{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:17:38Z","timestamp":1793215058518,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Natural Science Foundation of Shaanxi Province,China","award":["2022JQ-939"],"award-info":[{"award-number":["2022JQ-939"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of this study was to evaluate the feasibility of opportunistic screening for osteoporosis in postmenopausal females using the dual-energy CT(DECT)-derived hydroxyapatite (HAP) concentration and CT value of L1-vertebra. 239 consecutive postmenopausal female patients were enrolled and underwent both chest DECT and Dual energy X-ray absorptiometry (DXA). According to the T-score of the 1st lumbar vertebra on DXA, patients were divided into the osteoporosis group (T <jats:inline-formula><jats:alternatives><jats:tex-math>$$\\le$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mo>\u2264<\/mml:mo>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2212\u00a02.5, n\u2009=\u2009112) and non-osteoporosis group (T <jats:inline-formula><jats:alternatives><jats:tex-math>$$&gt;$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mo>&gt;<\/mml:mo>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula> \u2212\u00a02.5, n\u2009=\u2009127). The HAP values of the 1st lumbar vertebra were measured from the coronal-view HAP(Fat)-based material decomposition(MD) images, and CT values were measured on the 75\u00a0keV monochromatic image. The cutoff values of using HAP and CT value for diagnosing osteoporosis were obtained by drawing receiver operating characteristic (ROC) curves. Both HAP and CT value of the 1st lumbar vertebra had moderate-high correlation with bone-mineral-density measurement on DXA (HAP, r\u2009=\u20090.614; CT value, r\u2009=\u20090.625; all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The area-under-the-curve (AUC), sensitivity, specificity, PPV and NPV for diagnosing osteoporosis was 0.754, 0.714, 0.693, 0.68 and 0.752 using HAP (cutoff value: 142.05\u00a0mg\/cm<jats:sup>3<\/jats:sup>) and 0.766, 0.741, 0.7, 0.685 and 0.754 using CT value (cutoff value: 132HU), respectively. HAP measurements on HAP(Fat)-based MD images in DECT could provide reasonably accurate BMD quantification for diagnosing osteoporosis in postmenopausal females. DECT prescribed for lung cancer screening could also provide opportunistic screening for osteoporosis, extending the clinical application of DECT without additional radiation to patients.\n<\/jats:p>","DOI":"10.1038\/s41598-022-26237-4","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T17:03:35Z","timestamp":1671037415000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Opportunistic screening for osteoporosis using hydroxyapatite measurements of the vertebral by thorax dual-energy spectral CT in postmenopausal females"],"prefix":"10.1038","volume":"12","author":[{"given":"Lei","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.-Li","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongtong","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanxin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"issue":"6","key":"26237_CR1","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/0002-9343(93)90218-e","volume":"94","author":"Consensus development conference","year":"1993","unstructured":"Consensus development conference. Diagnosis, prophylaxis and treatment of osteoporosis. Am. J. Med. 94(6), 646\u2013650. https:\/\/doi.org\/10.1016\/0002-9343(93)90218-e(1993).","journal-title":"Am. J. Med."},{"issue":"5","key":"26237_CR2","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1359\/jbmr.2005.20.5.886","volume":"20","author":"LJ Melton","year":"2005","unstructured":"Melton, L. J. et al. How many women have osteoporosis? JBMR anniversary classic. JBMR, volume 7, number 9, 1992. J. Bone Miner. Res. 20(5), 886\u2013892. https:\/\/doi.org\/10.1359\/jbmr.2005.20.5.886 (2005).","journal-title":"J. Bone Miner. Res."},{"issue":"3","key":"26237_CR3","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.maturitas.2003.12.006","volume":"48","author":"FR P\u00e9rez-L\u00f3pez","year":"2004","unstructured":"P\u00e9rez-L\u00f3pez, F. R. Postmenopausal osteoporosis and alendronate. Maturitas 48(3), 179\u2013192. https:\/\/doi.org\/10.1016\/j.maturitas.2003.12.006 (2004).","journal-title":"Maturitas"},{"key":"26237_CR4","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1146\/annurev-med-070313-022841","volume":"66","author":"P Andreopoulou","year":"2015","unstructured":"Andreopoulou, P. & Bockman, R. S. Management of postmenopausal osteoporosis. Annu. Rev. Med. 66, 329\u2013342. https:\/\/doi.org\/10.1146\/annurev-med-070313-022841 (2015).","journal-title":"Annu. Rev. Med."