Uniform terminology and corresponding abbreviation for Dual X-ray Absorptiometry (DXA)
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Biomedical subjects
Publications and source records attributed to K G Faulkner.
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Three-dimensional quantitative computed tomographic (QCT) studies of the lumbar spine were extended with finite element analysis (FEA) to include bone distribution in assessment of vertebral body strength. Fifty-nine FEA models were created from data from 43 patients, 28 with no evidence of osteoporosis and 15 with previous vertebral fractures. Simulated loads were applied to the vertebral models to estimate vertebral strength. Yield strength in the models from patients with osteoporosis was 0.22-1.05 MPa (average, 0.57 MPa +/- 0.26 [mean +/- standard deviation]), compared with 0.80-2.79 MPa (1.46 +/- 0.52, P less than .001) in patients with normal bone. Yield strength of vertebrae in patients with osteoporosis uniformly fell below approximately 1.0 MPa, with minimal overlap between patients with osteoporosis and those with normal bone compared with the overlap in bone mineral content and trabecular mineral density. Reproducibility of the FEA technique was 12.1% in a subgroup of patients with normal bone. A constant relationship between cortical and trabecular contributions was observed in patients with osteoporosis but not in control patients.
Current methods for assessing osteoporotic fracture risk involve measuring the content and/or density of bone at a number of skeletal sites and relating the measurement to that in either age-matched or young control subjects measured at the same site with the same technique. These densitometric methods have been used to predict several types of fractures; however, engineering principles verify that the bone structure and loading conditions also affect skeletal strength. Many densitometric measurements inherently contain information about skeletal structure and bone distribution, yet this information is not clinically used. In this paper, the currently available techniques for assessing bone content and density, namely, single-photon absorptiometry, dual-photon absorptiometry, dual-energy X-ray absorptiometry, and quantitative CT, and their usefulness in assessing fracture risk and distinguishing between patients with and without osteoporosis are reviewed. Extensions of conventional densitometry that have been developed by several researchers to include information in addition to bone mass also are presented. Results from recent studies using new applications of ultrasound techniques and MR imaging are reviewed. Preliminary studies show the value of these new techniques in noninvasive measurement of bone structure in order to estimate bone strength and assess fracture risk more accurately. However, to become clinically useful, many of these methods require further investigation to increase their ease of use and decrease their cost.
OBJECTIVE: We investigated the long-term in vivo reproducibility of quantitative CT (QCT) examinations that were conducted in conformity with a standard and well established methodology. MATERIALS AND METHODS: The long-term reproducibility in vivo of QCT vertebral densitometry was studied in 12 normal postmenopausal women (mean age 51 years), who underwent four to five examinations over the same 2 year period. RESULTS: One group of six patients demonstrated good reproducibility with a coefficient of variation (CV) of bone mineral density (BMD) of < 2.4% and were considered "good cases." The other group of six patients showed poor reproducibility with a CV of BMD of > 3.2% and were considered "problem cases." A statistical study of the technical parameters of the QCT examination was performed to determine and correct for the factors that are correlated with reproducibility errors. Analyzing uncalibrated variations in Hounsfield numbers, we found that the surrounding soft tissues such as muscle, aorta, liver, and fat were correlated in both the good and the problem cases. However, only in the good cases did we find that the Hounsfield numbers of the vertebral bodies correlated strongly with the soft tissues and with parameters characteristic of the calibration regression line. CONCLUSION: Essentially, the calibration procedure appeared to fail in some examinations of the problem cases, causing poor long-term reproducibility. This calibration failure may be related to positioning of the subject in the gantry and to variations in electrical parameters of the X-ray tube. A CV > 1% between the four slopes of calibration for the individual vertebrae measured at the same visit may indicate calibration problems and may suggest the need for repeat scanning.
A data-acquisition system designed for x-ray medical imaging utilizes a segmented high-purity germanium (HPGe) detector array with 2-mm wide and 6-mm thick elements. The detectors are contained within a liquid-nitrogen cryostat designed to minimize heat losses. The 50-ns pulse-shaping time of the preamplifier electronics is selected as the shortest time constant compatible with the 50-ns charge collection time of the detector. This provides the detection system with the fastest count-rate capabilities and immunity from microphonics, with moderate energy resolution performance. A theoretical analysis of the preamplifier electronics shows that its noise performance is limited primarily by its input capacitance, and is independent of detector leakage current up to approximately 100 nA. The system experimentally demonstrates count rates exceeding 1 million counts per second per element with an energy resolution of 7 keV for the 60-keV gamma ray photon from 241Am. The results demonstrate the performance of a data acquisition system utilizing HPGe detector systems which would be suitable for dual-energy imaging as well as systems offering simultaneous x-ray transmission and radionuclide emission imaging.
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