Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DXA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

Comparison of quantitative ultrasound measurements in calcaneus with DXA and SXA at other skeletal sites: a population-based study on 280 children aged 11-16 years.

We performed ultrasound measurements (QUS) of the calcaneus in a population-based setting on 280 healthy children, aged 11-16 years, from a small urban area in southern Sweden. The results are compared with dual-energy X-ray absorptiometry (DXA) measurements in the total body, the lumbar spine and the hip, as well as single-energy X-ray absorptiometry (SXA) of the forearm. Normative data and correlations between the three different techniques were determined. We found significant correlations between QUS and age (r = 0.34-0.54), height (r = 0.13-0.56) and weight (r = 0.30-0.60), and between QUS and bone mineral density (BMD) measurements (r = 0.44-0.70). Boys increased all their bone mineral variables with age, whereas girls showed a decreasing trend from age 15 years. QUS had a significantly higher increase in standardized value with age than Ward's triangle BMD, but a significantly lower increase in standardized value with age than distal radius (cortical site) BMD. At other BMD sites we did not find any significant differences compared with QUS regarding changes with age. The measurements obtained by QUS, DXA and SXA, respectively, were divided into, quartiles. Of all subjects in the lowest quartile for QUS measurements, only 34-50% were also in the lowest quartiles for DXA and SXA measurements. In conclusion, QUS measurements of the calcaneus in children show similar results as for adult regarding the correlation with DXA and SXA; they also have a significant correlation with anthropometric data. QUS did not identify the same individuals with low bone mass as the X-ray techniques.

Absorptiometry, Photon↗

Comparison of calcaneal ultrasound and DXA to assess the risk of corticosteroid-induced osteoporosis: a cross-sectional study.

Patients on long-term oral corticosteroids have an increased risk of low bone mass and fragility fractures. Fracture risk rises soon after commencement of corticosteroid therapy and it is possible that these agents adversely influence bone architecture disproportionately to their effect on bone mass. The best means of assessing bone status in patients using corticosteroids remains uncertain, but quantitative ultrasound of the calcaneus may provide evidence of microarchitectural changes not detected by dual-energy X-ray absorptiometry (DXA). Patients with Crohn's disease have an increased risk of low bone mineral density (BMD), the etiology of which is multifactorial but includes corticosteroid use. We studied 118 consecutive patients with Crohn's disease, 21 of whom used continuous oral corticosteroids, 70 of whom were intermittent users, and 27 who had never used the drug. All patients received DXA of the lumbar spine, hip and calcaneus and quantitative ultrasound (QUS) of the calcaneus. The different techniques were compared using a femoral neck T-score < or = -1.5 as the threshold of corticosteroid-induced osteoporosis. When compared with the femoral neck T-score, there were no significant differences between the predictive values of lumbar spine DXA, calcaneal DXA or calcaneal QUS to identify low femoral neck BMD. However, the absolute T-score required to give similar discriminatory capacity to femoral neck T-score varied substantially (T= -0.81 to -1.5) between the different measurement techniques and sites.

Absorptiometry, Photon↗

Application of a triage approach to peripheral bone densitometry reduces the requirement for central DXA but is not cost effective.

A method proffered for the interpretation of measurements from peripheral dual energy X-ray absorptiometry (pDXA) is a triage approach to stratify patients into one of three risk categories; (i) high-treat, (ii) medium-refer for central DXA and (iii) low-reassure. The aim of this study was to apply the triage approach to measures from peripheral scanners and risk indices and stratify patients into one of three risk categories (i), (ii) or (iii). 207 post-menopausal women had central DXA from which they were categorised as non-osteoporotic or osteoporotic. Additional peripheral scans of the left calcaneus were performed on three scanners (GE Lunar Achilles and PIXI, McCue CubaClinical). From demographic details four risk indices were calculated and algorithms combining measures from peripheral scanners and one risk index were obtained. All peripheral measures, risk indices and combination algorithms were good at identifying women at risk of osteoporosis (ROC areas: 0.67-0.82). Each tool stratified varying numbers of osteoporotic and non-osteoporotic women into each risk category using the triage approach. One combination algorithm (PIXI & osteoporosis indices of risk (OSIRIS)) performed best by minimising misclassification (10% non-osteoporotic, 10% osteoporotic) and reducing requirement for central DXA to 36%. However the cost of implementing the triage approach for PIXI & OSIRIS was greater (263%) than central DXA (100%) scanning all women. Although the triage approach was an effective tool at identifying women at risk of osteoporosis the unnecessary treatment of non-osteoporotic women in the high risk category make it impractical. Therefore an alternative more cost-effective method has been suggested.

