Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques (original) (raw)
Related papers
The role of quantitative ultrasound in predicting osteoporosis defined by dual X-ray absorptiometry
Rheumatology International, 2001
The aim of this study was to establish whether quantitative ultrasound (QUS) parameters could identify patients classi®ed as osteoporotic and osteopenic on the basis of dual energy X-ray absorptiometry (DEXA). One hundred and twenty-three patients (39 male, 84 female) with osteoporosis and suspected of having osteoporosis were included in this study. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured and bone mineral densities (BMD) of the lumbar spine and left hip was measured by DEXA. Subjects were classi®ed into three groups (normal, osteopenic and osteoporotic) on the basis of BMD T-scores measured by DEXA. QUS parameters of the osteoporotic group were signi®cantly lower than those of osteopenic and normal groups; there was no dierence in QUS parameters between the normal and osteopenic groups. Correlations of both right and left SOS and BUA with the spine and femoral neck BMD were moderate (r 0.343±0.539, P < 0.001). There was also reasonable correlation between DEXA and QUS T-scores (r 0.364±0.510, P < 0.001). QUS had a sensitivity of 21% and a speci®city of 95% for diagnosing osteoporosis. We concluded that, although DEXA and QUS parameters were signi®cantly correlated, QUS parameters can not predict osteopenia as de®ned by DEXA, and sensitivities and speci®cities of QUS parameters were not suciently high for QUS to be used as an alternative to DEXA.
2020
Objective: This study was designed with an aim to evaluate the ability of dual-energy X-ray absorptiometry (DXA) in the diagnosis of osteopenia and osteoporosis. Materials and Methods: In this prospective study DXA scan was utilized to examine the bone density for 30 participants. The statistical diagnostic test was used to detect sensitivity, specificity and accuracy of a DXA scan regarding to the findings of histological histomorphometric parameters in the obtained bone biopsies. Results: The DXA scan revealed a T-score = -2.5 SD in participants 12 (40%) diagnosed with osteoporosis while a T-score = -1 SD was detected in participants 10 (33.3%) diagnosed with osteopenia. The sensitivity, specificity and accuracy of DXA T-score in diagnosing osteoporosis and osteopenia cases ANALYSIS 24(106), November December, 2020 Medical Science ISSN 2321–7359 EISSN 2321–7367
New Ultrasound-Based Methods for Early Osteoporosis Diagnosis and Fracture Risk Estimation
International Journal of Measurement Technologies and Instrumentation Engineering
Osteoporosis is the most common disorder of bone metabolism. The main consequence of this disease is the increased risk of fracture. Osteoporotic fractures represent a serious problem in terms of social and economic costs. Then, there is a strong need for the assessment of the best practices in prevention and treatment of osteoporosis. Dual X-ray absorptiometry (DXA) represents the current “gold standard” method for osteoporosis diagnosis. However, DXA cannot be employed for population mass screenings, because of required exposition to ionizing radiation and high management costs. The aim of this paper was to review the currently available techniques for osteoporosis diagnosis and also to illustrate the feasibility of an innovative quick, cheap and non-invasive ultrasound-based methodology. The results recently published by the authors' research group suggest that the proposed approach has the potential for routine application in early diagnosis, which is the key to resize the i...
Calcified Tissue International, 2002
The study assessed the precision, sensitivity, and speci®city of a recently developed peripheral dualenergy X-ray absorptiometry (DXA) scanner, applied to the calcaneus, in the identi®cation of individuals with osteoporosis at axial sites by DXA. Two hundred and two women, aged 55.2 l3.7 years (mean SD), participated in the study. The precisions (coecient of variation) of measurements in vitro (0.48%) and in vivo (1.40%) were very good. The in vivo precision was independent of the operator, foot size, foot width, weight, height, and body mass index. Calcaneus BMD correlated moderately (r = 0.494±0.690, P < 0.001) with axial BMD measurements by DXA. Using the World Health Organization (WHO) criterion for de®ning osteoporosis (T score £ )2.5) the speci®city of the calcaneus to identify patients with osteoporosis at total hip, femoral neck, spine, or any of these axial sites was excellent (97.0%, 97.0%, 96.5%, and 97.1%, respectively); however, the sensitivity was poor (58.8%, 36.4%, 21.8%, and 20.3%, respectively). Therefore, the WHO criterion is not appropriate for DXA calcaneus. Based on femoral neck BMD for detection of osteoporosis, a more appropriate calcaneus T score threshold would be )1.4 by analyses of receiver-operator characteristic curves; this might serve to select those patients who might appropriately be referred for axial DXA.
