Opportunistic screening of osteoporosis by CT scan compared to DXA: A systematic review and meta-analysis
The efficacy of opportunistic osteoporosis screening with computed tomography (CT) scans obtained for other indications has not yet been implemented by the current guidelines. We aimed to compile available evidence on the efficacy of osteoporosis screening with CT scans obtained for other indication...
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| Veröffentlicht in: | Clinical imaging 2025-02, Vol.118, p.110372, Article 110372 |
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| creator | Mousavi, Seyedeh Zahra Moshfeghinia, Reza Molavi Vardanjani, Hossein Sasani, Mohammad Reza |
| description | The efficacy of opportunistic osteoporosis screening with computed tomography (CT) scans obtained for other indications has not yet been implemented by the current guidelines. We aimed to compile available evidence on the efficacy of osteoporosis screening with CT scans obtained for other indications compared with dual X-ray absorptiometry (DXA).
Studies comparing the diagnostic performance of the CT scan with the DXA published before 2023 were retrieved. We conducted a bias assessment using the Newcastle-Ottawa Scale for cross-sectional studies. Correlation coefficients (CC), area under the curve (AUC), sensitivity, and specificity of the CT scans compared with the DXA were meta-analyzed with random effects modeling. 41 studies fulfilled the inclusion/exclusion criteria. The included studies reported weak to very strong CC (0.35 to 0.95) and low to high accuracy for opportunistic osteoporosis screening with CT scans. The meta-analysis showed a moderate pooled CC of 0.59 (95 % CI: 0.53–0.64, P-value |
| doi_str_mv | 10.1016/j.clinimag.2024.110372 |
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Studies comparing the diagnostic performance of the CT scan with the DXA published before 2023 were retrieved. We conducted a bias assessment using the Newcastle-Ottawa Scale for cross-sectional studies. Correlation coefficients (CC), area under the curve (AUC), sensitivity, and specificity of the CT scans compared with the DXA were meta-analyzed with random effects modeling. 41 studies fulfilled the inclusion/exclusion criteria. The included studies reported weak to very strong CC (0.35 to 0.95) and low to high accuracy for opportunistic osteoporosis screening with CT scans. The meta-analysis showed a moderate pooled CC of 0.59 (95 % CI: 0.53–0.64, P-value<0.001), and a relatively high AUC of 0.81 (95 % CI: 0.78–0.84, P-value<0.001). Subgroup analysis based on age and menopausal status did not show significant between-group differences. Significantly higher accuracy measures were estimated for CT scans of the proximal femur compared to other anatomic regions (CC: 0.70, 95 % CI: 0.57–0.82; AUC: 0.79, 95 % CI: 0.72–0.87), North American cases (CC: 0.66, 95 % CI: 0.52–0.80; AUC: 0.82, 95 % CI: 0.82–0.83), and populations with a higher percentage of women (CC: 0.60, 95 % CI: 0.52–0.69; AUC: 0.86, 95 % CI: 0.83–0.89). We observed a moderate performance of opportunistic osteoporosis screening with CT scans obtained for other indications.
•Scant studies have reviewed opportunistic osteoporosis screening via CT scans.•Weak to very strong correlations and low to high accuracies were found for CT scans.•Pooled correlation and AUC of 0.59 and 0.81 were seen for CT scans in meta-analysis.•CT scans of the femur showed higher accuracies compared to other anatomic regions.•North American cases and populations with more women showed higher results.</description><identifier>ISSN: 0899-7071</identifier><identifier>ISSN: 1873-4499</identifier><identifier>EISSN: 1873-4499</identifier><identifier>DOI: 10.1016/j.clinimag.2024.110372</identifier><identifier>PMID: 39615271</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>CT scan ; Dual X-ray absorptiometry ; Opportunistic screening ; Osteoporosis</subject><ispartof>Clinical imaging, 2025-02, Vol.118, p.110372, Article 110372</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c245t-bfc74543b2ae76ec16836775b190de4f1b996d34ecb73244d67a1ba9f82ef25d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clinimag.2024.110372$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39615271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mousavi, Seyedeh Zahra</creatorcontrib><creatorcontrib>Moshfeghinia, Reza</creatorcontrib><creatorcontrib>Molavi Vardanjani, Hossein</creatorcontrib><creatorcontrib>Sasani, Mohammad Reza</creatorcontrib><title>Opportunistic screening of osteoporosis by CT scan compared to DXA: A systematic review and meta-analysis</title><title>Clinical imaging</title><addtitle>Clin Imaging</addtitle><description>The efficacy of opportunistic osteoporosis screening with computed tomography (CT) scans obtained for other indications has not yet been implemented by the current guidelines. We aimed to compile available evidence on the efficacy of osteoporosis screening with CT scans obtained for other indications compared with dual X-ray absorptiometry (DXA).