Absorptiometry, Photon↗

Spinal and femoral DXA for the assessment of spinal osteoporosis.

The objective was to determine the diagnostic sensitivity of spinal and femoral dual x-ray absorptiometry (DXA) and to study whether a combination of both sites may enhance discriminatory capability in regard to the presence of vertebral fractures. Spinal and femoral DXA were obtained in 324 postmenopausal women, of whom 90 had at least one vertebral fracture. Age-adjusted logistic regression analyses, ROC analyses, and sensitivity-specificity statistics were used to assess the discriminatory ability of spinal and femoral bone density (BMD) alone and in combination. The age-adjusted odds ratios per standard deviation decrease in BMD (OR) for spinal and femoral measurements were comparable (Ward's triangle: OR = 1.62; femoral neck: OR = 1.51; total hip: OR = 1.47; spine: OR = 1.34). Combining spinal and femoral bone density measurements did not improve diagnostic sensitivity of DXA considerably as compared to using BMD of a single site and adjusting the "fracture threshold." The conclusion drawn is that spinal and femoral BMD measurements using DXA have a comparable diagnostic sensitivity for vertebral fracture discrimination. Different individuals at risk for osteoporosis may be identified using both methods. The clinical usefulness of a combination of two bone density measurements needs further study in a prospective setting.

Absorptiometry, Photon↗

The effect of weight change on DXA scans in a 2-year trial of etidronate therapy.

Variation in soft tissue composition is a potential cause of error in dual X-ray absorptiometry (DXA) measurements of bone mineral density (BMD). We investigated the effect of patients' change of weight on DXA scans in 152 women enrolled in a 2-year trial of cyclical etidronate therapy. Scans of the spine, hip, and total body were performed at baseline, 1 and 2 years on a Hologic QDR-2000. The study was completed by 135 subjects (64 on etidronate, 71 on placebo). Results were expressed as the percentage change in BMD (spine, femoral neck, total body) or bone mineral content (BMC)(total body only) at 2 years. Total body scans were analyzed using the manufacturer's 'standard' and 'enhanced' algorithms. Analysis was performed using multivariate regression with percentage change in BMD or BMC as the dependent variable, and treatment group and percentage change in weight as the independent variables. Weight change varied between -14.4% and +16.7%. All DXA variables showed a statistically significant treatment effect. Standard total body BMD and BMC and enhanced total body BMC all showed a significant dependence on weight change (P < 0.01, P < 0.001 and P < 0.01, respectively). No effect of weight change was seen on spine, femoral neck, or enhanced total body BMD. In order to investigate the effects of weight on long-term precision, patients were allocated to two groups according to baseline body mass index (BMI < 25 and > 25 kg/m2, respectively). For femoral neck BMD the root mean square (RMS) residual percentage change was statistically significantly larger in the high BMI group (P < 0.05) but all other bone density variables showed no significant difference. With patients allocated to two groups according to their absolute percentage change in weight (< 5% and > 5%, respectively) the RMS residual percentage changes in the bone density variables were statistically significantly larger in the large weight change group for femoral neck BMD (P < 0.05) and for standard and enhanced total body BMC (P < 0.01 and P < 0.05, respectively). With the exception of the standard total body algorithm, weight change in a longitudinal study of postmenopausal women was not found to cause systematic errors in the results of DXA studies but may adversely affect precision.

Absorptiometry, Photon↗

DXA for bone density measurement in small rats weighing 150-250 grams.

