Detection of aortic calcification during vertebral fracture assessment (VFA) compared to digital radiography.
BACKGROUND
Cardiovascular disease is the most common cause of mortality among post-menopausal women. Our objective was to determine whether or not lateral spine images obtained on a bone densitometer to detect prevalent vertebral fracture can also accurately detect radiographic abdominal aortic calcification (AAC), an important risk factor for cardiovascular disease independent of clinical risk factors.


RESULTS
One hundred seventy four postmenopausal women had bone densitometry, lateral spine densitometry imaging (called vertebral fracture assessment, or VFA), and lateral spine digital radiographs. Radiographs and VFA images were scored for AAC using a previously validated 24 point scale and a simplified, new 8 point scale (AAC-8). One hundred fifty six (90%) of the VFA images were evaluable for AAC. The non-parametric intraclass correlation coefficient between VFA and radiographic 24 point and AAC-8 readings, respectively, were 0.80 (95% C.I. 0.68-0.87) and 0.76 (95% C.I. 0.65-0.84). Areas under receiver operating characteristics (ROC) curves for VFA to detect those with a radiographic 24-point AAC score >or=5 were 0.86 (95% C.I. 0.77-0.94) using the 24 point scale and 0.84 (95% C.I. 0.76-0.92) using the AAC-8 scale.


CONCLUSIONS
VFA imaging intended to detect prevalent vertebral fracture can also detect radiographic AAC, an important cardiovascular disease risk factor. Since bone densitometry is recommended for all women age 65 and older, VFA imaging at the time of bone densitometry offers an opportunity to assess this risk factor in the post-menopausal female population at very little incremental time and expense.
Park Nicollet Health Services, Minneapolis, Minnesota, United States of America. john.schousboe@parknicollet.com
John T
JT
Schousboe
Kevin E
KE
Wilson
Thomas N
TN
Hangartner
D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D015519:Bone Density; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D003720:Densitometry / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods*; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000473:pathology