Multi-center validation of automated CT-based L1 vertebral Hounsfield unit
Authors' conclusion
For opportunistic CT screening and diagnosis, automated assessment of L1 trabecular attenuation was generalizable in a multi-center setting.
Study context
- Population
- Adults undergoing abdominal CT for any indication at five US medical systems; exclusions: IV contrast, non-120 kVp setting, non-physiologic outliers51.1% women, 79.6% White
- Participants
- 123,001 adults
- Outcome
- Variability of automated L1 trabecular attenuation (HU) among five medical systems; 100 HU threshold for opportunistic osteoporosis screening
Methodological detailsfive US medical systems, fully automated AI pipeline, age and sex matching
- Five US medical systems
- Fully automated AI pipeline
- Age and sex matching
Performance
As reported in the abstract
- White women age 50+, ≤ 100 HU
- 15%
- White women age 50+, ≤ 120 HU
- 30%
- White men, ≤ 100 HU
- 12%
- White men, ≤ 120 HU
- 26%
- Black women, ≤ 100 HU
- 7%
- Black women, ≤ 120 HU
- 17%
- Black men, ≤ 100 HU
- 5%
- Black men, ≤ 120 HU
- 11%
- 20-49-year-olds below 100 HU threshold
- about 1%
Original publication
Multi-center validation of automated CT-based L1 vertebral Hounsfield unit. Osteoporos Int. Published 5 September 2026. doi:10.
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