Opportunistic Screening for Osteoporosis Using Hand Radiographs: A Preliminary Study

Abstract

Patients with low bone mineral density (BMD) are at risk for fractures however are often undiagnosed. Therefore, there is a need to opportunistically screen for low BMD in patients who present for other studies. This is a retrospective study of 812 patients aged 50 years or older who had dual-energy X-ray absorptiometry (DXA) and radiographs of the hands within 12 months of each other. This dataset was randomly split into training/validation (n=533) and test (n=136) datasets. A deep learning (DL) framework was used to predict osteoporosis/osteopenia. Correlations between the textural analysis of the bones and DXA measurements were obtained. We found that the DL model had an accuracy of 82.00%, sensitivity of 87.03%, specificity of 61.00% and an area under the curve (AUC) of 74.00% to detect osteoporosis/osteopenia. Our findings show that radiographs of the hand can be used to screen for osteoporosis/osteopenia and identify patients who should get formal DXA evaluation.