Feasibility of Simultaneous Computed Tomographic Colonography and Fully Automated Bone Mineral Densitometry in a Single Examination

Purpose: To show the feasibility of calculating the bone mineral density (BMD) from computed tomographic colonography (CTC) scans using fully automated software. Materials and Methods: Automated BMD measurement software was developed that measures the BMD of the first and second lumbar vertebrae on computed tomography and calculates the mean of the 2 values to provide a per patient BMD estimate. The software was validated in a reference population of 17 consecutive women who underwent quantitative computed tomography and in a population of 475 women from a consecutive series of asymptomatic patients enrolled in a CTC screening trial conducted at 3 medical centers. Results: The mean (SD) BMD was 133.6 (34.6) mg/mL (95% confidence interval, 130.5-136.7; n = 475). In women aged 42 to 60 years (n = 316) and 61 to 79 years (n = 159), the mean (SD) BMDs were 143.1 (33.5) and 114.7 (28.3) mg/mL, respectively (P < 0.0001). Fully automated BMD measurements were reproducible for a given patient with 95% limits of agreement of −9.79 to 8.46 mg/mL for the mean difference between paired assessments on supine and prone CTC. Conclusions: Osteoporosis screening can be performed simultaneously with screening for colorectal polyps.

[1]  Ronald M. Summers,et al.  Automated spinal column extraction and partitioning , 2006, 3rd IEEE International Symposium on Biomedical Imaging: Nano to Macro, 2006..

[2]  Gabriele Armbrecht,et al.  Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: the 2007 ISCD Official Positions. , 2008, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[3]  A. Graser,et al.  Effect of computer-aided detection as a second reader in multidetector-row CT colonography , 2007, European Radiology.

[4]  P. Pickhardt,et al.  Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. , 2003, The New England journal of medicine.

[5]  A. Zauber,et al.  The National Polyp Study , 1990 .

[6]  G A Colditz,et al.  Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in Men , 1995, Annals of Internal Medicine.

[7]  David J. Goodenough,et al.  Precise measurement of vertebral bone density using computed tomography without the use of an external reference phantom , 1989, Journal of Digital Imaging.

[8]  D. Felsenberg,et al.  [Bone densitometry by dual energy methods]. , 1999, Der Radiologe.

[9]  J. Compston,et al.  Assessment of fracture risk and its application to screening for postmenopausal osteoporosis (WHO Technical Report Series No 843) , 1995 .

[10]  M. Karagas,et al.  Effect of calcium supplementation on the risk of large bowel polyps. , 2004, Journal of the National Cancer Institute.

[11]  N. Petrick,et al.  CT colonography with computer-aided detection as a second reader: observer performance study. , 2008, Radiology.

[12]  Ronald M Summers,et al.  Current status of CT colonography. , 2006, Academic radiology.

[13]  A. Kielar,et al.  Low-dose computed tomographic colonography versus optical colonoscopy: a critically appraised topic. , 2009, Seminars in roentgenology.

[14]  Stuart A. Taylor,et al.  Computed tomographic colonography: assessment of radiologist performance with and without computer-aided detection. , 2006, Gastroenterology.

[15]  Judith E. Adams,et al.  Quantitative computed tomography. , 2009, European journal of radiology.

[16]  T. Harris,et al.  Prevalence and trends in low femur bone density among older US adults: NHANES 2005–2006 compared with NHANES III , 2010, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[17]  S. Majumdar,et al.  Osteoporosis imaging. , 2003, Radiologic clinics of North America.

[18]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[19]  D. G. Altman,et al.  REGRESSION ANALYSIS , 1986, The Lancet.

[20]  M S Calvo,et al.  Prevalence of Low Femoral Bone Density in Older U.S. Adults from NHANES III , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[21]  H. Venema,et al.  Radiation dose in CT colonography–trends in time and differences between daily practice and screening protocols , 2008, European Radiology.

[22]  Judy Yee,et al.  Comparison of supine and prone scanning separately and in combination at CT colonography. , 2003, Radiology.

[23]  D. Felsenberg,et al.  Knochendichtemessung mit Zwei-Spektren-Methoden , 1999, Der Radiologe.

[24]  S. Wacholder,et al.  Risk factors for colorectal cancer in a prospective study among U.S. white men , 1998, International journal of cancer.

[25]  J. Aloia,et al.  Prevention of involutional bone loss by exercise. , 1978, Annals of internal medicine.

[26]  Timothy R Church,et al.  Vitamin D, calcium supplementation, and colorectal adenomas: results of a randomized trial. , 2003, Journal of the National Cancer Institute.

[27]  A. Zauber,et al.  The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. , 1990, Gastroenterology.

[28]  K. Strauss,et al.  The Image Gently campaign: working together to change practice. , 2008, AJR. American journal of roentgenology.

[29]  Sharmila Majumdar,et al.  Volumetric quantitative CT of the spine and hip derived from contrast-enhanced MDCT: conversion factors. , 2007, AJR. American journal of roentgenology.

[30]  André Mastmeyer,et al.  A hierarchical 3D segmentation method and the definition of vertebral body coordinate systems for QCT of the lumbar spine , 2006, Medical Image Anal..

[31]  C C Glüer,et al.  Spinal bone mineral density measured with quantitative CT: effect of region of interest, vertebral level, and technique. , 1990, Radiology.

[32]  D. Goodenough,et al.  Vertebral bone density in icelandic women using quantitative computed tomography without an external reference phantom , 1993, Osteoporosis International.

[33]  W. Willett,et al.  Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. , 2004, Journal of the National Cancer Institute.

[34]  A. Karantanas,et al.  Quantitative computed tomography for bone mineral measurement: technical aspects, dosimetry, normal data and clinical applications. , 1991, The British journal of radiology.

[35]  J. Yee,et al.  Accuracy of ct colonography for detection of large adenomas and cancers , 2009 .

[36]  G. Beck,et al.  Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study Group. , 1999, The New England journal of medicine.