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Background  Current techniques for evaluation of bone mineral density (BMD) commonly require phantom calibration. The purpose of this study was to evaluate a novel algorithm for phantomless in vivo dual-energy computed tomography (DECT)-based assessment of BMD of the lumbar spine in comparison with dual-energy X-ray absorptiometry (DEXA).    Methods  Data from clinically indicated DECT and DEXA examinations within two months comprising the lumbar spine of 47 patients were retrospectively evaluated. By using a novel automated dedicated post-processing algorithm for DECT, the trabecular bone of lumbar vertebrae L1–L4 was selected and analysed. Linear correlation was analysed using Pearson’s product-moment correlation coefficient for the comparison of the results from DECT and DEXA.    Results  A total of 186 lumbar vertebrae in 47 patients (mean age, 58 years; age range, 24–85 years) were analysed, 24 men (mean age, 55 years; age range, 24–85 years) and 23 women (mean age, 59 years; age range, 31–80 years). Mean BMD of L1–L4 determined with DEXA was 0.985 g/cm 2  and 20/47 patients (42.6%) showed an osteoporotic BMD (T score lower than – 2.5) of at least two vertebrae. Average DECT-based BMD of L1–L4 was 86.8 mg/cm 3 . Regression analysis demonstrated a lack of correlation between DECT- and DEXA-based BMD values with a Pearson’s product-moment correlation coefficient r = 0.4205.    Conclusions  Dedicated post-processing of DECT data using a novel algorithm for retrospective phantomless BMD assessment of the trabecular bone of lumbar vertebrae from clinically indicated DECT examinations is feasible.

european radiology experimental

Evaluation of bone mineral density of the lumbar spine using a novel phantomless dual-energy CT post-processing algorithm in comparison with dual-energy X-ray absorptiometry