Journal of Isfahan Medical School

Journal of Isfahan Medical School

Investigation of Errors Affecting Bone Mineral Density of Lumbar Spine and Hip in Dual Energy X-Ray Absorptiometry (DXA) Scan

Document Type : Original Article (s)

Authors
Mohammad Reza Salamat 1
Vajiheh Ahmadian 2
Mehri Khoshhali 3
Ahmad Shanei 1
1 Associate Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 MSc Student, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 PhD Student, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Osteoporosis in the lumbar spine and hip are diagnosed using dual-energy X-ray absorptiometry (DXA) scan. This method reveals remarkable accuracy and precision in the results. We aimed to determine the errors affecting measurements using DXA scan and investigate the changes in mineral density of hip and lumbar spine over one year.Methods: The study was performed on 65 patients referred to the Isfahan Osteoporosis Diagnosis Center, Iran, and changes in mineral density of the hip and lumbar spine were examined. Moreover, phantom study was conducted to determine the errors affecting the results of DXA scan including metal artifact, patient incorrect position, not calibration, and incorrect analysis of data gathered using DXA scan. Data were analyzed using SSPS software.Findings: This study showed that any error led to a slight change in measurements by DXA scan. Additionally, the mean value of changes in mineral density of hip and lumbar spine decreased 1.53 and 1.42 g/cm2, respectively, which was not significant (P > 0.05).Conclusion: According to the present study, any minor error can impact on the results of DXA scan. Furthermore, the reduction in bone mineral density of the hip and lumbar spine occurs after one year; however, it was not statistically significant.
Keywords
Bone mineral density
Lumbar cord
Hip
Dual-energy X-ray absorptiometry
  1. Salamat MR, Shanei A, Khoshhali M, Salamat AH, Siavash M, Asgari M. Use of conventional regional DXA scans for estimating whole body composition. Arch Iran Med 2014; 17(10): 674-8.
  2. Larijani B, Mohajeri Tehrani MR, Hamidi Z, Soltani A, Pazhohi M. Osteoporosis, prevention, diagnosis and treatment. J Reprod Fertil 2005; 6(1): 5-24. [In Persian].
  3. Salamat M, Rostampour N, Shanehsazzadeh S, Tavakoli MB, Siavash M, Almasi T. Assessment of bone mineral density with dual energy X-ray absorptiometry in pre-and post-menopausal women. Iran J Radiat Res 2008; 6 (2): 103-7.
  4. Salamat MR, Shanei A, Salamat AH, Khoshhali M, Asgari M. Anthropometric predictive equations for estimating body composition. Adv Biomed Res 2015; 4: 34.
  5. Salamat MR, Keshavarz A, Salamat A, Shanei A. Assessing the effect of in vitro soft tissue thickness on bone mineral density using dual-energy X-ray absorptiometry. J Isfahan Med Sch 2016; 34(378): 347-54. [In Persian].
  6. Salamat MR, Shanei A, Asgari M, Salamat AH, Khoshali M. Using anthropometric indices predictive equations for estimating whole-body fat mass instead of whole body dual-energy X-ray absorptiometry scan. J Isfahan Med Sch 2014; 32(292): 1046-53. [In Persian].
  7. Eastel R. Assessment of bone density and bone loss. Osteoporos Int 1996; 6(2): 3-5.
  8. Kim HS, Yang SO. Quality control of DXA system and precision test of radio-technologists. J Bone Metab 2014; 21(1): 2-7.
  9. El Maghraoui A, Achemlal L, Bezza A. Monitoring of dual-energy X-ray absorptiometry measurement in clinical practice. J Clin Densitom 2006; 9(3): 281-6.
  10. Bonnick SL, Johnston CC, Jr., Kleerekoper M, Lindsay R, Miller P, Sherwood L, et al. Importance of precision in bone density measurements. J Clin Densitom 2001; 4(2): 105-10.
  11. Blunt BA, Jones D, Svensen RK, Hans DB, Feinblatt JD, Genant HK. Good clinical practice and audits for dual X-ray absorptiometry and X-ray imaging laboratories and quality assurance centers involved in clinical drug trials, private practice, and research. J Clin Densitom 1998; 1(4): 323-37.
  12. Looker AC, Johnston CC, Jr., Wahner HW, Dunn WL, Calvo MS, Harris TB, et al. Prevalence of low femoral bone density in older U.S. Women from NHANES III. J Bone Miner Res 1995; 10(5): 796-802.
  13. Baim S, Wilson CR, Lewiecki EM, Luckey MM, Downs RW, Jr., Lentle BC. Precision assessment and radiation safety for dual-energy X-ray absorptiometry: position paper of the International Society for Clinical Densitometry. J Clin Densitom 2005; 8(4): 371-8.
  14. Zack MK. Reliability and Validity of body composition and bone mineral density measurements by DXA [MSc Thesis]. Blacksburg, VA: Virginia Polytechnic Institute and State University; 2002.
  15. Kiraç FS, Yüksel DG, Yaylali OT. Pitfalls in the measurement of bone mineral density by the dual-energy X-ray absorptiometric method. Clinical Nuclear Medicine 2001; 26(10): 874-5.
  16. Imai K. Ex vivo and in vivo assessment of vertebral strength and vertebral fracture risk assessed by dual energy X-ray absorptiometry. In: El Maghraoui A, editor. Dual energy X-ray absorptiometry. Rijeka, Croatia: InTech; 2012. p. 105-20.
  17. Tosi LL, Lane JM. Osteoporosis prevention and the orthopaedic surgeon: When fracture care is not enough. J Bone Joint Surg Am 1998; 80(11): 1567-9.
  18. Cauley JA, Lui LY, Stone KL, Hillier TA, Zmuda JM, Hochberg M, et al. Longitudinal study of changes in hip bone mineral density in Caucasian and African-American women. J Am Geriatr Soc 2005; 53(2): 183-9.
  19. Li X, Ominsky MS, Warmington KS, Morony S, Gong J, Cao J, et al. Sclerostin antibody treatment increases bone formation, bone mass, and bone strength in a rat model of postmenopausal osteoporosis. J Bone Miner Res 2009; 24(4): 578-88.
  20. Syed Z, Khan A. Bone densitometry: applications and limitations. J Obstet Gynaecol Can 2002; 24(6): 476-84.
Journal of Isfahan Medical School
Volume 35, Issue 449 - Serial Number 449
September and October 2017
Pages 1327-1332

  • Receive Date 04 January 2017
  • Accept Date 06 April 2022