Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India

Background: Early identification of reduced bone mineral density (BMD) and providing appropriate measures depending on BMD values, lead to early prevention and treatment of osteoporosis-related complications effectively. Quantification of osteoporosis can also be done by quantitative computed tomogr...

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Main Authors: Hemanth Kumar Deevi, Sanjay Kini B, Manjula A, Prakashini Koteshwara
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical Epidemiology and Global Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213398425001198
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author Hemanth Kumar Deevi
Sanjay Kini B
Manjula A
Prakashini Koteshwara
author_facet Hemanth Kumar Deevi
Sanjay Kini B
Manjula A
Prakashini Koteshwara
author_sort Hemanth Kumar Deevi
collection DOAJ
description Background: Early identification of reduced bone mineral density (BMD) and providing appropriate measures depending on BMD values, lead to early prevention and treatment of osteoporosis-related complications effectively. Quantification of osteoporosis can also be done by quantitative computed tomography (qCT). The present study was conducted to derive a reference standard BMD using phantomless qCT software for our local population of South India. Methods: A hospital-based cross-sectional study was conducted among patients >20 years of age who were undergoing a CT study which included T12, L1 & L2 vertebrae and were free of obvious bone pathology. The axial CT series was used to calculate the BMD. Using the average BMD, we obtained from the patients in the age group of 20–39 years, an average and a standard deviation were calculated. Later we recalculated the T scores for patients across all age groups using cross-tabulations to identify how many people were under the osteoporosis group in each of the standards [US standards ie; the University of California, San Francisco (UCSF) standards, World Health Organization (WHO) standards and locally derived standards). Results: The mean BMD for the age group of 20–39 years were obtained for both males and females as 149.4 mg/cc2 and 152.5 mg/cc2 respectively. Based on the bone attenuation in CT we found that attenuation >120 Hounsfield units (HU) did not have any osteoporosis and attenuation >200 HU did not have any osteopenia according to our reference standards. Similarly, when we considered the values of UCSF standards we found that attenuation >180 HU did not have any osteoporosis and attenuation >240 HU did not have any osteopenia whereas according to WHO standards attenuation >130 HU did not have any osteoporosis and attenuation >210 HU did not have any osteopenia. Conclusion: Given the enormous patient volume of body CT scanning currently performed in older adults for a wide variety of clinical indications, this represents a unique opportunity to expand osteoporosis screening.
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spelling doaj-art-da1ea895e4964205acace1b30ade9a992025-08-20T03:35:33ZengElsevierClinical Epidemiology and Global Health2213-39842025-07-013410203010.1016/j.cegh.2025.102030Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south IndiaHemanth Kumar Deevi0Sanjay Kini B1Manjula A2Prakashini Koteshwara3Department of Radiodiagnosis and Imaging, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Community Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Community Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Radiodiagnosis and Imaging, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Corresponding author.Background: Early identification of reduced bone mineral density (BMD) and providing appropriate measures depending on BMD values, lead to early prevention and treatment of osteoporosis-related complications effectively. Quantification of osteoporosis can also be done by quantitative computed tomography (qCT). The present study was conducted to derive a reference standard BMD using phantomless qCT software for our local population of South India. Methods: A hospital-based cross-sectional study was conducted among patients >20 years of age who were undergoing a CT study which included T12, L1 & L2 vertebrae and were free of obvious bone pathology. The axial CT series was used to calculate the BMD. Using the average BMD, we obtained from the patients in the age group of 20–39 years, an average and a standard deviation were calculated. Later we recalculated the T scores for patients across all age groups using cross-tabulations to identify how many people were under the osteoporosis group in each of the standards [US standards ie; the University of California, San Francisco (UCSF) standards, World Health Organization (WHO) standards and locally derived standards). Results: The mean BMD for the age group of 20–39 years were obtained for both males and females as 149.4 mg/cc2 and 152.5 mg/cc2 respectively. Based on the bone attenuation in CT we found that attenuation >120 Hounsfield units (HU) did not have any osteoporosis and attenuation >200 HU did not have any osteopenia according to our reference standards. Similarly, when we considered the values of UCSF standards we found that attenuation >180 HU did not have any osteoporosis and attenuation >240 HU did not have any osteopenia whereas according to WHO standards attenuation >130 HU did not have any osteoporosis and attenuation >210 HU did not have any osteopenia. Conclusion: Given the enormous patient volume of body CT scanning currently performed in older adults for a wide variety of clinical indications, this represents a unique opportunity to expand osteoporosis screening.http://www.sciencedirect.com/science/article/pii/S2213398425001198Quantitative computed tomographybone mineral densityOsteoporosis
spellingShingle Hemanth Kumar Deevi
Sanjay Kini B
Manjula A
Prakashini Koteshwara
Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
Clinical Epidemiology and Global Health
Quantitative computed tomography
bone mineral density
Osteoporosis
title Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
title_full Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
title_fullStr Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
title_full_unstemmed Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
title_short Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India
title_sort comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis standards insights from south india
topic Quantitative computed tomography
bone mineral density
Osteoporosis
url http://www.sciencedirect.com/science/article/pii/S2213398425001198
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