AI-derived opportunistic screening using chest radiographs identifies age- and sex-associated bone mineral density patterns and supports earlier osteoporosis evaluation
Authors' conclusion
AI-derived opportunistic screening using chest radiographs identified marked age- and sex-associated differences in skeletal status, particularly among women in the early postmenopausal age range.
Study context
- Population
- Adults aged ≥ 50 years who underwent chest radiographs with AI-derived lumbar spine bone mineral density (BMD) estimationvalidation subset n = 446
- Participants
- 6,028 adults
- Exposure
- Women vs men; 5-year age cohorts
- Outcome
- Age- and sex-associated differences in AI-derived T-scores and osteoporosis prevalence
Methodological detailsAI-derived opportunistic screening, deep learning model, internal validation subset vs DXA
- AI-derived opportunistic screening
- Deep learning model
- Internal validation subset vs DXA
Main finding
As reported in the abstract
AI-derived T-score
Women
- 2.15
mean · SD 0.97
Men
- 1.19
mean · SD 0.96
P < 0.001
- Mean AI-derived T-score, all participants
- - 1.64 ± 1.08
Observational data: associations, not effects.
Further findings
Independent association of female sex with osteoporosis
| OR (95% CI) | ||
|---|---|---|
| Female sex | 7.04 (5.22–9.50) | |
| 0.10.31310Odds ratio (log scale) |
Osteoporosis prevalence by age, women
- Ages 50-54
- 10.3%
- ≥ 80
- 67.0%
Osteoporosis prevalence by age, men
- Ages 50-54
- 5.0%
- ≥ 80
- 24.6%
Correlation of AI-derived T-scores with DXA T-scores (validation subset, n = 446)
- Lumbar spine DXA (strong)
- r = 0.859
- Total hip (moderate-to-strong)
- r = 0.730
- Femoral neck (moderate-to-strong)
- r = 0.635
- All P < 0.001
Original publication
AI-derived opportunistic screening using chest radiographs identifies age- and sex-associated bone mineral density patterns and supports earlier osteoporosis evaluation. Osteoporos Int. Published 14 August 2026. doi:10.
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