A Pilot Study to Assess Opportunistic Use of CT-Scan for Osteoporosis Screening in Chronic Pancreatitis

Julia McNabb-Baltar, Hanisha R. Manickavasagan, Darwin L. Conwell, Andrew Lu, Dhiraj Yadav, Philip A. Hart, Luis F. Lara, Zobeida Cruz-Monserrate, Steven Ing, Alice Hinton, Thomas A. Mace, David Bradley, Zarine K. Shah

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: CT scans are commonly performed in patients with chronic pancreatitis (CP). Osteopathy and fractures are recognized in CP but no osteoporosis screening guidelines are recommended. “Opportunistic” CT scan-derived bone density thresholds are assessed for identifying osteoporosis in CP. Methods: Retrospective pilot cohort study. CP subjects who had CT scans and dual-energy x-ray absorptiometry (DXA) within 1 year were included. CT-derived bone density was measured at the L1 level. Pearson’s correlation was performed between age and CT-derived bone density in Hounsfield unit (HU). Univariate analysis using HU to identify osteoporosis was performed at various thresholds of bone density. The discriminatory ability of the model was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC). Several HU thresholds were tested. Results: Twenty-seven CP subjects were included, of whom 11 had normal bone density, 12 osteopenia, and four osteoporosis on DXA. The mean age was 59.9 years (SD 13.0). There was a negative correlation of age with HU (r = −0.519, p = 0.006). CT-derived bone density predicted DXA-based osteoporosis in the univariable analysis (Odds Ratio (OR) = 0.97 95% Confidence Interval (CI) 0.94–1.00, p = 0.03). HU thresholds were tested. A threshold of 106 HU maximized the accuracy (AUC of 0.870). Conclusions: CT scan may be repurposed for “opportunistic” screening to rule out osteoporosis in CP. A larger study is warranted to confirm these results.

Original languageEnglish
Article number866945
JournalFrontiers in Physiology
Volume13
DOIs
StatePublished - May 31 2022

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases under award numbers: U01DK108327: DC, PH, DB, ZS, ZC-M, and LL U01DK108306: DY. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
Research reported in this publication was supported by the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases under award numbers: U01DK108327: DC, PH, DB, ZS, ZC-M, and LL U01DK108306: DY. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
Copyright © 2022 McNabb-Baltar, Manickavasagan, Conwell, Lu, Yadav, Hart, Lara, Cruz-Monserrate, Ing, Hinton, Mace, Bradley and Shah.

Keywords

  • CT scan
  • DXA (dual-energy X-ray absorptiometry)
  • chronic pancreatitis (CP)
  • opportunistic screening
  • osteoporosis

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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