Opportunistic Osteoporosis Screening in Breast Cancer Using AI-Derived Vertebral BMD from Routine CT: Validation Against QCT and Multivariable Diagnostic Modeling
Abstract
Background/Objectives: Breast cancer survivors face elevated risk of treatment-related bone loss, yet routine bone health assessment remains underutilized. Opportunistic bone density extraction from routine CT may address this gap. This study validated AI-derived vertebral bone mineral density (AI-vBMD) from non-contrast thoracoabdominal CT for osteoporosis screening and assessed its diagnostic value beyond clinical variables. Methods: This retrospective study included 332 breast cancer patients; AI-vBMD was successfully extracted in 325 (98%). Quantitative CT (QCT) served as reference standard. Agreement between AI-vBMD and QCT-vBMD was assessed using Pearson correlation, Bland–Altman analysis, and weighted kappa for QCT-defined osteoporosis (
Fields of Study & Subjects
Bone health and osteoporosis research
Medical Imaging Techniques and Applications
Bone health and treatments
Publication details
- Journal / source
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Volume
- 15
- Issue
- 2
- Pages
- 512–512
- Publication date
- 8 January 2026
- Language
- EN