},{"issue":"9","key":"26237_CR5","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1038\/s41574-019-0220-8","volume":"15","author":"NR Fuggle","year":"2019","unstructured":"Fuggle, N. R. et al. Fracture prediction, imaging and screening in osteoporosis. Nat. Rev. Endocrinol. 15(9), 535\u2013547. https:\/\/doi.org\/10.1038\/s41574-019-0220-8 (2019).","journal-title":"Nat. Rev. Endocrinol."},{"issue":"6","key":"26237_CR6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1007\/BF01622200","volume":"4","author":"JA Kanis","year":"1994","unstructured":"Kanis, J. A. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report WHO study group. Osteoporos. Int. 4(6), 368\u2013381. https:\/\/doi.org\/10.1007\/BF01622200 (1994).","journal-title":"Osteoporos. Int."},{"issue":"5","key":"26237_CR7","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1359\/jbmr.2001.16.5.799","volume":"16","author":"HH Bolotin","year":"2001","unstructured":"Bolotin, H. H. & Siev\u00e4nen, H. Inaccuracies inherent in dual-energy X-ray absorptiometry in vivo bone mineral density can seriously mislead diagnostic\/prognostic interpretations of patient-specific bone fragility. J. Bone Miner. Res. 16(5), 799\u2013805. https:\/\/doi.org\/10.1359\/jbmr.2001.16.5.799 (2001).","journal-title":"J. Bone Miner. Res."},{"issue":"1","key":"26237_CR8","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.bone.2007.02.022","volume":"41","author":"HH Bolotin","year":"2007","unstructured":"Bolotin, H. H. DXA in vivo BMD methodology: An erroneous and misleading research and clinical gauge of bone mineral status, bone fragility, and bone remodelling. Bone 41(1), 138\u2013154. https:\/\/doi.org\/10.1016\/j.bone.2007.02.022 (2007).","journal-title":"Bone"},{"key":"26237_CR9","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/895474","author":"N Li","year":"2013","unstructured":"Li, N. et al. Comparison of QCT and DXA: Osteoporosis detection rates in postmenopausal women. Int. J. Endocrinol. https:\/\/doi.org\/10.1155\/2013\/895474 (2013).","journal-title":"Int. J. Endocrinol."},{"key":"26237_CR10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.jot.2018.11.003","volume":"18","author":"XM Xu","year":"2018","unstructured":"Xu, X. M. et al. Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men. J. Orthop. Transl. 18, 59\u201364. https:\/\/doi.org\/10.1016\/j.jot.2018.11.003 (2018).","journal-title":"J. Orthop. Transl."},{"issue":"8","key":"26237_CR11","doi-asserted-by":"publisher","first-page":"588","DOI":"10.7326\/0003-4819-158-8-201304160-00003","volume":"158","author":"PJ Pickhardt","year":"2013","unstructured":"Pickhardt, P. J. et al. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann. Intern. Med. 158(8), 588\u2013595. https:\/\/doi.org\/10.7326\/0003-4819-158-8-201304160-00003 (2013).","journal-title":"Ann. Intern. Med."},{"issue":"3","key":"26237_CR12","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1007\/s00198-015-3318-4","volume":"27","author":"SJ Lee","year":"2016","unstructured":"Lee, S. J. et al. Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density. Osteoporos. Int. 27(3), 1131\u20131136. https:\/\/doi.org\/10.1007\/s00198-015-3318-4 (2016).","journal-title":"Osteoporos. Int."},{"issue":"1","key":"26237_CR13","doi-asserted-by":"publisher","first-page":"165","DOI":"10.2214\/AJR.16.16744","volume":"208","author":"HW Garner","year":"2017","unstructured":"Garner, H. W., Paturzo, M. M., Gaudier, G., Pickhardt, P. J. & Wessell, D. E. Variation in attenuation in L1 trabecular bone at different tube voltages: Caution Is warranted when screening for osteoporosis with the use of opportunistic CT. AJR Am. J. Roentgenol. 208(1), 165\u2013170. https:\/\/doi.org\/10.2214\/AJR.16.16744 (2017).","journal-title":"AJR Am. J. Roentgenol."},{"issue":"2","key":"26237_CR14","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1148\/radiol.2019181648","volume":"291","author":"S Jang","year":"2019","unstructured":"Jang, S. et al. Opportunistic osteoporosis screening at routine abdominal and thoracic CT: Normative L1 trabecular attenuation values in more than 20 000 adults. Radiology 291(2), 360\u2013367. https:\/\/doi.org\/10.1148\/radiol.2019181648 (2019).","journal-title":"Radiology"},{"issue":"2","key":"26237_CR15","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/00004424-197303000-00005","volume":"8","author":"WW Wooten","year":"1973","unstructured":"Wooten, W. W., Judy, P. F. & Greenfield, M. A. Analysis of the effects of adipose tissue on the absorptiometric measurement of bone mineral mass. Investig. Radiol. 8(2), 84\u201389. https:\/\/doi.org\/10.1097\/00004424-197303000-00005 (1973).","journal-title":"Investig. Radiol."},{"issue":"2","key":"26237_CR16","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/BF02405022","volume":"35","author":"RB Mazess","year":"1983","unstructured":"Mazess, R. B. Errors in measuring trabecular bone by computed tomography due to marrow and bone composition. Calcif. Tissue Int. 35(2), 148\u2013152. https:\/\/doi.org\/10.1007\/BF02405022 (1983).","journal-title":"Calcif. Tissue Int."