Cardiac CT can screen for osteoporosis with little change to radiology workflows

Cardiac CT exams normally reserved to assess patients’ heart health can also effectively screen for osteoporosis, according to new research published in Radiology.

Danish physicians tested this approach in nearly 1,500 individuals who underwent a scan for heart disease, along with an added bone mineral density test. Together, the exams identified patients with low BMD, with a subset later diagnosed with an osteoporosis-related fracture.

Lead author Josephine Therkildsen, MD, with Herning Hospital in Denmark, says incorporating bone density testing into heart CT exams is quick and can flag those with weakened bones who may benefit from earlier treatment.

“Osteoporosis is a prevalent, under-diagnosed and treatable disease associated with increased morbidity and mortality,” Therkildsen added in a Tuesday statement. “Effective anti-osteoporotic treatment exists and so, identifying individuals with greater fracture rate who may benefit from such treatment is imperative.”

The study included 1,487 participants who received cardiac CT and BMD testing in three thoracic vertebrae. In total, 170 had very low bone mineral density. And after three year follow-up, on average, 80 were diagnosed with a fracture, with 31 related to osteoporosis.

Therkildsen and colleagues say the association between low density and a higher rate of fracture suggests thoracic spine BMD can guide preventative measures and treatment decisions for the disease that impacts an estimated 200 million people worldwide.

And with current technological advances, adding the exam to a cardiac CT scan may actually reduce radiation dose, as long as the modality is properly calibrated.

“We believe that opportunistic BMD testing using routine CT scans can be done with little change to normal clinical practice and with the benefit of identifying individuals with a greater fracture rate,” Therkildsen said. “Our research group is dedicated to extend the research in this field, as we believe it should be added to clinical practice."

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