31. Quantitative Computed Tomography in Children and Adults

  1. Clifford J. Rosen MD
  1. C.C. Glüer

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch31

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Glüer, C.C. (2013) Quantitative Computed Tomography in Children and Adults, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch31

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • adults;
  • bone mineral density (BMD);
  • children;
  • clinical application;
  • finite element (FE) modeling;
  • fracture risk assessment;
  • quantitative computed tomography (QCT);
  • spinal single-slice QCT

Summary

Quantitative computed tomography (QCT) is a potential alternative for the future because in addition to volumetric density it permits assessment of bone microstructure and calculation of whole bone strength. This chapter outlines the technical and clinical considerations. Z-scores should be used for diagnostic assessment of children. T-scores should be used for diagnostic assessment of adults. The diagnostic threshold given by the World Health Organization (WHO) of a T-score of -2.5 cannot be applied to QCT. QCT methods permit assessment of volumetric density and bone microstructure. For spinal single-slice QCT, the risk of fracture at a given T-score level is smaller than for dual X-ray absorptiometry (DXA) because a larger fraction of the T-score reflects age-associated risk, leaving less to BMD-associated risk. A major advantage of tomographic approaches is the feasibility to use the data as the basis for finite element (FE) analysis.