Short-term Precision Error in Dual Energy X-Ray Absorptiometry, Bone Mineral Density and Trabecular Bone Score Measurements; and Effects of Obesity on Precision Error.
Hopkins, SJ; Welsman, JR; Knapp, KM
Date: 1 May 2014
Article
Journal
Journal of Biomedical Graphics and Computing
Publisher
Sciedu Press
Publisher DOI
Abstract
Introduction: Bone mineral density (BMD) measured by dual energy x-ray absorptiometry (DXA) is the primary
screening tool for diagnosis of osteopenia and osteoporosis. BMD alone does not provide information regarding the
structural characteristics of bone and this limitation has been a driver for the development of techniques, ...
Introduction: Bone mineral density (BMD) measured by dual energy x-ray absorptiometry (DXA) is the primary
screening tool for diagnosis of osteopenia and osteoporosis. BMD alone does not provide information regarding the
structural characteristics of bone and this limitation has been a driver for the development of techniques, including
trabecular bone score (TBS) software, to assess bone microarchitecture. Precision error in DXA is important for accurately
monitoring changes in BMD and it has been demonstrated that BMD precision error increases with increasing body mass
index (BMI). Information on in vivo precision error for TBS is very limited. This study evaluated short-term precision
error (STPE) of lumbar spine BMD & TBS measurement, and investigated the effect of obesity on DXA precision error.
Method: DXA lumbar spine scans (L1-L4) were performed using GE Lunar Prodigy. STPE was measured in ninety-one
women at a single visit by duplicating scans with repositioning in-between. Precision error was calculated as the
percentage coefficient of variation. Participants were sub-divided into four groups based on BMI to assess the effect of
obesity on STPE.
Results: STPE is poorer for TBS than for BMD. STPE is adversely affected for both BMD and TBS measurements by
increasing BMI but this effect is mitigated for TBS in the highest BMI category where use of the thick scanning mode
improves signal to noise ratio.
Conclusion: Results from serial BMD and TBS measurements should take account of differences in precision error in the
two techniques and in different BMI categories.
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