TOPLINE

Automated extraction of trabecular volumetric bone mineral density (vBMD) from thoracic CT scans showed reproducibility across diverse technical acquisition scenarios, supporting its feasibility for opportunistic osteoporosis screening, a retrospective study found.

METHODOLOGY

• Researchers retrospectively evaluated data of 178 patients from a single institution in Germany who underwent at least two consecutive routine thoracic or abdominal CT examinations within 1 month between 2016 and 2020.
• A total of 914 vBMD observations were analysed using the automated extraction of trabecular vBMD, spanning two central thoracic regions: T5-T7 (122 patients; 367 observations) and T8-T10 (172 patients; 547 observations).
• The researchers assessed reproducibility across six technical scenarios, ranging from different reconstructions of the same scan to variations in scanners and contrast phases.
• They calculated reproducibility as the root mean square coefficient of variation (RMSCV) for each scenario.

TAKEAWAY

• RMSCV values ranged from 0.83% to 4.90% at T5-T7 and from 1.40% to 6.80% at T8-T10 across six reproducibility scenarios, from different reconstructions of the same scan to full scanner/contrast variation.
• Reconstructing the same scan had the lowest error, with an RMSCV value of 0.83% (T5-T7) and 1.40% (T8-T10), highlighting the robustness of the automated framework against reconstruction variability.
• A significant overall difference was observed across the six reproducibility scenarios in both regions (T5-T7: F, 27.9; T8-T10: F, 23.6; P < .001 for both).
• T5-T7 showed significantly smaller absolute vBMD differences than T8-T10 for both reconstructions of the same scan (P = .005) and changes in scanners and contrast phases (P = .02), making T5-T7 the more reproducible region.

IN PRACTICE

"With the impending implementation of national lung cancer screening programs utilizing LDCT [low-dose CT], an extraordinary opportunity emerges to address the substantial osteoporosis treatment gap through opportunistic bone health assessment," the authors wrote.

"Establishing reliable thoracic spine vBMD measurement protocols could enable simultaneous evaluation of both lung cancer and osteoporosis risk," they added.

SOURCE

The study was led by Philipp Raffler, MD, Technical University of Munich, Munich, Germany. It was published online on July 29, 2026, in the British Journal of Radiology.

LIMITATIONS

The study was limited by its retrospective design with a lack of control over scanning protocols and patient factors, a 1-month interscan interval requiring two CT scans within 1 month, and the development and optimisation of the automated segmentation and contrast phase correction pipelines at a single institution using overlapping scanner types.

DISCLOSURES

This study received funding from the Bavarian Research Foundation (Bayerische Forschungsstiftung). Three authors disclosed being co-founders of Bonescreen, Munich, Germany.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.