Opportunistic Osteoporosis Screening Using CT-Derived Volumetric Bone Mineral Density Reference Curves
Authors' conclusion
These findings indicate that CT-derived vBMD percentile thresholds offer clinically meaningful cut-points for opportunistic screening and support their use as a diagnostic flag for further evaluation.
Study context
- Population
- Clinical computed tomography (CT) scans with linked administrative health data; a subset with corresponding DXA imaging within one yearclinical CT scans analyzed, 2,368 males and 2,050 females · subset with corresponding DXA imaging within one year 1,088 · males 2,368 · females 2,050
- Participants
- 4,418 scans
- Outcome
- Fracture cases with vertebral body volumetric bone mineral density (vBMD) below the CT-defined osteoporosis threshold
Main finding
As reported in the abstract
Female fracture cases below threshold
66.3%
n=67
Male fracture cases below threshold
41.9%
n=26
Observational data: associations, not effects.
Further findings
Fracture cases below the CT threshold who had not undergone DXA screening
- Among female fracture cases below threshold, had not undergone DXA screening
- 44.8% (n=30)
- Among male fracture cases below threshold, had not undergone DXA screening
- 76.9% (n=20)
Risk of major osteoporotic fracture (MOF) with CT-defined osteoporosis
- Individuals classified as osteoporotic based on CT-derived thresholds had up to 2.86 times higher risk of sustaining an MOF across all vertebral sites in both sexes
- 2.86
- Cox proportional hazards models
Original publication
Opportunistic Osteoporosis Screening Using CT-Derived Volumetric Bone Mineral Density Reference Curves. J Bone Miner Res. Published 8 November 2026. doi:10.
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