Osteoporosis prevalence high for all races, incomes undergoing lung cancer screening
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Key takeaways:
- Osteoporosis prevalence was high for current or former smokers undergoing lung cancer screening.
- CT with AI can detect osteoporosis risk and body composition without exposure to further radiation or testing.
Osteoporosis prevalence is high for patients undergoing lung cancer screening, regardless of race, ethnicity and income, but CT with AI detects osteoporosis and body composition without additional testing or radiation, researchers reported.
“Opportunistic CTs, CT scans performed for routine clinical purposes, can be used — with the help of AI — to quantify the amount of calcium buildup in the abdominal aorta,” Miriam A. Bredella, MD, MBA, radiologist at NYU Langone Health, told Healio. “We found that having any abdominal aortic calcification increased the risk of major adverse cardiovascular events by approximately twofold.”
Bredella and colleagues conducted an observational study, published in Bone, with 3,708 patients (mean age, 64 years; 46% women) who underwent lung cancer screening and had available demographic information and chest CT data for trabecular attenuation analysis. All patients were current or former smokers.
Overall, osteoporosis by trabecular attenuation was present among 69% of all patients when using the high-sensitivity threshold and 22% when using the high-specificity threshold.
Osteoporosis was more prevalent for women vs. men (74% vs. 65%; P < .001) and for white patients vs. other races and ethnicities (72% vs. 49%; P < .0001). However, researchers observed high osteoporosis prevalence across all races and ethnicities (Black patients, 38%; Asian patients, 55%; Hispanic patients, 56%). In addition, patients of all income classes had high osteoporosis prevalence, with 69% for low- and middle- and 91% for high-income classes.
Having a high visceral fat to subcutaneous fat ratio, aortic calcification and hepatic steatosis were all associated with lower trabecular attenuation (P < .01). Conversely, muscle mass was positively associated with trabecular attenuation (P < .01).
“CTs performed for routine clinical purposes should also be evaluated for aortic calcifications. This information can be used to prevent cardiovascular disease,” Bredella said. “Prospective studies need to be conducted to investigate whether opportunistic imaging can help guide appropriate cardiovascular prevention strategies.”
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