Update on Bone Density Measurement
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Keywords:
Densitometry
Densitometer
Background
Objectives
To determine t-score values which should be applied for the screening of osteoporosis in postmenoapusal women when using a peripheral os calcis densitometer (PIXI).Methods
Heel bone mineral density (BMD) was measured in 81 postmenopausal women with a PIXI densitometer (LUNAR). Results (t-score values) were classified according to the WHO definition and to the manufacturer recommendations (LUNAR): normal >-0,6; osteopenia from -0,6 to -1,6 and osteoporosis <-1,6. Hip BMD measurements (DEXA) were used as to compare the results.Results
Conclusion
False-negative results for osteoporosis become reduced when t-score classification recommended by the manufacturer are used as cut-off points in heel densitometry. An accurate collection of osteoporosis risk factors can help to identify those patients with hip osteoporosis among patients with heel osteopenia.Densitometry
Osteopenia
Densitometer
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Bone tissue samples excised from the femoral heads of human were X-rayed together with the aluminum reference standard of density. The radiograms were scanned with the laser densitometer UltroScan XL (Pharmacia). Form the optical density profiles of bone samples the mean optical densities were determined. The optical densities were recalculated into equivalent thickness of the aluminium standard [mm Al]. Inter-measurement reproducibility of optical density determination was found to be very good (SD less than 3% of the mean). Relatively high variability (SD about 13% of the mean) was found for the optical density determination of a single bone sample X-rayed repeatedly. The inter-individual variability, which reflects the variability of bone tissue density between human subjects, was estimated as about 25% (SD as percent of the mean). We concluded that the laser densitometry performed according to our protocol provides the precise estimation of bone tissue density. Therefore, laser densitometry of bone tissue radiograms is potentially useful method for studies of bone in medical research and diagnosis.
Densitometry
Densitometer
Optical density
Bone tissue
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A single-source low-energy Compton densitometer has been used to investigate the effects of multiple scattering on density determinations. The relative electron density and mass density were determined in samples of known density, and in samples of human cancellous bone tissue. The influence of sample diameter on the measured relative electron density of known samples was investigated. The measured value was strongly dependent on the diameter and the density range of the sample. The bias inherent in the density determination which is attributable to multiple scattering and attenuation in human femoral bone was evaluated, and a correction for these effects is suggested for clinical measurements.
Densitometer
Densitometry
Cancellous bone
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Densitometry has primarily been a quantitative measurement technique. The first skeletal images from a densitometer, such as that seen in Fig. 2-7, were only vaguely reminiscent of the actual bone. The poor image quality had little effect on the ability to quantify the bone density, which was the primary purpose of the various techniques. With the advent of dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT), skeletal imaging as a potential application of densitometry has been anticipated for over 10 years. Continued improvements in the technology combined with modern computer capabilities have resulted in spine images with more than sufficient clarity to diagnose fractures. Truly remarkable images of the spine such as the RVA™ image from a Hologic Discovery seen in Fig. 12-1 are possible today. The physical dimensions of the vertebrae and proximal femur can be measured from densitometry images using morphometric software applications. These imaging applications have potential effects on both diagnosis and fracture risk assessment. Recognition of a vertebral fracture may result in a different diagnosis than would otherwise result based on the bone density alone. In addition, the presence of vertebral fracture and proximal femur geometry have been recognized as independent predictors of fracture risk.KeywordsFemoral NeckVertebral FractureVertebral DeformityVertebral Fracture AssessmentFemoral Neck WidthThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Densitometry
Densitometer
Dual energy
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The authors studied the feasibility of an additional software application for dual-energy X-ray bone densitometer series «Discovery W» (HOLOGIC inc., USA). 45 patients with osteoporotic vertebral compression fractures underwent technique of «Vertebral Fracture Assessment» in one session with standard densitometry at the lumbar spine and proximal femur. This program is based on a semi-quantitative morphometry of the spine (N.K. Genant; 1993) is an alternative to radiography for the diagnosis of vertebral fractures. Determination of the index values of the vertebral bodies by this method allows identification not only explicit, but subtle compression vertebral fractures of both thoracic and lumbar spine. The methodology should be ordered by an osteoporosis specialist, evaluated by radiologist, it can be performed in one session with standard densitometry procedure. Assessment of the bone structure of the vertebral bodies by this imaging technology is not feasible.
