Efficacy of Hounsfield Units Measured by Lumbar Computer Tomography on Bone Density Assessment: A Systematic Review
Abstract
A systematic search was conducted comparing the Hounsfield units (HU) value obtained from computed tomography and the T-score of dual-energy X-ray absorptiometry (DXA) in the prediction of the lumbar spine bone mineral density (BMD). Current data evidences favorable results regarding the possibility of establishing a threshold value for osteoporosis diagnosis from CT measurements of HU. Study Design. Systematic review. Objective. This work aimed to compare the Hounsfield units (HU) value obtained from computed tomography and the t score of dual-energy x-ray absorptiometry (DXA) in the prediction of the lumbar spine bone mineral density (BMD). Summary of Background Data. Several reports have found a correlation between HU and BMD values based on DXA. Using HUs to infer bone quality has a thorough clinical relevance as it could triage patients at risk for osteoporotic and fragility fractures or modify surgical indications. Methods. A systematic review in Cochrane Library, Medline, Scopus and Web of Science was performed, using the following query: “hounsfield units” AND (“osteoporosis” OR “spine” OR “bone mineral density” OR “dual x-ray absorptiometry”). We included 18 cohort studies that compared HU value obtained from computed tomography and t score of DXA for predicting regional BMD. Results. A total of 18 studies were included, enrolling 5307 patients. The HU measurement was most frequently made at L1 (N = 3; 18.8%). The mean HU values differentiated based on BMD measured…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,307 participants or records.
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