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CORRELATION BETWEEN PSOAS MUSCLE INDEX ON COMPUTED TOMOGRAPHY AND BONE MINERAL DENSITY MEASURED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY
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Abstract
Objectives: This study aimed to evaluate the correlation between the Psoas Muscle Index (PMI) measured on computed tomography (CT) and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DEXA), as well as to analyze the association between vertebral Hounsfield Unit (HU) values and BMD. Methods: A cross-sectional, retrospective study was conducted on 379 patients who underwent abdominal CT scans (100–120 kV) and DEXA within 6 months at Tam Anh General Hospital, Ho Chi Minh City. Variables included age, sex, body mass index (BMI), PMI (L2–L4), vertebral HU values (L2–L4), and T-scores derived from DEXA. Correlations were assessed using Spearman’s test, group comparisons were performed with the Kruskal – Wallis test, and diagnostic performance was evaluated through receiver operating characteristic (ROC) curve analysis. Results: The mean age of the study population was 57.2 ± 12.7 years, with a predominance of females. PMI decreased progressively with age, was lower in females, and showed a positive correlation with BMI. PMI exhibited a weak correlation with T-score (r = 0.348, p < 0.05). Vertebral HU values from L2 to L4 demonstrated a strong correlation with T-scores obtained from DEXA (r ≈ 0.70–0.78; p < 0.05). For 100 kV scans, an L3 HU value >183 was strongly indicative of normal BMD, whereas values <104 suggested osteoporosis; values between 104 and 183 indicated osteopenia or osteoporosis. For 120 kV scans, an L3 HU value >149 indicated normal BMD, whereas values <80 suggested osteoporosis; values between 80 and 149 suggested osteopenia or osteoporosis. Conclusions: Vertebral HU values obtained from routine abdominal CT scans provide a strong predictive value for bone status, particularly at the L3 level. PMI showed only a weak association with BMD. HU measurements may serve as an opportunistic screening tool for osteoporosis in patients undergoing routine abdominal CT.
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Keywords
Osteoporosis, Psoas Muscle Index (PMI), Dual-Energy X-ray Absorptiometry (DEXA)
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