Radiology experts recommend routine chest CT as ‘cost free’ method to assess other concerns in certain patients

Radiology researchers are recommending routine chest CT as a “cost free” method to assess certain patient populations for other concerns.

University of Washington, Seattle, scientists are focused on lung transplant recipients, who are at an increased risk of osteoporosis following surgery. Incidence of fragility fractures stemming from the disease can occur in 35% to 50% of lung transplant recipients, a 2022 study found.

Ali Nabipoorashrafi, MD, and colleagues sought to better understand how this potential practice might work, analyzing data from 110 individuals who underwent lung transplantation and at least two CT scans.

“In recent years, there has been a growing acknowledgment that routine CT imaging conducted for various reasons can serve as opportunistic imaging to identify individuals with osteoporosis,” Nabipoorashrafi, a postdoctoral researcher at UW, and co-authors detailed July 30 in Clinical Imaging [1]. “The main purpose of this study is to show the feasibility of using data from chest CT as a cost-free screening tool for early diagnosis of osteoporosis in lung transplant recipients.”

The current “gold standard” for measuring bone mineral density is dual-energy X-ray absorptiometry, the authors noted. However, DEXA can come with limitations including frequent false negative results among osteoporotic patients with vertebral compression fractures and measurement skewness. Lung transplant patients already must undergo multiple CT scans, containing “hidden information that can be used for various purposes.”

For the analysis, Nabipoorashrafi and co-authors identified all patients who underwent lung transplants at the Seattle institution between 2021 and early 2023. A total of 93 participants met the study criteria at an average age of 58. The most common underlying ailment leading to a transplant was interstitial lung disease (57%). Researchers discovered “significant” reduction in thoracic vertebral body bone density from levels T3 to T12 of the spine, with the greatest seen at T10. The inter-scan interval was about 34 months, and the authors noted a decrease in the average vertebral compression ratio.

“Our results demonstrate a significant reduction in vertebral body bone density and compression ratio using chest CT in lung transplant recipients,” Nabipoorashrafi et al. wrote. “This study shows that utilizing routinely ordered chest CT scans in lung transplant recipients can be considered as a cost-free tool for assessing the vertebral body bone changes and provide information that can potentially be used to prevent complications related to osteoporosis.”

Read more, including potential study limitations, at the link below.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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