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dc.contributor.authorAggarwal, Veenaen
dc.contributor.authorMaslen, Christinaen
dc.contributor.authorAbel, Richard Len
dc.contributor.authorBhattacharya, Pinakien
dc.contributor.authorBromiley, Paul Aen
dc.contributor.authorClark, Emma Men
dc.contributor.authorCompston, Julieten
dc.contributor.authorCrabtree, Nicolaen
dc.contributor.authorGregory, Jennifer Sen
dc.contributor.authorKariki, Eleni Pen
dc.contributor.authorHarvey, Nicholas Cen
dc.contributor.authorWard, Kate Aen
dc.contributor.authorPoole, Kennethen
dc.date.accessioned2021-05-20T23:30:33Z
dc.date.available2021-05-20T23:30:33Z
dc.date.issued2021-01en
dc.identifier.issn1759-720X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/322772
dc.description.abstractOsteoporosis causes bones to become weak, porous and fracture more easily. While a vertebral fracture is the archetypal fracture of osteoporosis, it is also the most difficult to diagnose clinically. Patients often suffer further spine or other fractures, deformity, height loss and pain before diagnosis. There were an estimated 520,000 fragility fractures in the UK in 2017 (costing £4.5 billion), a figure set to increase 30% by 2030. One way to improve both vertebral fracture identification and the diagnosis of osteoporosis is to assess a patient’s spine or hips during routine Computed Tomography (CT) scans. Patients attend routine CT for diagnosis and monitoring of various medical conditions, but the skeleton can be overlooked as radiologists concentrate on the primary reason for scanning. More than half a million CT scans done each year in the NHS could potentially be screened for osteoporosis (increasing 5% annually). If CT-based screening became embedded in practice, then the technique could have a positive clinical impact in the identification of fragility fracture and/or low bone density. Several companies have developed software methods to diagnose osteoporosis/ fragile bone strength and/or identify vertebral fractures in CT datasets, using various methods that include image processing, computational modelling, artificial intelligence and biomechanical engineering concepts. Technology to evaluate Hounsfield Units is used to calculate bone density, but not necessarily bone strength. In this rapid evidence review, we summarize the current literature underpinning approved technologies for opportunistic screening of routine CT images to identify fractures, bone density or strength information. We highlight how other new software technologies have become embedded in NHS clinical practice (having overcome barriers to implementation) and highlight how the novel osteoporosis technologies could follow suit. We define the key unanswered questions where further research is needed to enable the adoption of these technologies for maximal patient benefit.
dc.description.sponsorshipRoyal Osteoporosis Society and NIHR Cambridge Biomedical Research Centre
dc.format.mediumElectronic-eCollectionen
dc.languageengen
dc.publisherSAGE Publications
dc.rightsAll rights reserved
dc.rights.uri
dc.titleOpportunistic diagnosis of osteoporosis, fragile bone strength and vertebral fractures from routine CT scans; a review of approved technology systems and pathways to implementation.en
dc.typeArticle
prism.publicationDate2021en
prism.publicationNameTherapeutic advances in musculoskeletal diseaseen
prism.startingPage1759720X211024029
prism.volume13en
dc.identifier.doi10.17863/CAM.70228
dcterms.dateAccepted2021-05-18en
rioxxterms.versionofrecord10.1177/1759720x211024029en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2021-01en
dc.contributor.orcidAggarwal, Veena [0000-0002-3641-6388]
dc.contributor.orcidCompston, Juliet [0000-0001-5660-4151]
dc.contributor.orcidGregory, Jennifer S [0000-0002-6328-4560]
dc.contributor.orcidPoole, Kenneth [0000-0003-4546-7352]
dc.identifier.eissn1759-7218
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idARTHRITIS RESEARCH UK (17822)
pubs.funder-project-idArthritis Research Uk (20109)
pubs.funder-project-idEvelyn Trust (unknown)
pubs.funder-project-idNational Institute for Health Research ()
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (A095016 NIHR RfPB)
cam.orpheus.successMon Aug 02 07:30:51 BST 2021 - Embargo updated*
cam.orpheus.counter11*
rioxxterms.freetoread.startdate2021-01-31


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