Studies comparing the diagnostic performance of the CT scan with the DXA published before 2023 were retrieved. We conducted a bias assessment using the Newcastle-Ottawa Scale for cross-sectional studies. Correlation coefficients (CC), area under the curve (AUC), sensitivity, and specificity of the CT scans compared with the DXA were meta-analyzed with random effects modeling. 41 studies fulfilled the inclusion/exclusion criteria. The included studies reported weak to very strong CC (0.35 to 0.95) and low to high accuracy for opportunistic osteoporosis screening with CT scans. The meta-analysis showed a moderate pooled CC of 0.59 (95 % CI: 0.53–0.64, P-value<0.001), and a relatively high AUC of 0.81 (95 % CI: 0.78–0.84, P-value<0.001). Subgroup analysis based on age and menopausal status did not show significant between-group differences. Significantly higher accuracy measures were estimated for CT scans of the proximal femur compared to other anatomic regions (CC: 0.70, 95 % CI: 0.57–0.82; AUC: 0.79, 95 % CI: 0.72–0.87), North American cases (CC: 0.66, 95 % CI: 0.52–0.80; AUC: 0.82, 95 % CI: 0.82–0.83), and populations with a higher percentage of women (CC: 0.60, 95 % CI: 0.52–0.69; AUC: 0.86, 95 % CI: 0.83–0.89). We observed a moderate performance of opportunistic osteoporosis screening with CT scans obtained for other indications.
•Scant studies have reviewed opportunistic osteoporosis screening via CT scans.•Weak to very strong correlations and low to high accuracies were found for CT scans.•Pooled correlation and AUC of 0.59 and 0.81 were seen for CT scans in meta-analysis.•CT scans of the femur showed higher accuracies compared to other anatomic regions.•North American cases and populations with more women showed higher results.</description><subject>CT scan</subject><subject>Dual X-ray absorptiometry</subject><subject>Opportunistic screening</subject><subject>Osteoporosis</subject><issn>0899-7071</issn><issn>1873-4499</issn><issn>1873-4499</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNqFkMtu2zAQRYmgQew6-YWAy27k8iVRzKqG0xdgwJsEyI6gyFFAQyJVUm7hvy8NJ912NYs59w7mIHRPyZoS2nw-rO3ggx_N65oRJtaUEi7ZFVrSVvJKCKU-oCVplaokkXSBPuZ8ICWohLxBC64aWjNJl8jvpymm-Rh8nr3F2SaA4MMrjj2OeYZYtjH7jLsT3j6VvQnYxnEyCRyeI3582TzgDc6nwo7mXJHgt4c_2ASHR5hNZYIZTqXhFl33Zshw9zZX6Pnb16ftj2q3__5zu9lVlol6rrreSlEL3jEDsgFLm5Y3UtYdVcSB6GmnVOO4ANtJzoRwjTS0M6pvGfSsdnyFPl16pxR_HSHPevTZwjCYAPGYNaeCtG1LpShoc0Ft-TEn6PWUitJ00pTos2Z90O-a9Vmzvmguwfu3G8duBPcv9u61AF8uAJRPi4-ks_UQLDifwM7aRf-_G38BCr2SoA</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Mousavi, Seyedeh Zahra</creator><creator>Moshfeghinia, Reza</creator><creator>Molavi Vardanjani, Hossein</creator><creator>Sasani, Mohammad Reza</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20250201</creationdate><title>Opportunistic screening of osteoporosis by CT scan compared to DXA: A systematic review and meta-analysis</title><author>Mousavi, Seyedeh Zahra ; Moshfeghinia, Reza ; Molavi Vardanjani, Hossein ; Sasani, Mohammad Reza</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c245t-bfc74543b2ae76ec16836775b190de4f1b996d34ecb73244d67a1ba9f82ef25d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>CT scan</topic><topic>Dual X-ray absorptiometry</topic><topic>Opportunistic screening</topic><topic>Osteoporosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mousavi, Seyedeh