Densitometry
Densitometer
Dual energy
Vertebral Compression Fracture
Gold standard (test)
Digital radiography
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Background
Assessment of postmenopausal osteoporosis is usually delayed due to central densitometers' lack in some areas. Peripheral densitometers have been proposed for osteoporosis screening.Objectives
To assess the relationship between bone mineral density (BMD) measurements in post-menopausal women using central (DEXA) and peripheral (PIXI) densitometers.Methods
81 women, included in a post-menopausal osteoporosis assessment schedule, were consecutively selected for this study. In all women, we collected: 1) an osteoporosis risk factors' questionnaire; 2) measurement of hip BMD, using a DEXA densitometer (NORLAND); and 3) measurement of calcaneus BMD, using the peripheral densitometer PIXI(LUNAR).Results
Osteoporosis risk factors collected: mean age (years) = 63(9.6 sd); mean time since menopause (years) = 15.6(9.2 sd); mean body mass index = 28.9(4.5 sd); mother's hip fracture = 6.2%; previous Colles fracture = 8.6%; previous vertebral fracture = 6.2%; previous hip fracture = 1.2%; other non-traumatic fractures = 13.6%; calcium intake < 1 g/d = 88.9%; sedentarism = 45.7%. Statistical significance was found between absolute BMD values (Pearson's correlation coefficient: r = 0.501(p = 0.01)), and t-score values (Pearson's correlation coefficient: r = 0.575 (p = 0.01)) obtained with both densitometers.Conclusion
Peripheral densitometers can be a reliable and suitable choice for postmenopausal osteoporosis screening in primary health centres.Densitometer
Densitometry
Hip Fracture
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Osteoporosis is often diagnosed after fracture occurrence, when therapy is less effective. The dual photon densitometry has been the proposed method for osteoporosis early diagnosis. In the present study is presented our experience on the lumbar vertebral and femoral neck bone mass measurement by utilizing a Lunar DP-3 densitometer in normal young 82 volunteers and 103 women with radiologically and clinically diagnosed osteoporosis. The values found in osteoporotical patients were significantly lower when compared to those normals either in lumbar vertebrae (L2-L4) or in the femoral neck. The method's coefficient of variation was less than 0.5%, when determinated with a synthetic phantom aid and less than 1.5% repeating the exam in 10 normal volunteers. These results show that dual photon densitometry is a simple, sensitive and non-invasible method for early diagnosis and therapeutic follow-up of osteoporotical patients.
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This report provides general information about osteoporosis and describes the use of bone densitometry as a tool to screen for, diagnose and manage osteoporosis in white postmenopausal women. Discussion is limited to white women because of lack of research on osteoporosis in men, and in women of different racial and ethnic groups. The report does not evaluate the safety and efficacy of all bone densitometry devices, but focuses on the two diffusing most rapidly in Minnesota--dual x-ray absorptiometry (DXA or DEXA) and quantitative computed tomography (QCT). Osteoporosis is a degenerative bone disease that affects approximately 24 million Americans. Of that number 33 percent are post-menopausal women who have decreased bone density due to lowered estrogen levels. Because the estimated cost of osteoporosis-related fractures in the United States is between $8 and $10 billion each year, there is great interest in the diagnosis, prevention and treatment of the disease. Of all related fractures, hip fractures pose the most serious health problem. The incidence of this fracture appears to be increasing, with 250,000 to 300,000 occurring each year Treatment options are limited, if a person's bone mass or density has deteriorated to the point where fractures may occur. Preventive measures should therefore be undertaken by all women early in life to decrease their risk of osteoporosis. Based on available evidence, the HTAC concludes that state-of-the-art bone densitometry is safe and indicated as a diagnostic and treatment aid for postmenopausal women at risk for the disease. However, bone densitometry is not indicated as a broad screening tool for all postmenopausal women, regardless of whether they are at risk for the disease.
Densitometry
Bone disease
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The present paper intends to check the possibility of improving convenience of the osteoporosis model from ovariectomy in the rat by anticipating the operation to the 40th week rather than the 52nd week of age, thought by some authors to be the optimum model. To this end two parameters have been examined: 1. the bone mass variation determined with the vertebral photon densitometer and weighing of the femur ashes; 2. the chemico-crystallographic characteristics of the bone determined through chemical analysis and X-ray diffractometry. The results obtained induce us to believe that ovariectomy carried out on rats of 40 or 52 weeks of age determine bone mass losses that are statistically comparable. The variations in the dry bone weight/ash bone weight ratio are superposable and the structural chemical characteristics, due to the increase in bone turnover are testified by the increase in osteocalcin. Moreover, it was observed that the most reliable evaluation of bone mass loss can be obtained with the vertebral photon densitometry. Thus, it is thought that the model which foresees ovariectomy of rats 40 weeks after birth compared with those operated 52 weeks after birth, represents a good model of osteoporosis from estrogen deficiency which, due to the evident practical advantages deriving from the use of younger animals it associates a decrease in the use of laboratory animals with statistically reliable results.
Densitometry
Densitometer
Peak bone mass
Bone mineral content
Rat model
Bone remodeling
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The principles of densitometric and radiological examination in diagnosing of osteoporosis are presented. Peripheral and whole body densitometers are described and their quality is assessed on basis of precision and accuracy of bone mineral density measurements (BMD). WHO criteria of diagnosis, which introduce clinical category of the basis of BMD (expressed in T-scores) are described as follows: normal-(T-score up to -1.0); osteopenia-(T-score below -1.0 but more than -2.5); osteoporosis-(T-score -2.5 or below); severe osteoporosis-(T-score below -2.5 and one or more fractures). Evaluation of osteoporotic changes on the spine, pelvis and hand radiographs are discussed. Quantitative and possible quantitative analysis of radiographs are described.
Densitometry
Osteopenia
Densitometer
Standard score
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