Diagnostic efficiency of chest CT for opportunistic screening for osteoporosis and low BMD in postmenopausal women

Early diagnosis and treatment of osteoporosis and low bone mineral density (BMD) may help avoiding vertebral or other fractures and improving the outcomes. While computed tomography (CT) scans are beneficial for diagnosis, the optimal and most convenient method for opportunistic screening is not yet determined. This retrospective study evaluated how well chest CT can diagnose osteoporosis and low BMD at the T11 and T12 levels, using dual-energy X-ray absorptiometry (DXA) as the standard reference in participants who received CT and DXA scans. We included 147 postmenopausal women. Based on the lowest T-score from the DXA test, all patients were classified into normal, osteopenia, and osteoporosis groups. Both T11 HU and T12 HU showed a strong correlation with T-scores (P < 0.01). They are similar in their ability to diagnose osteoporosis (AUC, 0.806 vs. 0.841; P = 0.210) and low BMD (AUC, 0.824 vs. 0.825; P = 0.977), which may serve as a readily accessible screening tool for early diagnosis.