Computed tomography (CT) image-based biomarkers for opportunistic screening of osteoporotic fractures: a systematic review and meta-analysis
Authors' conclusion
Compared to areal BMD, volumetric BMD and FE-derived parameters may provide a significant improvement in the discrimination of osteoporotic fractures using opportunistic CT assessments.
Study context
- Population
- Studies of image-based biomarkers from existing clinical routine CT scans for hip, vertebral and major osteoporotic fracture prediction; searched until July 202361 studies
- Comparison
- CT image-based biomarkers (finite element (FE)-derived, volumetric bone mineral density (BMD), image attenuation) vs areal BMD for osteoporotic fracture prediction
- Outcome
- AUC with 95% CI for discrimination of osteoporotic fractures
Methodological detailsrandom effects models, modified QUADAS-2 quality assessment
- Random effects models
- Modified QUADAS-2 quality assessment
Pooled result
As reported in the abstract
Pooled AUC for predicting osteoporotic fractures
| Group | Value | AUC |
|---|---|---|
| Areal BMD | 0.73 (95% CI 0.71–0.75) | 0.73 |
| FE-derived | 0.77 (95% CI 0.72–0.81) | 0.77 |
| Volumetric BMD | 0.76 (95% CI 0.71–0.81) | 0.76 |
| Image attenuation | 0.73 (95% CI 0.66–0.79) | 0.73 |
Value
Areal BMD0.73 (95% CI 0.71–0.75)
FE-derived0.77 (95% CI 0.72–0.81)
Volumetric BMD0.76 (95% CI 0.71–0.81)
Image attenuation0.73 (95% CI 0.66–0.79)
AUC
Areal BMD0.73
FE-derived0.77
Volumetric BMD0.76
Image attenuation0.73
- FE-derived vs Areal BMD: P < 0.01 — significantly higher
- Volumetric BMD vs Areal BMD: P < 0.01 — significantly higher
- Image attenuation vs Areal BMD: P = 0.93 — no significant difference
Original publication
CT image-based biomarkers for opportunistic screening of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. Published 14 February 2024. doi:10.
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