Conventional Computed Tomography Imaging and Bone Mineral Density: Opportunistic Screening or “Incidentaloporosis”? (2013)

Editorials16 April 2013Conventional Computed Tomography Imaging and Bone Mineral Density: Opportunistic Screening or “Incidentaloporosis”?Sumit R. Majumdar, MD, MPH and William D. Leslie, MD, MScSumit R. Majumdar, MD, MPHFrom University of Alberta, Edmonton, Alberta, and University of Manitoba, Winnipeg, Manitoba, Canada.Search for more papers by this author and William D. Leslie, MD, MScFrom University of Alberta, Edmonton, Alberta, and University of Manitoba, Winnipeg, Manitoba, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-8-201304160-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Osteoporosis is common, chronic, and costly and is associated with substantial morbidity, disability, and even death. It has a long preclinical phase, and its only clinical manifestation is fracture (1). Approved treatments can safely and cost-effectively reduce the risk for fracture by 35% to 50% (2). Thus, osteoporosis fulfills the basic requirements for successful screening (1).The U.S. Preventive Services Task Force recommends bone mineral density (BMD) testing with central dual energy x-ray absorptiometry (DXA) in women aged 65 years or older and younger persons whose fracture risk exceeds that of a 65-year-old white woman without additional risk factors (3). ...References1. Mazanec D. Osteoporosis screening: time to take responsibility [Editorial]. Arch Intern Med. 2004;164:1047-8. [PMID: 15159261] CrossrefMedlineGoogle Scholar2. MacLean C, Newberry S, Maglione M, McMahon M, Ranganath V, Suttorp M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148:197-213. [PMID: 18087050] LinkGoogle Scholar3. U.S. Preventive Services Task Force. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med. 2011;154:356-64. [PMID: 21242341] LinkGoogle Scholar4. Curtis JR, Carbone L, Cheng H, Hayes B, Laster A, Matthews R, et al. Longitudinal trends in use of bone mass measurement among older americans, 1999-2005. J Bone Miner Res. 2008;23:1061-7. [PMID: 18302495] CrossrefMedlineGoogle Scholar5. Majumdar SR, McAlister FA, Johnson JA, Bellerose D, Siminoski K, Hanley DA, et al. Interventions to increase osteoporosis treatment in patients with ‘incidentally’ detected vertebral fractures. Am J Med. 2012;125:929-36. [PMID: 22938928] CrossrefMedlineGoogle Scholar6. Pickhardt PJ, Pooler BD, Lauder T, Muñoz del Rio A, Bruce RJ, Binkley N. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med. 2013;158:588-95. LinkGoogle Scholar7. Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, et al; Osteoporotic Fractures Research Group. BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res. 2003;18:1947-54. [PMID: 14606506] CrossrefMedlineGoogle Scholar8. Lumbreras B, Donat L, Hernández-Aguado I. Incidental findings in imaging diagnostic tests: a systematic review. Br J Radiol. 2010;83:276-89. [PMID: 20335439] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sumit R. Majumdar, MD, MPH; William D. Leslie, MD, MScAffiliations: From University of Alberta, Edmonton, Alberta, and University of Manitoba, Winnipeg, Manitoba, Canada.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0443.Corresponding Author: Sumit R. Majumdar, MD, MPH, Department of Medicine, University of Alberta, 2F1.24 Walter Mackenzie Health Sciences Centre, 8440 112th Street, Edmonton, Alberta T6G 2B7, Canada; e-mail, majumdar@ualberta.ca.Current Author Addresses: Dr. Majumdar: Department of Medicine, University of Alberta, 2F1.24 Walter Mackenzie Health Sciences Centre, 8440 112th Street, Edmonton, Alberta T6G 2B7, Canada.Dr. Leslie: Department of Medicine (C5121), St. Boniface General Hospital, 409 Tache Avenue, Winnepeg, Manitoba R2H 2A6, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpportunistic Screening for Osteoporosis Using Abdominal Computed Tomography Scans Obtained for Other Indications Perry J. Pickhardt , B. Dustin Pooler , Travis Lauder , Alejandro Muñoz del Rio , Richard J. Bruce , and Neil Binkley Metrics Cited byLow vertebral CT Hounsfield units: a risk factor for new osteoporotic vertebral fractures after the treatment of percutaneous kyphoplastyHounsfield unit measurement method and related factors that most appropriately reflect bone mineral density on cervical spine computed tomographySupport vector machines are superior to principal components analysis for selecting the optimal bones’ CT attenuations for opportunistic screening for osteoporosis using CT scans of the foot or ankleUtilizing machine learning for opportunistic screening for low BMD using CT scans of the cervical spineCorrelation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXAOpportunistic CT screening of osteoporosis on thoracic and lumbar spine: a meta-analysisCharacterizing Bone Mineral Density Using Lumbar Spine Computed Tomography Attenuation in Patients With Distal Radius FracturesOpportunistic Screening for Osteoporosis Using Body CT Scans Obtained for Other Indications: the UW ExperienceSacral bone mineral density (BMD) assessment using opportunistic CT scansScattered image artifacts from cone beam computed tomography and its clinical potential in bone mineral density estimationComparison between the MDCT and the DXA scanners in the evaluation of BMD in the lumbar spine densitometryHyoid bone fusion and bone density across the lifespan: prediction of age and sexFEA to Measure Bone Strength: A ReviewUse of routine thoracic and abdominal computed tomography scans for assessing bone mineral density and detecting osteoporosisOpportunistic screening for osteoporosis on routine computed tomography? An external validation studyClinical Use of Quantitative Computed Tomography–Based Advanced Techniques in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions—Part IIIOsteoporosis in acute fractures of the cervical spine: the role of opportunistic CT screeningAssessing Bone Mineral Density Following Acute Hip FracturesOpportunistic Computed Tomography Screening Shows a High Incidence of Osteoporosis in Ankylosing Spondylitis Patients With Acute Vertebral FracturesThe Use of Computed Tomography Attenuation to Evaluate Osteoporosis Following Acute Fractures of the Thoracic and Lumbar Vertebra 16 April 2013Volume 158, Issue 8Page: 630-631KeywordsBoneBone mineral densityComputed axial tomographyDual energy x ray absorptiometryOsteoporosisRadiologistsRisk managementSpecificitySpineThorax ePublished: 16 April 2013 Issue Published: 16 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...