Comprehensive Summary
This study examines age-related changes to vBMD using analysis of chest CT scans to observe the proximal humerus. Using a nnU-Net–based deep learning pipeline, trained on 200 randomly chosen chest CT scans, 2675 chest CT scans of patients ranging in sex and age were analyzed. Three regions of interest were quantitatively measured in Houndsfield units, then those values were further analyzed to be converted into vBMD. Lumbar spine vBMD values were also collected with a similar methodology. The data shows that females have a marked decrease in vBMD with age after their perimenopausal transition, and that there is a consistent loss in vBMD for both sexes as they age. Lumbar spine vBMD showed a low correlation with vBMD total and other vBMD metrics measured based on the proximal humerus. The discussion states that the female vBMD lumbar data has higher values than men before the age of 45, followed by an inflection point and steep decline. The discussion also highlights the value of the findings on female vBMD in the Lumbar spine and the novel methodology of analyzing the proximal humerus for vBMD.
Outcomes and Implications
This study is valuable due to the novel insight it has on proximal humeral vBMD, and the findings of sex-specific age-related changes in vBMD. These findings can be built upon clinically by analyzing data to better inform preoperative planning, which will improve patient outcomes. The data on age-related changes will also serve as practical for estimating vBMD based on age alone