Journal of Clinical Densitometry, 2008
Peripheral assessment of bone density using photon absorptiometry techniques has been available for over 40 yr. The initial use of radio-isotopes as the photon source has been replaced by the use of X-ray technology. A wide variety of models of single-or dual-energy X-ray measurement tools have been made available for purchase, although not all are still commercially available. The Official Positions of the International Society for Clinical Densitometry (ISCD) have been developed following a systematic review of the literature by an ISCD task force and a subsequent Position Development Conference. These cover the technological diversity among peripheral dualenergy X-ray absorptiometry (pDXA) devices; define whether pDXA can be used for fracture risk assessment and/or to diagnose osteoporosis; examine whether pDXA can be used to initiate treatment and/or monitor treatment; provide recommendations for pDXA reporting; and review quality assurance and quality control necessary for effective use of pDXA.
Osteoporosis and Sarcopenia, 2021
Objectives: Calcaneal quantitative ultrasound measurement (QUS) has been considered an alternative to dual-energy X-ray absorptiometry (DXA) based bone mineral density (BMD) for assessing bone health. This study sought to examine the utility of QUS as an osteoporosis screening tool by evaluating the correlation between QUS and DXA. Methods: The study was a part of the Vietnam Osteoporosis Study that involved 1270 women and 773 men aged 18 years and older. BMD at the femoral neck, total hip and lumbar spine was measured using DXA. Osteoporosis was diagnosed based on the femoral neck T-score using World Health Organization criteria. Broadband ultrasound attenuation (BUA) at the calcaneus was measured by QUS. The concordance between BUA and BMD was analyzed by the linear regression model. Results: In all individuals, BUA modestly correlated with femoral neck BMD (r ¼ 0.35; P < 0.0001) and lumbar spine BMD (r ¼ 0.34; P < 0.0001) in both men and women. In individuals aged 50 years and older, approximately 16% (n ¼ 92/575) of women and 3.2% (n ¼ 10/314) of men were diagnosed to have osteoporosis. Only 0.9% (n ¼ 5/575) women and 1.0% (n ¼ 3/314) men were classified as "Low BUA". The kappa coefficient of concordance between BMD and BUA classification was 0.09 (95% CI, 0.04 to 0.15) for women and 0.12 (95% CI, 0.03 to 0.22) for men. Conclusions: In this population-based study, QUS BUA modestly correlated with DXA BMD, suggesting that BUA is not a reliable method for screening of osteoporosis.
Dual-Energy X-Ray Absorptiometry (DEXA) Scan Versus Computed Tomography for Bone Density Assessment
Cureus
Rationale and objective Osteoporosis, a common non-pathological disease of bones, has been the cause of many disastrous consequences, in terms of physical, psychological, social, and economic loss. Therefore, it is crucial to diagnose it early for timely prevention and treatment of osteoporotic fractures. Dual-Energy X-Ray Absorptiometry (DEXA) is currently routinely used for determining bone mineral density. However, it has its limitations. Nowadays, CT technology has advanced so rapidly that the Hounsfield units (HU) values can be used in opportunistic screening for osteoporosis in patients during routine CT abdomen for other causes. Hence, there would be no need for additional study with DEXA and also reduce radiation exposure. The aim of our research is to determine whether there is a correlation between the bone mineral density and the Tscore measured by DEXA and the HU values measured from the diagnostic CT images of L1-4 vertebrae. Also, to determine reference CT values that would help in screening the patients with osteoporosis. Materials and methods We conducted a retrospective study of 78 female patients who underwent CT lumbar spine, abdomen, and pelvis in our hospital between the years 2016-2020. We collected data of patients who performed DEXA and CT scans within an interval of up to two years. The final collected data was analyzed to find correlation values of HU with age group and with DEXA bone mineral density (BMD) and T-score using Pearson correlation coefficient.
Journal of Chitwan Medical College, 2019
Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorptiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis. Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius. Results: Significant correlations were observed between QUS and DEXA T score. Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.