},{"issue":"3","key":"26237_CR17","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1118\/1.595951","volume":"13","author":"JR Vetter","year":"1986","unstructured":"Vetter, J. R., Perman, W. H., Kalender, W. A., Mazess, R. B. & Holden, J. E. Evaluation of a prototype dual-energy computed tomographic apparatus. II. Determination of vertebral bone mineral content. Med. Phys. 13(3), 340\u2013343. https:\/\/doi.org\/10.1118\/1.595951 (1986).","journal-title":"Med. Phys."},{"issue":"7","key":"26237_CR18","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1097\/00004424-199407000-00006","volume":"29","author":"MM Goodsitt","year":"1994","unstructured":"Goodsitt, M. M., Hoover, P., Veldee, M. S. & Hsueh, S. L. The composition of bone marrow for a dual-energy quantitative computed tomography technique. A cadaver and computer simulation study. Investig. Radiol. 29(7), 695\u2013704. https:\/\/doi.org\/10.1097\/00004424-199407000-00006 (1994).","journal-title":"Investig. Radiol."},{"issue":"5","key":"26237_CR19","doi-asserted-by":"publisher","first-page":"398","DOI":"10.3414\/ME11-02-0034","volume":"51","author":"S Wesarg","year":"2012","unstructured":"Wesarg, S. et al. Dual-energy CT-based assessment of the trabecular bone in vertebrae. Methods Inf. Med. 51(5), 398\u2013405. https:\/\/doi.org\/10.3414\/ME11-02-0034 (2012).","journal-title":"Methods Inf. Med."},{"issue":"2","key":"26237_CR20","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1148\/radiol.2018181286","volume":"290","author":"C Booz","year":"2019","unstructured":"Booz, C. et al. Virtual noncalcium dual-energy CT: Detection of lumbar disk herniation in comparison with standard gray-scale CT. Radiology 290(2), 446\u2013455. https:\/\/doi.org\/10.1148\/radiol.2018181286 (2019).","journal-title":"Radiology"},{"issue":"6","key":"26237_CR21","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/RLI.0b013e31820e1486","volume":"46","author":"MA Fischer","year":"2011","unstructured":"Fischer, M. A. et al. Quantification of liver fat in the presence of iron and iodine: An ex-vivo dual-energy CT study. Investig. Radiol. 46(6), 351\u2013358. https:\/\/doi.org\/10.1097\/RLI.0b013e31820e1486 (2011).","journal-title":"Investig. Radiol."},{"issue":"5","key":"26237_CR22","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.ejrad.2015.01.007","volume":"84","author":"Y Dong","year":"2015","unstructured":"Dong, Y. et al. Differential diagnosis of osteoblastic metastases from bone islands in patients with lung cancer by single-source dual-energy CT: Advantages of spectral CT imaging. Eur. J. Radiol. 84(5), 901\u2013907. https:\/\/doi.org\/10.1016\/j.ejrad.2015.01.007 (2015).","journal-title":"Eur. J. Radiol."},{"issue":"6","key":"26237_CR23","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1177\/0284185118801139","volume":"60","author":"D Yue","year":"2019","unstructured":"Yue, D. et al. The relationship between calcium (water) density and age distribution in adult women with spectral CT: Initial result compared to bone mineral density by dual-energy X-ray absorptiometry. Acta Radiol. 60(6), 762\u2013768. https:\/\/doi.org\/10.1177\/0284185118801139 (2019).","journal-title":"Acta Radiol."},{"issue":"11","key":"26237_CR24","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.2106\/JBJS.J.00160","volume":"93","author":"JJ Schreiber","year":"2011","unstructured":"Schreiber, J. J., Anderson, P. A., Rosas, H. G., Buchholz, A. L. & Au, A. G. Hounsfield units for assessing bone mineral density and strength: A tool for osteoporosis management. J. Bone Joint Surg. Am. 93(11), 1057\u20131063. https:\/\/doi.org\/10.2106\/JBJS.J.00160 (2011).","journal-title":"J. Bone Joint Surg. Am."},{"key":"26237_CR25","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1515\/med-2019-0061","volume":"14","author":"KJ Kim","year":"2019","unstructured":"Kim, K. J. et al. Hounsfield units on lumbar computed tomography for predicting regional bone mineral density. Open med. 14, 545\u2013551. https:\/\/doi.org\/10.1515\/med-2019-0061 (2019).","journal-title":"Open med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-26237-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-26237-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-26237-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T17:06:08Z","timestamp":1671037568000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-26237-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["26237"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-26237-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]},"assertion":[{"value":"25 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21642"}}