CPT® Code 0691T

1. Indications

The automated analysis of an existing computed tomography study for vertebral fracture(s) is indicated for the following conditions:

• Assessment of Vertebral Fractures This procedure is performed to evaluate existing vertebral fractures, which are common in patients with osteoporosis.
• Risk Assessment for Future Fractures It is utilized to estimate vertebral strength and assess the risk of future fractures, particularly in patients who may present with normal bone mineral density on DXA scans.
• Bone Density Evaluation The analysis may also be indicated when there is a need to assess bone density, especially in cases where traditional methods may not provide a complete picture of bone health.

2. Procedure

The procedure for automated analysis of an existing computed tomography study for vertebral fractures involves several detailed steps:

• Step 1: Image Acquisition The process begins with the acquisition of a CT study that has already been performed on the patient. This existing imaging data serves as the foundation for the automated analysis.
• Step 2: Image Segmentation The next step involves segmenting the bone image from the CT study. This segmentation process isolates the vertebral structures from surrounding tissues, allowing for a focused analysis of the vertebrae.
• Step 3: Voxel Conversion Following segmentation, voxel intensity values are converted into bone mineral density measurements. The bone volume is transformed into 1x1x1mm voxels, which are essential for the subsequent analysis.
• Step 4: Finite Element Modeling Each voxel is then converted into a hexahedral finite element, with properties assigned based on the corresponding bone mineral density. This modeling is crucial for simulating the mechanical behavior of the vertebrae under stress.
• Step 5: Simulation of Axial Compression The procedure includes the application of simulated uniform axial compression in a virtual environment. This simulation helps in determining the strength of the vertebrae under load conditions.
• Step 6: Strength Assessment After the simulation, the vertebral strength is assessed based on the results of the finite element analysis, providing valuable insights into the risk of fracture.
• Step 7: Volumetric Bone Density Calculation Additionally, the same software can be used to assess integral volumetric bone density by calculating the average density over the entire vertebral body, offering a comprehensive evaluation of bone health.

3. Post-Procedure

Post-procedure care for the automated analysis of vertebral fractures typically involves the interpretation of the results and the generation of a detailed report. The findings from the analysis should be discussed with the patient to inform them of their fracture risk and any necessary follow-up actions. There are no specific recovery requirements associated with this analysis, as it is a non-invasive procedure that utilizes existing imaging data. However, healthcare providers may recommend further diagnostic testing or treatment options based on the results of the analysis and the patient's overall clinical picture.