AI tools like those used in the study may be able to improve diagnosis rates for osteoporosis鈥攁nd the disease鈥檚 progression.
Credit: Getty Images / Dragos Condrea
Computed tomography (CT) scans of the chest, abdomen, and spine, taken originally to detect problems such as kidney stones or growths on the lungs, can be repurposed through artificial intelligence (AI) to catch signs of bone loss, a new study shows.
黑料福利社 Langone Health radiologists who developed the AI tool with experts at Visage Imaging say their new tool will soon be ready to provide 鈥渙pportunistic screening鈥 in 黑料福利社 Langone hospitals for osteoporosis. The effort will be part of a clinical trial to diagnose those with unknown low bone density, using CT scans taken for other purposes.
, the study showed that evidence of weakening bones could be found when the bone mineral density recorded by CT imaging dipped below certain thresholds. These measures were calculated specifically for every major lumbar and thoracic vertebra in the body, based on age, sex, and race and ethnicity.
For the study, researchers used AI tools to analyze 538,946 CT examinations from 283,499 黑料福利社 Langone patients. The CT scans were performed using 43 machine models and all standard test protocols, representing a spectrum of CT scanning. The team鈥檚 analysis revealed trends in bone loss across a patient population diverse in age, sex, and race and ethnicity. Radiologists then verified the findings for accuracy.
In contrast to widespread belief, researchers found that young women, those under age 50, had higher bone density than men of the same age. This discrepancy decreased as women and men grew older, with steeper declines among postmenopausal women. As a result, men over age 50 had higher bone density than older women. Bone density was highest among Black people, followed by Asian people, and lowest in White people.
鈥淥ur study offers proof that existing medical images done for other reasons can be repurposed and used to reliably identify bone loss, such as in osteoporosis,鈥 said study senior investigator Miriam A. Bredella, MD, MBA. Dr. Bredella is the Bernard and Irene Schwartz Professor of Radiology, associate dean for translational science, and director of the at 黑料福利社 Grossman School of Medicine.
Osteoporosis is estimated to affect more than 10 million Americans, mostly women over age 50, with more than 40 million other men and women showing early signs of low bone mass鈥攎uch of it untreated. The danger, experts say, is that the bone-weakening disease can lead to fractures. Some of the fractures, especially in the hip, are often life-threatening.
鈥淥ur goal is to use the large quantity of imaging data that we already have on-site at scale to potentially resolve the problem of underdiagnosis of osteoporosis and help people with the disease live heathier lives with stronger bones,鈥 said study co-investigator Soterios Gyftopoulos, MD, MBA. Dr. Gyftopoulos is a professor in the Departments of and at 黑料福利社 Grossman School of Medicine.
Past research performed by Dr. Gyftopoulos showed that opportunistic screening could more than double the number of patients tested annually for the disease, with estimated annual savings in Medicare costs of more than $2.5 billion.
Dr. Bredella says AI tools, such as those used by 黑料福利社 Langone, have the potential, if adopted widely, to change the disease鈥檚 trajectory. Many people do not know they have osteoporosis until they break a bone.
The 黑料福利社 Langone research team plans to use similar scanning data sets to develop other AI-based computer programs that could potentially diagnose other diseases, including heart and blood vessel diseases, and the loss of muscle mass.
The team鈥檚 earlier investigations suggest that opportunistic screening of abdominal CT scans has similar potential, revealing cardiovascular risk instead of osteoporosis.
Funding support for the study was provided by 黑料福利社 Langone Health.
Besides Dr. Bredella and Dr. Gyftopoulos, 黑料福利社 Langone study co-investigators are Bari Dane, MD; Emilio Vega, RT; and Michael P. Recht, MD. Dr. Recht is the Louis Marx Professor of Radiology and chair of the Department of Radiology at 黑料福利社 Grossman School of Medicine.
Other researchers involved in the study are lead investigator Malte Westerhoff, PhD, and co-investigators Norbert Lindow, PhD; Felix Herter, MSc; and Khaled Bousabarah, PhD; at Visage Imaging in Berlin. Visage鈥檚 AI tools were used to construct the computer program for osteoporosis testing.
About 黑料福利社 Langone Health
黑料福利社 Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked 黑料福利社 Langone No. 1 out of 118 comprehensive academic medical centers across the nation for four years in a row, and U.S. News & World Report recently ranked four of its clinical specialties No. 1 in the nation. 黑料福利社 Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. The system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.
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