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<p>Spine age estimated from lateral spine radiographs and DXA VFAs could be associated with fracture and mortality risk. In the VERTE-X cohort (<i>n</i> = 10,341, derivation set) and KURE cohort (<i>n</i> = 3517; external test set), spine age discriminated prevalent vertebral fractures and osteoporosis better than chronological age. Predicted age difference was associated with overall (adjusted HR [aHR] 1.22 per 1 SD increment, <i>p</i> &lt; 0.001), vertebral, non-vertebral incident fractures, and mortality (aHR 1.31, <i>p</i> = 0.001) during a median 6.6 years follow-up in KURE, independent of chronological age and covariates. Spine age to estimate FRAX hip fracture probabilities, instead of chronological age, improved the discriminatory performance for incident hip fracture (AUROC 0.83 vs. 0.78, <i>p</i> = 0.027). Shorter height, lower femoral neck BMD, diabetes, vertebral fractures, and surgical prosthesis were associated with higher predicted age difference, explaining 40% of variance. Spine age estimated from lateral spine radiographs and DXA VFA enhanced fracture risk assessment and mortality prediction over chronological age.</p>

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Spine age estimation using deep learning in lateral spine radiographs and DXA VFA to predict incident fracture and mortality

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月9日

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  • Sang Wouk Cho,
  • Namki Hong,
  • Kyoung Min Kim,
  • Young Han Lee,
  • Chang Oh Kim,
  • Hyeon Chang Kim,
  • Yumie Rhee,
  • Brian H. Chen,
  • William D. Leslie,
  • Steven R. Cummings

摘要

Spine age estimated from lateral spine radiographs and DXA VFAs could be associated with fracture and mortality risk. In the VERTE-X cohort (n = 10,341, derivation set) and KURE cohort (n = 3517; external test set), spine age discriminated prevalent vertebral fractures and osteoporosis better than chronological age. Predicted age difference was associated with overall (adjusted HR [aHR] 1.22 per 1 SD increment, p < 0.001), vertebral, non-vertebral incident fractures, and mortality (aHR 1.31, p = 0.001) during a median 6.6 years follow-up in KURE, independent of chronological age and covariates. Spine age to estimate FRAX hip fracture probabilities, instead of chronological age, improved the discriminatory performance for incident hip fracture (AUROC 0.83 vs. 0.78, p = 0.027). Shorter height, lower femoral neck BMD, diabetes, vertebral fractures, and surgical prosthesis were associated with higher predicted age difference, explaining 40% of variance. Spine age estimated from lateral spine radiographs and DXA VFA enhanced fracture risk assessment and mortality prediction over chronological age.