans," said Tian, of the Chinese Academy of Engineering and the Peking University School of Medicine, in a statement. "Our study revealed the unexpectedly high prevalence of osteoporosis in men, which may impact the management strategy of men in the future."

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Tian and his colleagues applied thoracic LDCT to data from the China Biobank Study, a prospective, nationwide multicenter population cohort study registered with the U.S. clinical trials database, to retrospectively assess lumbar spine trabecular volumetric bone mineral density (BMD). The LDCT scans were assessed using quantitative CT software and the American College of Radiology QCT diagnostic criteria for osteoporosis.

The researchers identified osteoporosis in 69,095 patients who took part in the China Biobank Study between June 2018 and June 2019. Participants underwent low-dose chest CT as part of their analysis, with 40,733 men and 28,362 women showing signs of osteoporosis. Men had a mean age of 49±12.7 years and for women, 49.6±14.6 years. Chinese Census Data form 2010 was used for age-standardization. Investigators estimated the prevalence of osteoporosis from Chinese people, age 50 and over, to be 29% among women and 13.5% among men.

DXA diagnoses showed similar prevalence in diagnosis among women but half of that among men (6.46% vs 13.53%). The findings showed that transbecular volumetric BMD declined with age in both men and women, with women having a higher peak trabecular volumetric BMD than men (185.4 mg/cm3 vs 176.6 mg/cm3) between 30 and 34. This switched at age 80, with men having a higher density (92.1 mg/cm3 vs 62.4 mg/cm3).

“We show that LDCT-based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses,” wrote the authors.

The findings were published in the Journal of Bone and Mineral Research.

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