Opportunistic Chest CT Paraspinal Muscle Biomarkers to Predict Longitudinal Thoracic Vertebral Bone Mineral Density Loss: Results from MESA.
Abstract
Background Muscle and bone loss commonly coexist with aging, but the role of paraspinal muscle in predicting longitudinal thoracic vertebral bone mineral density (BMD) remains poorly understood. Purpose To evaluate whether CT-derived paraspinal muscle attenuation and volume independently predict longitudinal thoracic vertebral BMD loss in a prospective, multicenter cohort. Materials and Methods In this secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), noncontrast chest CT scans from examinations 5 (baseline, April 2010) and 6 (September 2016) were analyzed after excluding participants with incomplete Fracture Risk Assessment Tool without BMD (FRAXnb) data or failed segmentations. Multilevel (T1 through T10) deep learning (DL)-based three-dimensional segmentation was used to derive paraspinal muscle volume and attenuation, which were compared with manual segmentation (reference standard). Paraspinal muscle volume and attenuation were dichotomized (quartile 1 vs quartiles 2-4) for multivariable regression models predicting follow-up vertebral BMD and incident vertebral fracture (VF), adjusted for clinical risk factors and compared with baseline BMD. Results A total of 1316 participants (mean age, 67.2 years [IQR, 60-74 years]; 694 female) were included. DL-derived three-dimensional segmentations correlated with manual segmentations (Dice score, 0.94). At baseline, participants with low versus high attenuation (quartile 1 vs quartiles 2-4; 4 HU vs 27 HU)…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,316 participants or records.
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