The present study evaluated the use of a small animal total body software of dual energy x-ray absorptiometry (DXA) in the assessment of total body and regional bone mineral content (BMC) and bone mineral density (BMD) in small rats. Twenty-three rats, with weights ranging from 146 to 246 g, were included in the study. All were scanned using the same software version and same scan procedure (speed and scanned area). Total body BMD, BMC, and body weight were measured by DXA in each rat. Femoral BMC and BMD were analyzed by using regional analysis facilities. The repeatability (precision) of this software version was assessed prior to the study and the coefficients of variation (CV) were 2.9% for total body BMC, 0.8% for total body BMD, 1.2% for body weight, and 2.2% for mean femoral BMD. DXA measurements were compared with the measurements obtained by using established standards, namely weight and bone ash content. Total body ash content and femoral ash content were measured separately in all rats. There was a strong linear correlation between BMC and ash content in total body (r2 = 0.98, p = 0.0001) and in femur (r2 = 0.94, p = 0.0001). There was also an excellent linear association between body weight measured by DXA and scale weight (r2 = 0.99, p = 0.0001). We conclude that this software version is suitable for study on small animals and is a useful tool for assessment of regional as well as total body bone mineral status.

Absorptiometry, Photon↗

An evaluation of sex and body weight determination from the proximal femur using DXA technology and its potential for forensic anthropology.

Dual energy X-ray absorptiometry (DXA) is a rarely used technology in forensic anthropology. These densitometers quantify bone mineral density (BMD) and bone mineral content (BMC) and thus introduce new variables which are important for the application of forensic anthropology. This study investigates the importance of these variables and of this technology using bone scans of the proximal femur in sex and body weight determination. Two data sets from studies conducted at the University of Alabama at Birmingham were examined. The first study had 41 White patients, of which there were 17 males and 24 females, ranging in age from 61 to 79 years and in weight from 99 to 242 lb. The following variables were utilized from the DXA scans: BMD in the femoral neck, greater trochanter and in Ward's triangle. A manual ruler in the software facilitated measurements on the minimum neck diameter and shaft diameter just below the lesser trochanter from each scan. The second study had 128 female patients, 71 of which were Black and 57 were White. They ranged in age from 23 to 47 1/2 years and they weighed between 31 1/2 and 98 1/4 kg. The same variables were examined on these DXA scans as in the first study, with the addition of BMC of the femoral neck and the deletion of the minimum shaft diameter below the lesser trochanter. The first study showed statistically significant sex determination relationships (p < 0.02, t-tests for equality of means) at the supero-inferior femoral neck and lesser trochanter diameters, and from BMD at the femoral neck, trochanter, and Ward's triangle. Discriminant function analysis correctly classified sex over 92% of the original grouped cases using these variables. Multiple regression analysis using body weight as the dependent variable and various measures of the proximal femur as independent variables shows that while they are statistically significant and they have reasonably high R2 values up to 0.49; nevertheless, their standard errors of the estimates are too wide to be of much forensic use. The second study examined ethnic differences, Blacks and Whites, and body weight relationships in a larger, all female data set. Statistically significant differences between Blacks and Whites of BMD were found at Ward's triangle. Multiple regression analyses were again run on body weight and various measures of the proximal femur. The results were also broken down by ethnicity. Some body weight relationships were again statistically significant such as between the BMC of the femoral neck and the BMD of the greater trochanter and the BMC of the neck and the minimum neck diameter, but again, the standard error of the estimate is too wide to be of much use. In addition, the square of the correlation coefficient (R2) is very low, for example, below 0.1 in all cases. Thus, there is very little variability in weight that can be accounted for with these variables. DXA technology offers the potential of a living skeletal data bank and of variables that are useful in cause-effect relationships between bone mineralization and skeletal loads.

Absorptiometry, Photon↗

A randomized trial to assess the impact of direct reporting of DXA scan results to patients on quality of osteoporosis care.

Consecutive patients identified as having osteoporosis on screening dual-energy X-ray absorptiometry (DXA) scans were randomized to: (1) a patient activation intervention consisting of mailing patients their DXA scan results supplemented by a call from a nurse educator or (2) usual care. Three months after the DXA scan, patients were contacted to assess: (1) use of antiresorptive therapy, (2) osteoporosis specific knowledge, and (3) satisfaction with their osteoporosis-related care. A total of 1,035 consecutive patients were screened to identify 422 eligible patients. Of these, 56 patients met inclusion criteria and were subsequently randomized. At follow-up, use of antiresorptive agents was numerically more common in the intervention arm (62%) than the control arm (54%), but this difference was not statistically significant (p=0.58). Patients in the intervention group were more likely to report being notified of their DXA results in a timely fashion (p=0.03), but osteoporosis-specific knowledge was similar.

