Osteoporosis often goes undetected until a bone breaks. But what if a CT scan you're already getting for another reason could spot it early? A new study suggests that routine spine CT scans may help predict osteoporosis risk by looking at the outer layer of bone, called cortical bone.
Researchers analyzed CT scans of 169 people who also had a specialized bone density test (QCT). They measured the thickness, area, and density of the cortical bone in the first lumbar vertebra. They found that these measurements decreased with age and with worsening bone health—from normal to osteopenia to osteoporosis.
The study found that certain cortical bone parameters could predict osteoporosis with good accuracy. For men, the total volume of cortical bone had an AUC of 0.84, meaning it correctly identified osteoporosis 84% of the time. The average area had 90% specificity, so it rarely flagged healthy people as having osteoporosis. Similar trends were seen in women.
This is a retrospective study, meaning it looked back at existing data. It shows an association, not cause and effect. The researchers say these parameters "may potentially help" in detecting osteoporosis, but more research is needed before this becomes standard practice. Still, for anyone getting a spine CT, this could one day mean an early warning without an extra test.