Validation of a Deep Learning Tool for Opportunistic Osteoporosis Screening Using Routine Non-Contrast CT Scans
Prospective Clinical Validation Study of a Deep Learning Model for Opportunistic Osteoporosis Screening Based on Non-Contrast CT Scans
The goal of this clinical trial is to test if an artificial intelligence (AI) tool called DeepBMD can accurately identify people at high risk for osteoporosis using routine chest or abdomen CT scans. The main questions it aims to answer are:
- Can the DeepBMD tool correctly identify people who have osteoporosis compared to the standard bone density test, dual-energy X-ray absorptiometry (DXA)?
- Is it practical to use this AI tool in real-world hospital settings to find and contact high-risk patients? Researchers will use the DeepBMD tool to analyze existing CT scans. If the tool flags a patient as high risk, researchers will call them to invite them for a standard bone density test (DXA).
Participants will:
- Have their existing chest or abdomen CT scan analyzed by the DeepBMD AI tool;
- Receive a phone call from the research team if identified as high risk;
- Visit the clinic for a free standard bone density test (DXA) if they agree to participate.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Locations
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Hubei
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Wuhan, Hubei, China, 430022
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Underwent non-contrast CT at our institution, with qualified image quality and no severe artifacts;
- Identified as high-risk for osteoporosis by the DeepBMD model;
- Had valid contact information available in the PACS, possessed normal cognitive and communication abilities, and was able to cooperate with telephone follow-ups and on-site examinations;
- Voluntarily participated in the study, was able to sign a written informed consent form on-site, and agreed to undergo DXA examination.
Exclusion Criteria:
- Severe spinal deformity, postoperative spinal internal fixation, malignant bone metastasis, or severe osteolytic lesions that may interfere with measurements;
- A confirmed diagnosis of osteoporosis with ongoing standardized treatment;
- Inability to be contacted, explicit refusal of follow-up, or inability to visit the hospital for informed consent signing and DXA examination.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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High-risk patients for osteoporosis identified by DeepBMD model
Patients who underwent routine chest or abdominal CT scans and were identified as high risk for osteoporosis by the DeepBMD AI model.
These participants will be contacted via telephone, invited to the clinic, and undergo a free DXA scan to verify bone mineral density.
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The DeepBMD model is applied to routine chest or abdominal CT scans to identify patients at high risk for osteoporosis.
This is a non-invasive image analysis used solely for screening and recruitment purposes, not as a therapeutic intervention.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic performance of DeepBMD model for osteoporosis screening
Time Frame: Concurrent with the DXA validation visit following the CT analysis (within 7 days).
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The diagnostic performance of the DeepBMD model will be evaluated by comparing its predictions against the gold standard Dual-energy X-ray Absorptiometry (DXA).
Specifically, we will calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the Area Under the Receiver Operating Characteristic Curve (AUC) for identifying patients with osteoporosis.
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Concurrent with the DXA validation visit following the CT analysis (within 7 days).
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility of the DeepBMD screening and recall workflow
Time Frame: At the end of recruitment
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It will be assessed by calculating the proportion of patients identified as high-risk by DeepBMD who successfully complete the telephone follow-up and undergo the confirmatory DXA scan within the scheduled timeframe.
We will also record the reasons for refusal or loss to follow-up to evaluate the acceptability of this AI-driven screening pathway.
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At the end of recruitment
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Fan Yang, PhD, MD, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Publications and helpful links
General Publications
- Jang S, Graffy PM, Ziemlewicz TJ, Lee SJ, Summers RM, Pickhardt PJ. Opportunistic Osteoporosis Screening at Routine Abdominal and Thoracic CT: Normative L1 Trabecular Attenuation Values in More than 20 000 Adults. Radiology. 2019 May;291(2):360-367. doi: 10.1148/radiol.2019181648. Epub 2019 Mar 26.
- Wang P, She W, Mao Z, Zhou X, Li Y, Niu J, Jiang M, Huang G. Use of routine computed tomography scans for detecting osteoporosis in thoracolumbar vertebral bodies. Skeletal Radiol. 2021 Feb;50(2):371-379. doi: 10.1007/s00256-020-03573-y. Epub 2020 Aug 7.
- Smith AD. Screening of Bone Density at CT: An Overlooked Opportunity. Radiology. 2019 May;291(2):368-369. doi: 10.1148/radiol.2019190434. Epub 2019 Mar 26. No abstract available.
- Zeng Q, Li N, Wang Q, Feng J, Sun D, Zhang Q, Huang J, Wen Q, Hu R, Wang L, Ma Y, Fu X, Dong S, Cheng X. The Prevalence of Osteoporosis in China, a Nationwide, Multicenter DXA Survey. J Bone Miner Res. 2019 Oct;34(10):1789-1797. doi: 10.1002/jbmr.3757. Epub 2019 Aug 29.
- Cheng X, Zhao K, Zha X, Du X, Li Y, Chen S, Wu Y, Li S, Lu Y, Zhang Y, Xiao X, Li Y, Ma X, Gong X, Chen W, Yang Y, Jiao J, Chen B, Lv Y, Gao J, Hong G, Pan Y, Yan Y, Qi H, Ran L, Zhai J, Wang L, Li K, Fu H, Wu J, Liu S, Blake GM, Pickhardt PJ, Ma Y, Fu X, Dong S, Zeng Q, Guo Z, Hind K, Engelke K, Tian W; China Health Big Data (China Biobank) project investigators. Opportunistic Screening Using Low-Dose CT and the Prevalence of Osteoporosis in China: A Nationwide, Multicenter Study. J Bone Miner Res. 2021 Mar;36(3):427-435. doi: 10.1002/jbmr.4187. Epub 2020 Nov 4.
- Lin X, Xiong D, Peng YQ, Sheng ZF, Wu XY, Wu XP, Wu F, Yuan LQ, Liao EY. Epidemiology and management of osteoporosis in the People's Republic of China: current perspectives. Clin Interv Aging. 2015 Jun 25;10:1017-33. doi: 10.2147/CIA.S54613. eCollection 2015.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- UHCT260668
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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