Absorptiometry, Photon↗

Femoral strength is better predicted by finite element models than QCT and DXA.

Clinicians and patients would benefit if accurate methods of predicting and monitoring bone strength in-vivo were available. A group of 51 human femurs (age range 21-93; 23 females, 28 males) were evaluated for bone density and geometry using quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA). Regional bone density and dimensions obtained from QCT and DXA were used to develop statistical models to predict femoral strength ex vivo. The QCT data also formed the basis of a three-dimensional finite element (FE) models to predict structural stiffness. The femurs were separated into two groups; a model training set (n = 25) was used to develop statistical models to predict ultimate load, and a test set (n = 26) was used to validate these models. The main goal of this study was to test the ability of DXA, QCT and FE techniques to predict fracture load non-invasively, in a simple load configuration which produces predominantly femoral neck fractures. The load configuration simulated the single stance phase portion of normal gait; in 87% of the specimens, clinical appearing sub-capital fractures were produced. The training/test study design provided a tool to validate that the predictive models were reliable when used on specimens with "unknown" strength characteristics. The FE method explained at least 20% more of the variance in strength than the DXA models. Planned refinements of the FE technique are expected to further improve these results. Three-dimensional FE models are a promising method for predicting fracture load, and may be useful in monitoring strength changes in vivo.

Absorptiometry, Photon↗

Components of variance when assessing the reproducibility of body composition measurements using bio-impedance and the Hologic QDR-2000 DXA scanner.

This study evaluated the reproducibility of measuring lean tissue mass (LTM), fat mass(FM(DXA)), bone mineral content (BMC) and density (BMD) with a Hologic QDR-2000 DXA scanner, and both fat free mass (FFM(bio)) and fat mass (FM(bio)) with an impedance meter. Furthermore, the study aimed to assess whether sheets and pillows significantly altered the DXA results. Fifty-one healthy volunteers aged 20-61 years were examined before and after repositioning (n = 20), removal of the sheets (n = 10), addition of two foam pillows (n = 11) or a regular pillow (n = 10). One to 7 days later a re-examination was performed (n = 35). Eight surgical patients were also scanned twice 1-7 days apart. The day to day coefficients of variation were about 1% for most measurements, though more than 2% for FM(DXA), and FM(bio). For total tissue mass, LTM, and BMC there was a significant biological day to day variance whereas for the other measurements the day to day variation could be accounted for by just measurement variance. Pillows systematically changed the estimates of bone mineral and soft tissue, but sheets did not.

Journal Article↗

DXA scanning.

The steady improvement in densitometric technique is reviewed in this paper culminating in the newest generation of DXA scanners. The suitability of the lumbar spine, femur and hand as sites for the densitometric measurement of bone loss in rheumatoid disease is assessed. The recent improvement in hand scanning technique using DXA has led to improved clinical utility in the detection of juxta-articular bone loss. The enhanced resolution offered by the newest, solid state detector DXA scanners, and their ability to detect bone loss where no systemic features are evident, makes it possible that DXA scanning of the hand will be a useful modality for the monitoring of early rheumatoid disease.

Absorptiometry, Photon↗

DXA body composition properties: inherent in the physics or specific to scanner type?

Experimental results with DXA body composition are partly attributable to the DXA technology itself (X-ray physics) and partly to the particular implementation (Lunar DPX, Hologic QDR, etc). This paper identifies a number of advantages and disadvantages of DXA body composition measurement, distinguishing between those which are common to all DXA and those which are specific to particular instruments.

Absorptiometry, Photon↗

Body composition measurements using DXA and other techniques in tamoxifen-treated patients.

