{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:15:18Z","timestamp":1785420918222,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Medicine Ramathibodi Hospital, Mahidol University"},{"id":[{"id":"https:\/\/ror.org\/01znkr924","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: This study aimed to determine the prevalence of DXA-detected lumbar scoliosis in postmenopausal women based on dual-energy X-ray absorptiometry (DXA) scans and identify associated risk factors. Methods: A total of 261 postmenopausal women aged \u226550 years who underwent lumbar spine DXA before June 2021 were included. Lumbar scoliosis was defined as a Cobb angle \u2265 10\u00b0 measured from DXA images. Logistic regression analysis was performed to evaluate associated risk factors. Diagnostic performance of DXA-based Cobb angle measurements was assessed in the radiographic validation subgroup using radiography as the reference standard. Results: The prevalence of DXA-detected lumbar scoliosis was 14.9% (39\/261; 95% CI, 10.8\u201319.9%). Increasing age was significantly associated with scoliosis, while body mass index, bone mineral density, and T-scores at the lumbar spine, hip, and femoral neck were not. DXA and radiographic Cobb angle measurements demonstrated strong agreement (ICC = 0.91, 95% CI 0.73\u20130.96), with a mean difference of \u22122.63\u00b0. Diagnostic accuracy was 82.1%, with sensitivity 62.1%, specificity 97.4%, PPV 94.7%, and NPV 77.0%. ROC analysis demonstrated good discriminative performance (AUC = 0.88, 95% CI, 0.79\u20130.98); an exploratory cutoff of 6.5\u00b0 yielded the highest Youden index. Conclusions: DXA-detected lumbar scoliosis was identified in 14.9% of postmenopausal women undergoing DXA. DXA-based Cobb angle measurements demonstrated strong agreement with radiographic assessment and may facilitate opportunistic case detection of likely lumbar scoliosis during routine BMD assessment.<\/jats:p>","DOI":"10.3390\/diagnostics16121878","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:31Z","timestamp":1781675791000},"page":"1878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opportunistic Detection of Lumbar Scoliosis on DXA Images in Postmenopausal Women"],"prefix":"10.3390","volume":"16","author":[{"given":"Kasidech","family":"Suwanpidok","sequence":"first","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"},{"name":"Division of Nuclear Medicine, Department of Radiology, Chonburi Cancer Hospital, Chonburi 20000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7607-1786","authenticated-orcid":false,"given":"Chanika","family":"Sritara","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8781-1265","authenticated-orcid":false,"given":"Wichana","family":"Chamroonrat","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasivimol","family":"Promma","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1445-8624","authenticated-orcid":false,"given":"Arpakorn","family":"Kositwattanarerk","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaninart","family":"Sakulpisuti","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0128-651X","authenticated-orcid":false,"given":"Kanungnij","family":"Thamnirat","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","first-page":"261","article-title":"Outline for the study of scoliosis","volume":"5","author":"Cobb","year":"1948","journal-title":"Instr. 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