AI-derived T12 bone density trajectories from serial health-checkup chest CT in midlife women

In 1,034 women (4,185 chest CTs), AI-derived T12 bone density trajectories showed low baseline bone status was not a consistent marker of faster loss: absolute decline 10.82 vs 12.52 mg/cm3 (P=0.022), slope -3.08 vs -3.91 mg/cm3/yr (P=0.011).

• Retrospective single-center cohort of women aged 45-65 years; automated T11 and T12 bone mineral density was derived from serial noncontrast chest CT without a dual-energy X-ray absorptiometry or phantom-calibrated quantitative CT reference standard.
• Greater relative bone loss in the low baseline bone status group was not sustained after covariate adjustment or T11-only sensitivity analysis, indicating sensitivity to baseline dependence and status definition.
• Adding T11 bone mineral density to clinical variables did not clearly improve discrimination for rapid loss (AUC 0.708 vs 0.716; P=0.128).

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