{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:10:43Z","timestamp":1791475843130,"version":"4.3.4"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,15]],"date-time":"2023-01-15T00:00:00Z","timestamp":1673740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background: Multidetector computer tomography (CT) has been used to diagnose pathologies such as osteoporosis via opportunistic screening, where the assessment of the bone structure and the measurement of bone mineral density (BMD) are of great relevance. Purpose: To construct reference BMD values based on the measurement of the attenuation of the L1 vertebral body by multidetector CT scan (in the soft tissue and bone windows) in adult patients and to establish normative ranges by sex and age of BMD values. Materials and Methods: A retrospective cross-sectional study of 5080 patients who underwent multidetector CT scan between January and December 2021. Adult patients (\u226518 years) with non-contrast multidetector CT scan of the abdomen or thorax\u2013abdomen at a voltage 120 kV. The attenuation of the L1 vertebral body in Hounsfield units (HU) in both windows were compared using the Mann\u2014Whitney U-test with \u03b1 = 0.05. Additionally, the quartiles of the BMD were constructed (in both windows) grouped by sex and age. Results: Only 454 (51.30 \u00b1 15.89 years, 243 women) patients met the inclusion criteria. There is no difference in BMD values between windows (soft tissue: 163.90 \u00b1 57.13, bone: 161.86 \u00b1 55.80, p = 0.625), mean L1 attenuation decreased linearly with age at a rate of 2 HU per year, and the presence of BMD deficit among patients was high; 152 of 454 (33.48%) patients presented BMD values suggestive of osteoporosis, and of these, approximately half 70 of 454 (15.42%) corresponded to patients with BMD values suggestive of a high risk of osteoporotic fracture. Conclusions: From clinical practice, the bone mineral density (BMD) of a patient in either window below the first quartile for age- and sex-matched peers suggests a deficit in BMD that cannot be ignored and requires clinical management that enables identification of the etiology, its evolution, and the consequences of this alteration.<\/jats:p>","DOI":"10.3390\/tomography9010013","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T06:03:30Z","timestamp":1673849010000},"page":"150-161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Identification of Bone Mineral Density Deficit Using L1 Trabecular Attenuation by Opportunistic Multidetector CT Scan in Adult Patients"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-4387","authenticated-orcid":false,"given":"Juan Andr\u00e9s","family":"Castillo-L\u00f3pez","sequence":"first","affiliation":[{"name":"Department of Radiology, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n 37660, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Bravo-Ontiveros","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n 37660, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-9626","authenticated-orcid":false,"given":"Edel Rafael","family":"Rodea-Montero","sequence":"additional","affiliation":[{"name":"Department of Research, Hospital Regional de Alta Especialidad del Baj\u00edo, Le\u00f3n 37660, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ejrad.2004.03.007","article-title":"Imaging of opportunistic fungal infections in immunocompromised patient","volume":"51","author":"Franquet","year":"2004","journal-title":"Eur. J. Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1148\/radiol.211561","article-title":"Value-added Opportunistic CT Screening: State of the Art","volume":"303","author":"Pickhardt","year":"2022","journal-title":"Radiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"582","DOI":"10.2214\/AJR.20.22874","article-title":"Value-added opportunistic CT: Insights into osteoporosis and sarcopenia","volume":"215","author":"Boutin","year":"2020","journal-title":"Am. J. Roentgenol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1148\/rg.2016160004","article-title":"Imaging findings of metabolic bone disease","volume":"36","author":"Chang","year":"2016","journal-title":"Radiographics"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1038\/s41598-018-19253-w","article-title":"Biomolecular regulation, composition and nanoarchitecture of bone mineral","volume":"8","author":"Poundarik","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1749-6632.2009.05378.x","article-title":"Looking beyond bone mineral density: Imaging assessment of bone quality","volume":"1192","author":"Griffith","year":"2010","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1148\/radiol.12110462","article-title":"Osteoporosis imaging: State of the art and advanced imaging","volume":"263","author":"Link","year":"2012","journal-title":"Radiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1007\/s00198-005-1937-x","article-title":"Diagnosis of osteoporosis: Visual assessment on conventional versus digital radiographs","volume":"16","author":"Wagner","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1109\/TUFFC.2008.828","article-title":"A new quality of bone ultrasound research","volume":"55","year":"2008","journal-title":"IEEE Trans. Ultrason. Ferroelectr. Freq. Control"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Guglielmi, G., and Lang, T.F. (2002). Quantitative Computed Tomography. Semin Musculoskelet Radiol, Thieme Medical Publishers, Inc.","DOI":"10.1055\/s-2002-36719"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1007\/s11999-010-1766-x","article-title":"High-resolution computed tomography for clinical imaging of bone microarchitecture","volume":"469","author":"Burghardt","year":"2011","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1359\/jbmr.1998.13.1.122","article-title":"A comparative study of trabecular bone properties in the spine and femur using high resolution, MRI and, CT","volume":"13","author":"Link","year":"1998","journal-title":"J. Bone Miner. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.chest.2016.12.033","article-title":"Chest CT Signs in Pulmonary Disease: A Pictorial Review","volume":"151","author":"Raju","year":"2017","journal-title":"Chest"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1148\/rg.304095175","article-title":"Dual-energy multidetector CT: How does it work, what can it tell us, and when can we use it in abdominopelvic imaging?","volume":"30","author":"Coursey","year":"2010","journal-title":"Radiographics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1148\/radiol.14141356","article-title":"Computed tomography: Revolutionizing the practice of medicine for 40 years","volume":"273","author":"Rubin","year":"2014","journal-title":"Radiology"},{"key":"ref_16","first-page":"265","article-title":"Emerging clinical applications of computed tomography","volume":"8","author":"Liguori","year":"2015","journal-title":"Med. Devices Evid. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1053\/j.sult.2009.10.002","article-title":"Utilization Patterns of Multidetector Computed Tomography in Elective and Emergency Conditions: Indications, Exposure Risk, and Diagnostic Gain","volume":"31","author":"Romano","year":"2010","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1148\/rg.2017160060","article-title":"Radiologic assessment of native renal vasculature: A multimodality review","volume":"37","author":"Shetty","year":"2017","journal-title":"Radiographics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.annemergmed.2013.02.018","article-title":"Emergency department computed tomography utilization in the United States and Canada","volume":"62","author":"Berdahl","year":"2013","journal-title":"Ann. Emerg. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1148\/radiol.2532082010","article-title":"Radiologic and nuclear medicine studies in the United States and worldwide: Frequency, radiation dose, and comparison with other radiation sources\u20141950\u20132007","volume":"253","author":"Mettler","year":"2009","journal-title":"Radiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1148\/radiol.2313030325","article-title":"In vitro and in vivo spiral CT to determine bone mineral density: Initial experience in patients at risk for osteoporosis","volume":"231","author":"Link","year":"2004","journal-title":"Radiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1148\/radiol.2019181648","article-title":"Opportunistic osteoporosis screening at routine abdominal and Thoracic CT: Normative L1 trabecular attenuation values in more than 20,000 adults","volume":"291","author":"Jang","year":"2019","journal-title":"Radiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"588","DOI":"10.7326\/0003-4819-158-8-201304160-00003","article-title":"Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications","volume":"158","author":"Pickhardt","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1007\/s00198-019-04931-w","article-title":"Opportunistic screening for osteoporosis using thoraco-abdomino-pelvic CT-scan assessing the vertebral density in rheumatoid arthritis patients","volume":"30","author":"Omorou","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_25","first-page":"e540","article-title":"Screening for osteoporosis using L1 vertebral density on abdominal CT in an Australian population. Clin Radiol","volume":"77","author":"Abbouchie","year":"2022","journal-title":"R. Coll. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109568","DOI":"10.1016\/j.ejrad.2021.109568","article-title":"Opportunistic screening for osteoporosis and osteopenia by routine computed tomography scan: A heterogeneous, multiethnic, middle-eastern population validation study","volume":"136","author":"Cohen","year":"2021","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_28","unstructured":"Mexican Gobernation Secretary (2022, June 20). General Health Law. Official Gazzete of the Federation. Available online: https:\/\/www.diputados.gob.mx\/LeyesBiblio\/pdf\/LGS.pdf."},{"key":"ref_29","unstructured":"R Core Team (2019). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.r-project.org."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00198-016-3804-3","article-title":"Opportunistic screening for osteoporosis by routine CT in Southern Europe","volume":"28","author":"Alacreu","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s11657-018-0492-y","article-title":"Opportunistic screening for osteoporosis in abdominal computed tomography for Chinese population","volume":"13","author":"Li","year":"2018","journal-title":"Arch. Osteoporos."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/00004728-200011000-00015","article-title":"The use of clinical CT for baseline bone density assessment","volume":"24","author":"Hopper","year":"2000","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/j.bone.2008.08.106","article-title":"International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions","volume":"43","author":"Lewiecki","year":"2008","journal-title":"Bone"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00198-015-3318-4","article-title":"Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density","volume":"27","author":"Lee","year":"2016","journal-title":"Osteoporos. Int."}],"container-title":["Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2379-139X\/9\/1\/13\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:06:45Z","timestamp":1760119605000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2379-139X\/9\/1\/13"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,15]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["tomography9010013"],"URL":"https:\/\/doi.org\/10.3390\/tomography9010013","relation":{},"ISSN":["2379-139X"],"issn-type":[{"value":"2379-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,15]]}}}