Imaging Sci Dent.  2014 Dec;44(4):263-271. 10.5624/isd.2014.44.4.263.

Osteoporosis prediction from the mandible using cone-beam computed tomography

• Barngkgei
• Al Haffar
• Khattab R

• KMID: 1974494
• DOI: http://doi.org/10.5624/isd.2014.44.4.263

Abstract

PURPOSE
This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program.
MATERIALS AND METHODS
Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cmx15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores.
RESULTS
RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae.
CONCLUSION
Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

Keyword

Bone Density; Cone-Beam Computed Tomography; DXA Scan; Osteoporosis

MeSH Terms

Absorptiometry, Photon
Bone Density
Cone-Beam Computed Tomography*
Diagnosis
Female
Femur Neck
Hip
Humans
Logistic Models
Lumbar Vertebrae
Mandible*
Osteoporosis*
Sensitivity and Specificity

Figure

• 

  Fig. 1 The angulation adjustment procedure of the CBCT images is seen. Coronal (A) and axial (B) slices before angulation adjustment. Note that the openings of the left and the right foramina do not appear symmetrical in the same coronal slice. The angulation of the coronal slice (C) is adjusted using the coronal (the green) cursor on the axial slice window (D). Now, both foramina appear simultaneously on the coronal views. This is checked further by navigating through all the coronal slices. Using the axial (the red) cursor on the coronal slice window (E), we adjusted the angulation of the axial slice (F) to be parallel with the lower border of both foramina.

• 

  Fig. 2 Measurement procedure for the radiographic density (gray values) and the area (mm2) of the whole bony region and for the trabecular bone alone the mandibular body slice. A. The image shows the slice before the adjustment of the window width and level. B. The window width and level are adjusted to 0 and 960 gray values, respectively. C. The radiographic density (gray values) and the area (mm2) of the whole bony region are measured using the software. D. The radiographic density (gray values) and the area(mm2) of the trabecular bony region are measured.

• 

  Fig. 3 Measurement procedure for the radiographic density (gray values) and the area(mm2) of the whole bony region and for the trabecular bone alone the ramus slice A. The axial image shows the slice before the adjustment of the window width and level. B. The window width and level are adjusted to 0 and 960 gray values, respectively. C. The radiographic density (gray values) and the area (mm2) of the whole bony region are measured. D. The radiographic density (gray values) and the area (mm2) of the trabecular bony region are measured.

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