Zahra</creatorcontrib><creatorcontrib>Moshfeghinia, Reza</creatorcontrib><creatorcontrib>Molavi Vardanjani, Hossein</creatorcontrib><creatorcontrib>Sasani, Mohammad Reza</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mousavi, Seyedeh Zahra</au><au>Moshfeghinia, Reza</au><au>Molavi Vardanjani, Hossein</au><au>Sasani, Mohammad Reza</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Opportunistic screening of osteoporosis by CT scan compared to DXA: A systematic review and meta-analysis</atitle><jtitle>Clinical imaging</jtitle><addtitle>Clin Imaging</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>118</volume><spage>110372</spage><pages>110372-</pages><artnum>110372</artnum><issn>0899-7071</issn><issn>1873-4499</issn><eissn>1873-4499</eissn><abstract>The efficacy of opportunistic osteoporosis screening with computed tomography (CT) scans obtained for other indications has not yet been implemented by the current guidelines. We aimed to compile available evidence on the efficacy of osteoporosis screening with CT scans obtained for other indications compared with dual X-ray absorptiometry (DXA).
Studies comparing the diagnostic performance of the CT scan with the DXA published before 2023 were retrieved. We conducted a bias assessment using the Newcastle-Ottawa Scale for cross-sectional studies. Correlation coefficients (CC), area under the curve (AUC), sensitivity, and specificity of the CT scans compared with the DXA were meta-analyzed with random effects modeling. 41 studies fulfilled the inclusion/exclusion criteria. The included studies reported weak to very strong CC (0.35 to 0.95) and low to high accuracy for opportunistic osteoporosis screening with CT scans. The meta-analysis showed a moderate pooled CC of 0.59 (95 % CI: 0.53–0.64, P-value<0.001), and a relatively high AUC of 0.81 (95 % CI: 0.78–0.84, P-value<0.001). Subgroup analysis based on age and menopausal status did not show significant between-group differences. Significantly higher accuracy measures were estimated for CT scans of the proximal femur compared to other anatomic regions (CC: 0.70, 95 % CI: 0.57–0.82; AUC: 0.79, 95 % CI: 0.72–0.87), North American cases (CC: 0.66, 95 % CI: 0.52–0.80; AUC: 0.82, 95 % CI: 0.82–0.83), and populations with a higher percentage of women (CC: 0.60, 95 % CI: 0.52–0.69; AUC: 0.86, 95 % CI: 0.83–0.89). We observed a moderate performance of opportunistic osteoporosis screening with CT scans obtained for other indications.
•Scant studies have reviewed opportunistic osteoporosis screening via CT scans.•Weak to very strong correlations and low to high accuracies were found for CT scans.•Pooled correlation and AUC of 0.59 and 0.81 were seen for CT scans in meta-analysis.•CT scans of the femur showed higher accuracies compared to other anatomic regions.•North American cases and populations with more women showed higher results.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39615271</pmid><doi>10.1016/j.clinimag.2024.110372</doi></addata></record> |
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| subjects | CT scan Dual X-ray absorptiometry Opportunistic screening Osteoporosis |
| title | Opportunistic screening of osteoporosis by CT scan compared to DXA: A systematic review and meta-analysis |
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