Opportunistic Computed Tomography Screening for Osteoporosis and Fracture

• Guenoun Daphne
• Champsaur Pierre

• Opportunistic computed tomography
• Osteoporosis
• Bone mineral density
• Quantitative computed tomography
• Asynchronous calibration

Osteoporosis is underdiagnosed and undertreated, leading to loss of treatment for the patient and high costs for the health care system. Routine thoracic and/or abdominal computed tomography (CT) performed for other indications can screen opportunistically for osteoporosis with no extra cost, time, or irradiation. Various methods can quantify fracture risk on opportunistic clinical CT: vertebral Hounsfield unit bone mineral density (BMD), usually of L1; BMD measurement with asynchronous or internal calibration; quantitative CT; bone texture assessment; and finite element analysis. Screening for osteoporosis and vertebral fractures on opportunistic CT is a promising approach, providing automated fracture risk scores by means of artificial intelligence, thus enabling earlier management.