Osteoporosis is a disorder of bone that leads to an increased risk of fracture, when it loses an excessive amount of mineral compositions. Bone densitometry techniques are useful to diagnose the disease as well as to predict the future risk of fracture. Dual energy x-ray absorptiometry (DXA) is currently considered as the ‘gold’ standard for measuring areal bone mineral density, BMD (gcm-2). Quantitative computed tomography (QCT) is used to measure volumetric BMD (g cm-3) at lumbar spine using a phantom with a dedicated software; but it cannot be used to measure femur volumetric BMD. The aim of this study was to estimate apparent physical BMD (Estvol.BMD, g cm-3) of the proximal femur from CT image with good accuracy in the evaluation of post-menopausal osteoporosis. A total number of 50 Indian women, age ranged from 20-80 years were studied. No one had previous osteoporotic fractures. Each woman, the following investigations were carried out: i) BMD of the right proximal femur by DXA whole-body bone densitometer; and ii) CT image of the right proximal femur. WHO’s diagnostic criteria based on the measured femur neck BMD was used to classify the patients. According to this, total women were divided into the following groups: i) Normal (n=23, mean ± SD age = 42.8 ±11.1 years); ii) Osteopenia (n= 17, mean ± SD age = 49.6 ±12.5 years); and iii) Osteoporosis (n=10, mean ± SD age =69.2 ±12.7 years); The CT image was analysed by Materialise’s interactive medical image control system (MIMICS) software. Hounsfield Unit (HU) was measured in the regions of the proximal femur: i) Neck; ii) Trochanter, iii) Head; and iv) Shaft; Using the measured mean HU value, Est-vol.BMD (g cm-3) was estimated. Data was analysed by SPSS statistical software package. In osteoporotic Indian women group (n=10), the Est-vol.BMD (g cm-3) of femur neck was correlated statistically significant (p=0.05) with BMD-DXA (g cm-2) of all ROI’s of the proximal femur, viz., femur neck, Ward’s triangle, trochanter, femur shaft, and total hip. The obtained square of the correlation coefficients (r2) were 0.22, 0.25, 0.23, 0.41, and 0.34 respectively. In osteoporotic women, the mean values of BMD-DXA (g cm-2) and Est-vol.BMD (g cm-3) of femur neck were significantly (p=0.01) reduced by 36.7% and 71.8% respectively, when comparing to normal healthy women. Further, in osteoporotic women, the mean values of BMD-DXA as well as Est-vol.BMD of trochanter were significantly (p=0.01) reduced by 45.7% and 80.2% respectively, when comparing to normal healthy women. It was found that the percentage decrease in Est-vol.BMD was greater in osteoporotic women than the measured BMD-DXA, and it can be useful in the evaluation of the disease.
Journal of Clinical Densitometry, 2007
Dual energy X-ray absorptiometry (DXA) measurements from different manufacturers provide different bone mineral density (BMD) values and derived T-scores and Z-scores. These differences result partly from technical differences in the algorithms for the determination of bone mineral content and bone area and partly from the use of different manufacturer-derived reference databases. The present study was to implement a uniform expression of BMD in all male patients by using standardized BMD (sBMD) values and referring to a newly established national male reference sample. In 8 bone densitometry centers throughout Belgium 229 young healthy men were measured on Hologic (Bedford, MA) or GE-Lunar (Madison, WI) bone densitometers. Quality control procedures were implemented and site cross-calibration performed using the European Spine Phantom. Absolute BMD values were converted to standardized values by validated formulas (sBMD). Clinically acceptable between-center differences were noted. No discrepancy was observed in terms of mean sBMD and standard deviations at the lumbar spine and proximal femur between the Belgian and the US reference populations. Region-specific sBMD thresholds for the diagnosis of male osteoporosis were calculated. The current data provide a basis to implement a nation-wide, uniform expression of BMD in male patients and allow harmonization of the BMD-based diagnosis and treatment of osteoporosis in men. a BBC is a national nonprofit scientific organization devoted to promoting bone research and the awareness of osteoporosisdits board members are listed in Appendix A. b NEMO is a Thematic Network supported by the European Commission under contract QLK6-CT-2002-00491dits participants are listed in Appendix B.