The accuracy of bone mineral density measurement using dual-energy spectral CT and quantitative CT: a comparative phantom study

AIM To compare bone mineral density (BMD) measurement accuracy by dual-energy spectral computed tomography (CT) and quantitative CT (QCT) using an anthropomorphic European spine phantom (ESP). MATERIALS AND METHODS An ESP containing three hydroxyapatite inserts with densities of 50, 100, and 200 mg/cm3 was scanned 10 times each using spectral CT and QCT protocols. Their BMD values were measured using hydroxyapatite-based spectral CT material decomposition images and QCT images and compared with the true values in ESP. RESULTS Both protocols had good repeatability in BMD measurement with low coefficient-of-variance (spectral CT: CONCLUSION BMD can be accurately measured using either QCT or spectral CT, and spectral CT has smaller bias than QCT.