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Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography

BACKGROUND: The proximal humerus is a common site of osteoporotic fractures, and bone quality is a predictor of surgical reduction quality. Dual-energy computed tomography (DECT) is assuming an increasingly important role in the quantification of bone mineral density (BMD) due it is ability to perfo...

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Autores principales: Yu, Qinqin, Yang, Jia, Zhou, Chenwei, Xu, Zhihan, Liu, Chao, Luo, Qian, Zhang, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498250/
https://www.ncbi.nlm.nih.gov/pubmed/37711831
http://dx.doi.org/10.21037/qims-22-927
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author Yu, Qinqin
Yang, Jia
Zhou, Chenwei
Xu, Zhihan
Liu, Chao
Luo, Qian
Zhang, Lei
author_facet Yu, Qinqin
Yang, Jia
Zhou, Chenwei
Xu, Zhihan
Liu, Chao
Luo, Qian
Zhang, Lei
author_sort Yu, Qinqin
collection PubMed
description BACKGROUND: The proximal humerus is a common site of osteoporotic fractures, and bone quality is a predictor of surgical reduction quality. Dual-energy computed tomography (DECT) is assuming an increasingly important role in the quantification of bone mineral density (BMD) due it is ability to perform three-material decomposition. We aimed to analyze the bone quality and distribution of the proximal humerus with DECT quantitatively. METHODS: Sixty-five consecutive patients (average age 49.5±15.2 years; male: female ratio 32:33) without proximal humerus fractures who had undergone DECT were retrospectively selected. The humeral head was divided into 4 regions on a cross section in the medial plane between the greater tuberosity and the surgical neck. The quantitative parameters, including virtual noncalcium (VNCa) value, computed tomography value of calcium (CaCT), computed tomography value of mixed-energy images (regular CT value) (rCT), and relative calcium density (rCaD), were measured. The correlations between the quantitative parameters and age and body mass index (BMI) were analyzed, and the correlations of age, sex, BMI, region of the humeral head, and VNCa value on CaCT were evaluated. RESULTS: The differences in CaCT, rCT, and rCaD between the 4 regions of proximal humerus were statistically significant (P<0.001), while the difference in VNCa values was not (P=0.688). The calcium concentration (CaCT and rCaD) was the densest in the posteromedial zone. The differences of CaCT, rCT, and rCaD between males and females in the 4 regions of proximal humerus were statistically significant (P<0.05), while those of the posterolateral zone were not (rCT; P>0.05). The differences in VNCa values between males and females were also not significant (P>0.05). Multivariable linear regression analysis indicated that sex, age, BMI, regions, and VNCa were significant (P<0.05) predictors of the CaCT value. CONCLUSIONS: The concentration of calcium was the densest in the posteromedial region of proximal humerus, and the VNCa value of DECT may be used for quantifying the BMD of the proximal humerus.
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spelling pubmed-104982502023-09-14 Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography Yu, Qinqin Yang, Jia Zhou, Chenwei Xu, Zhihan Liu, Chao Luo, Qian Zhang, Lei Quant Imaging Med Surg Original Article BACKGROUND: The proximal humerus is a common site of osteoporotic fractures, and bone quality is a predictor of surgical reduction quality. Dual-energy computed tomography (DECT) is assuming an increasingly important role in the quantification of bone mineral density (BMD) due it is ability to perform three-material decomposition. We aimed to analyze the bone quality and distribution of the proximal humerus with DECT quantitatively. METHODS: Sixty-five consecutive patients (average age 49.5±15.2 years; male: female ratio 32:33) without proximal humerus fractures who had undergone DECT were retrospectively selected. The humeral head was divided into 4 regions on a cross section in the medial plane between the greater tuberosity and the surgical neck. The quantitative parameters, including virtual noncalcium (VNCa) value, computed tomography value of calcium (CaCT), computed tomography value of mixed-energy images (regular CT value) (rCT), and relative calcium density (rCaD), were measured. The correlations between the quantitative parameters and age and body mass index (BMI) were analyzed, and the correlations of age, sex, BMI, region of the humeral head, and VNCa value on CaCT were evaluated. RESULTS: The differences in CaCT, rCT, and rCaD between the 4 regions of proximal humerus were statistically significant (P<0.001), while the difference in VNCa values was not (P=0.688). The calcium concentration (CaCT and rCaD) was the densest in the posteromedial zone. The differences of CaCT, rCT, and rCaD between males and females in the 4 regions of proximal humerus were statistically significant (P<0.05), while those of the posterolateral zone were not (rCT; P>0.05). The differences in VNCa values between males and females were also not significant (P>0.05). Multivariable linear regression analysis indicated that sex, age, BMI, regions, and VNCa were significant (P<0.05) predictors of the CaCT value. CONCLUSIONS: The concentration of calcium was the densest in the posteromedial region of proximal humerus, and the VNCa value of DECT may be used for quantifying the BMD of the proximal humerus. AME Publishing Company 2023-07-20 2023-09-01 /pmc/articles/PMC10498250/ /pubmed/37711831 http://dx.doi.org/10.21037/qims-22-927 Text en 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Yu, Qinqin
Yang, Jia
Zhou, Chenwei
Xu, Zhihan
Liu, Chao
Luo, Qian
Zhang, Lei
Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title_full Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title_fullStr Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title_full_unstemmed Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title_short Quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
title_sort quantification of bone quality and distribution of the proximal humerus with dual-energy computed tomography
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498250/
https://www.ncbi.nlm.nih.gov/pubmed/37711831
http://dx.doi.org/10.21037/qims-22-927
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