Osteodensitometry (bone density measurement) using quantitative computed tomography (QCT) is used for early diagnosis and follow-up of osteoporosis (bone loss). This procedure is used to determine bone density (mineral salt content of the bones). Note: Whether osteoporosis is present according to the WHO definition can only be determined by the DEXA method. Furthermore, with the quantitative CT-based CTXA (Computed Tomography X-Ray Absorptiometry) procedure, DXA-equivalent T-scores could be determined at the hip.
Indications (areas of application)
- Osteoporosis:
- Early detection of osteoporosis (bone loss).
- Early detection of osteopenia (reduction in bone density).
- Fracture risk assessment (bone fracture risk assessment).
- Stage classification of manifest osteoporosis.
- Follow-up of the progression
- Follow-up of the (drug) therapy.
- Patients over 65 years of age without risk factors for bone density reduction.
- Patients over 65 years of age with the following risk factors:
- Family history of osteoporosis – at least two family members with osteoporosis.
- Family history of diseases associated with bone density reduction.
- Hypogonadism – gonadal insufficiency (testes/ovaries) of male and female, respectively.
- Early climacteric (menopause, menopause)
- Fracture (bone fracture) after menopause.
- Age-related, significant loss of body size.
- Consumption of stimulants: alcohol (woman: > 20 g/day; man: > 30 g/day); tobacco (smoking – in osteoporosis after menopause).
- Lack of exercise
- BMI (body mass index) < 20 kg/m²
- Unintentional weight loss of more than 10 kg or of more than 10% in the last few years
- No estrogen substitution in the postmenopausal period.
- Other indications:
- Hormonal factors – estrogen deficiency in girls and young women, e.g., late menarche (delayed puberty, > 15 years of age).
- Early onset of menopause (< 45 years of age) or early ovariectomy (removal of the ovaries).
- Menopause (menopause in women)
- Andropause (menopause of the male)
- Anorexia nervosa (anorexia)
- Chronic diseases or surgeries that can trigger bone loss, e.g., small intestine diseases and stomach surgery
- Chronic renal insufficiency (chronic renal failure).
- Increased risk of falls (more than 2 falls in 6 months).
- Previously occurred fractures (bone fractures)
- Joint diseases with restricted movement
- Hyperthyroidism (hyperthyroidism)
- Hyperparathyroidism (parathyroid hyperfunction).
- Osteopathies (bone diseases)
- Glucocorticoid long-term therapy – cortisol intake.
- Systemic long-term therapy with the following other drugs: Antiepileptic drugs, glucocorticoids, heparin, Marcumar.
- Therapy with immunosuppressants after organ transplantation.
- Patients after transplantation, especially of kidney, liver and heart.
- Condition after surgery in the gastrointestinal tract (gastrointestinal tract).
The procedure
Rays penetrate the bone at different intensities depending on the bone density. This intensity is measured and aligned with a standard value. Quantitative computed tomography (QCT) is an x-ray tomography technique that allows separate measurement of the outer layer and the bone belly. Measurements are performed on the spine (QCT) or peripherally (peripheral quantitative computed tomography, pQCT), i.e., on the forearm, metacarpus, lower leg, or heel.
Benefits
Osteodensitometry (bone densitometry) using quantitative computed tomography (QCT) is a powerful diagnostic technique for assessing bone density and bone composition of the entire skeletal system. The most important field of application is the diagnosis, staging and follow-up of osteoporosis with regard to fracture risk. Regular check-ups will significantly reduce your risk of fracture and improve your quality of life.