Tamoxifen is an anti-oestrogenic drug which is widely used in the treatment of patients with breast cancer. There is increasing interest in using the drug both for benign breast disease and as a chemo-preventative agent of the drug in women at high risk of breast cancer. Despite the fact that the acute side-effects of the drug are few, its agonistic and antagonistic oestrogenic effects are not fully known and may have some undesirable effects for patients treated with the drug for several years. A number of studies carried out recently indicate a varying degree of change in bone mineral content following treatment with tamoxifen. These studies concentrated mainly on bone mineral density measurements only and non of them reported the effects of tamoxifen on lean body mass and fat mass. In this study we measured lean body mass and fat mass in tamoxifen-treated females and a comparison group to determine the difference between the two groups. Twenty-six women receiving tamoxifen (20 mg/d) have participated in this study. The control group comprised 31 healthy women of a similar age. Total body bone mineral (TBBM) was measured using a dual-energy X-ray absorptiometry (DXA) (Hologic INV., Waltham, U.S.A.). Similarly, regional and total body soft tissue (lean and fat tissue) were measured using the DXA system. In addition to DXA measurements, percentage body fat (%BF) was measured using total body potassium counting (TBK), skinfold anthropometry (SF), infrared interactance (i.r.) and bioelectric impedance analysis (BIA). Results from DXA alone showed that there were no significant differences between the two groups for TBBM, regional and total body lean tissue mass. However, there was a significant difference between the two groups (P < 0.05) for %BF measurement. Similarly there was a significant difference between the two groups (P < 0.05) for %BF measured by other body composition techniques. Although there is no other research reported on the effects of tamoxifen on %BF, this retrospective study indicates that tamoxifen may lead to increase in fact content in women who are subjected to this treatment. We conclude that this observation is probably related to the agonistic oestrogenic effect of Tamoxifen on body fat. To our knowledge this deleterious effect has not been reported before and it should be taken into considerable when comprising different types of anti-oestrogenic drugs. Furthermore, patients should be warned about this side-effect when they are prescribed Tamoxifen therapy.

Absorptiometry, Photon↗

Comparison of different models for interpreting bone mineral density measurements using DXA and MRI technology.

Bone mineral density measurements using dual X-ray absorptiometry (DXA) are commonly expressed as areal density (g/cm2). However, areal BMD (BMDareal) is dependent on bone size and this can lead to erroneous interpretations of BMD values. We have previously presented a simple method for calculating apparent volumetric bone mineral density (BMDvol) using ancillary DXA-derived data. In the present study we tested the validity of our model using in vivo volumetric data obtained from magnetic resonance imaging (MRI) of lumbar vertebrae. BMDareal and BMDvol of L3 were measured from sixteen pairs of identical twins (24 men, 8 women), aged 25-69 years. The dimensions of the lumbar vertebra L3 were measured from MR images and BMD values were corrected for these dimensions. The DXA-derived apparent volumetric bone mineral density (BMDvol) correlated moderately with MRI-derived BMDs (r values from 0.665 to 0.822). In contrast to BMDareal, BMDvol and MRI-derived BMDs were not related to body size variables. All these volume-corrected BMDs diminished the erroneous effect of vertebral size on areal BMD. We conclude that the simple DXA-derived BMDvol can be used for normalization of bone mineral density values in subjects of different body sizes, and especially in growing children.

Absorptiometry, Photon↗

The intra- and inter-instrument reliability of DXA based on ex vivo soft tissue measurements.

OBJECTIVE: Comparison of ex-vivo soft tissue measurements using the GE/Lunar pencil (DPX-L; GE/Lunar Co., Madison, WI) and fan beam (Prodigy dual-energy X-ray absorptiometers (DXA) GE/Lunar Co.). RESEARCH METHODS AND PROCEDURES: Intra-instrument reliability was assessed by repeatedly scanning soft tissue phantoms for lean tissue (water) and fat tissue (methanol) using one DPX-L and two identical Prodigy DXAs at fast, medium, and slow scan modes. For each machine, 10 scans of each phantom were performed at each scan speed. The number of scans per instrument totaled 60. Data were analyzed using ANOVA to ascertain whether scan speed affected the intra-instrument reliability and to test whether soft tissue measurements differed among instruments. Percentage fat (phantom density) was the outcome variable. RESULTS: Intra-instrument reliability, expressed as coefficient of variation, ranged between 0.7% and 5.2% for the DPX-L and 0.4% and 4.5% for the Prodigy, with the lowest coefficients of variation observed when scanning the fat tissue phantom. Scan speed also affected the intra-instrument reliability (p < 0.01). Furthermore, differences in the measurement of percentage body fat for both the lean and fat tissue phantoms were observed among all three absorptiometers (all p < 0.01). After adjusting for scan speed, differences persisted for all three instruments. DISCUSSION: Intra- and inter-instrument reliability of DXA machines, even those from the same manufacturer, remains unpredictable. Thus, when measuring body composition using DXA, it is important to consider that even in the absence of measurement bias, the use of different DXA machines, particularly when using a variety of speed settings, will increase the residual error around the true value.

