1.Diagnostic accuracy of Lumbar Spine Bone Mineral Density (BMD) measurements via Quantitative Computed Tomography (QCT) in the assessment of osteoporosis in Filipino women diagnosed with breast cancer using Dual-Energy X-ray Absorptiometry (DXA) as gold standard
Raquel Marie R. Cabatu ; Angela Krista V. Pedroso ; Irene g S. Bandon
The Philippine Journal of Nuclear Medicine 2021;16(1):8-15
Background:
Breast cancer, chemotherapy and endocrine treatment are risk factors for osteoporosis. Dual-energy x-ray
absorptiometry (DXA) remains the gold standard in the diagnosis of osteoporosis. A quantitative computed
tomography (QCT) with a bone mineral density analysis software on the whole abdomen CT may be used for
screening osteoporosis without additional radiation exposure or cost.
Objective:
To determine the accuracy of QCT in detecting osteoporosis among breast cancer patients using DXA as gold
standard.
Methods:
This is a cross-sectional analytic study of 76 Filipino women with breast cancer who underwent both DXA and
whole abdomen CT scans. The DXA measurements were obtained using Lunar iDXA manufactured by GE
Healthcare while the QCT measurements were made using the BMD analysis software available in the Philips
Extended Brilliance Workspace post-processing system.
Results:
Out of the 76 Filipino women with breast cancer, 92% were menopausal women with mean age of 58.9 (SD 8.7)
years, 69.7% had IDCA and 94.7% had mastectomy. Majority had normal BMD (44.7%), 34.2% had osteopenia
and 21.1% had osteoporosis based on DXA. QCT has 90% (95% CI: 55.5-99.8) sensitivity, 63.6% (95% CI: 30.1-
89.1) specificity, 69.2% (95% CI: 50.1-83.5) PPV, 87.5 (95% CI:50.8-97.9) NPV, 2.5 (95% CI:1.1-5.6) LR(+) and
0.16 (95% CI:0.02-1.06) LR (-).
Conclusion
The prevalence of osteoporosis and osteopenia among Filipino women with breast cancer was 21.1% and
34.2%. The sensitivity and specificity of QCT in detecting osteoporosis was 90% and 63.6%.
Osteoporosis
;
Bone Diseases, Metabolic
;
Breast Neoplasms