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Purpose: Toevaluatetheuseofdual-energyspectralCTimagingforquantifyingbonedensityinthespinefordiabeticpatients. Methods: Retrospectivelyanalyzed34malepatientswhohadnon-contrast,dual-energyspectralCTscansthatinvolvedspine. Amongthe34patients,16werediabeticpatientsformorethan5years(GroupA),and18werewithoutdiabetes.Theinclusion criteriawerenocontrast-enhancedscaninaweekbeforespectralCT;nomalignanttumorhistory;nodiseaseinthedigestive system;nodiffusebonemarrowdiseaseandnoindicationsofmetabolicdiseases.Materialdecompositionimageswere reconstructedwithastandardkernelatthicknessof1.25mmusinghydroxyapatite(HAP)andfatasabasismaterialpairin spectralCTreconstruction,andweretransferredtoanAW4.6workstationforquantitativeimageanalysis.ROIofabout100mm2 wasselectedbytwophysiciansofmorethan5-yearsofexperiencetocoverthecenterofthevertebraofL1-L4,avoidingvertebral veins,bonehyperplasiaandprominentartifacts.ThedensitymeasurementsforHAPandfatoftheL1-L4wereobtainedonthe HAP-basedandfat-basedmaterialdecompositionspectralCTimages,respectively.AnalyseswereperformedbyusingSPSS17.0 statisticalsoftware. Results:Age(57.25±7.74vs.55.66±10.29years)andBMI(23.42±2.68vs.23.31±3.21kg/m2)betweenthe2groupsshowedno difference(P>0.05).HAPdensityforthespinewas127.32±18.70mg/mlinthediabeticgroup(A),statisticallylowerthan the147.22±24.98mg/mlinthenormalgroup,(P<0.05).Thefatdensitiesforthespinewerethesameintwogroups(952.49±10.47 vs.947.16±17.00mg/ml),(P=0.73).Forthenormalgroup,HAPdensityforL3waslowerthanL1,L2andL4,butwasnot statisticallysignificant,whilethefatdensitieswerethesame.TheHAPvariationinthediabeticpatientgroupforL1-L4was smaller. Conclusion: Thereisdifferenceinbonedensitymeasurementinthespinebetweendiabeticandnon-diabeticpatients,andbone densitymaybequantifiedusingHAP-basedmaterialdecompositionimagesindual-energyspectralCTimaging.