Absorptiometry, Photon↗

Measurement of visceral adipose tissue by DXA combined with anthropometry in obese humans.

OBJECTIVE: To get accurate measurements of visceral adipose tissue (VAT) using dual energy X-ray absorptiometry (DXA). DESIGN: DXA and anthropometric data and their combinations were compared to the VAT area calculated from a computed tomography (CT) single scan. SUBJECTS: 71 overweight subjects (44 women, 27 men), age: 16-70 y, BMI: 27-52 kg/m2. MEASUREMENTS: Total body and segmental tissue composition, and new parameters obtained from DXA, in addition to waist and hip circumferences and abdominal sagittal diameter measurements. RESULTS: The ratio measured at the umbilical level (sagittal diameter - subcutaneous fat width) x (transverse internal diameter)/(height) was closely related to VAT (r=0.94 for women and 0.88 for men). It gave the most predictive equation for VAT: y = 79.6x (s.e. 3.9) - 149 cm2 for the whole population (r2=0.86, P<0.0001, root mean square error=38.2 cm2. An independent relationship between lean mass or its index (r=0.52 and 0.72, P<0.001) and VAT was also found in women. CONCLUSION: This study demonstrates the potential usefulness of DXA to supply accurate measurements of VAT in addition to total body composition determination in obese subjects.

Absorptiometry, Photon↗

Adapting pediatric DXA scanning to clinical orthopaedics.

Osteoporosis and low bone density for age is increasingly recognized in children yet poorly understood and often overlooked. DXA scanning in children is problematic due to lack of guidelines and inexperience of most DXA practitioners. The International Society for Clinical Densitometry recommends spine or total body scans as the preferred skeletal sites for study in children, yet we find multiple regional scans to be far more useful in the clinical practice of pediatric DXA scanning, especially in a pediatric orthopaedic setting. DXA scans of 119 children are reviewed: 20% of the children had orthopaedic hardware or other artifact that would have rendered the whole body scan unusable. In 20 of 119 patients, the only scan that could be obtained, either due to contracture or patient cooperation, was the distal lateral femoral scan. Scanning multiple regions of interest including spine, hip, and/or distal lateral femora as indicated is the recommended protocol for assessment of BMD in the pediatric orthopaedic setting.

Absorptiometry, Photon↗

Comparison of DXA, Siri's 2C, and Lohman' s Db-mineral models for estimating the body fat of physically active adults.

The authors used 3-component (3C) Db-mineral-model (Lohman, 1986) reference measures to cross-validate Siri's (1961) 2-component (2C) conversion formula and dual-energy X-ray absorptiometry (DXA) estimates of relative body fat (%BF) for physically active adults. Participants varied in age (18 to 59 y), body fatness, ethnicity (black, Hispanic, white), and physical activity level. The 3C Db-mineral model was used to obtain reference measures of % BF (%BF3C) for comparison with body-composition measures from DXA and hydrodensitometry. For men (n = 110) and women (n= 110), %BF3C (14.0 % BF and 24.4 % BF, respectively) was more accurately estimated by Siri's 2C formula (% FSiri; men, r = 0.97, SEE = 1.77 % BF; women, r = 0.98, SEE = 1.56 % BF) than by DXA (% FDXA; men, r = 0.86, SEE = 3.54 % BF; women, r =0.88, SEE = 3.73 % BF). The average %BFSiri (men, 15.8 % BF; women, 24.7 % BF) and % FDXA (men, 16.2 % BF; women, 26.0 %BF) differed significantly (P < 0.001) from %BF3C. Siri's 2C model estimated the average % BF3C in this sample more accurately than DXA did.

Absorptiometry, Photon↗