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Lin YH, Chou CS, Teng MMH. The choice of region of interest after spinal procedures alters bone mineral density measurements. PLoS One 2023; 18:e0285898. [PMID: 37192199 DOI: 10.1371/journal.pone.0285898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
PURPOSE Vertebrae affected by artifacts, such as metallic implants or bone cement, should be excluded when measuring the spine bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). Exclusion may be performed using two methods: first, the affected vertebrae are included in the region of interest (ROI) and subsequently excluded from the analysis; second, the affected vertebrae are completely excluded from the ROI. This study aimed to investigate the influence of metallic implants and bone cement on BMD with and without the inclusion of artifact-affected vertebrae in the ROI. METHODS DXA images of 285 patients, including 144 with spinal metallic implants and 141 who had undergone spinal vertebroplasty from 2018 to 2021, were retrospectively reviewed. Spine BMD measurements were performed when the images were evaluated using two different ROIs for each patient during the same examination. In the first measurement, the affected vertebrae were included in the ROI; however, the affected vertebrae were excluded from the BMD analysis. In the second measurement, the affected vertebrae were excluded from the ROI. Differences between the two measurements were evaluated using a paired t-test. RESULTS Among 285 patients (average age, 73 years; 218 women), spinal metallic implants led to an overestimation of bone mass in 40 of 144 patients, whereas bone cement resulted in an underestimation of bone mass in 30 of 141 patients when the first measurement was compared with the second measurement. The opposite effect occurred in 5 and 7 patients, respectively. Differences in results between the inclusion and exclusion of the affected vertebrae in the ROI were statistically significant (p<0.001). Spinal implants or cemented vertebrae included in the ROI might significantly alter BMD measurements. Additionally, different materials were associated with varying modifications in BMD. CONCLUSION The inclusion of affected vertebrae in the ROI may notably alter BMD measurements, even when they are excluded from the analysis. This study suggests that the vertebrae affected by spinal metallic implants or bone cement should be excluded from the ROI.
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Affiliation(s)
- Yen-Huai Lin
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Che-Shi Chou
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Michael Mu Huo Teng
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Araz M, Sutcu G, Surucu Kara L, Eminoglu T, Ozkan E. A Rare Pitfall in Bone Mineral Densitometry: Gaucher Disease. Clin Nucl Med 2022; 47:e568-e569. [PMID: 35797635 DOI: 10.1097/rlu.0000000000004159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT We report a rare case of type 3 Gaucher disease presenting with calcified mesenteric lymph nodes that interfere with bone mineral densitometric measurements.
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Affiliation(s)
- Mine Araz
- From the Departments of Nuclear Medicine
| | | | | | - Tuba Eminoglu
- Pediatric Metabolism, Ankara University Medical School, Ankara, Turkey
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Albano D, Agnollitto PM, Petrini M, Biacca A, Ulivieri FM, Sconfienza LM, Messina C. Operator-Related Errors and Pitfalls in Dual Energy X-Ray Absorptiometry: How to Recognize and Avoid Them. Acad Radiol 2021; 28:1272-1286. [PMID: 32839098 DOI: 10.1016/j.acra.2020.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Dual-energy X-ray absorptiometry (DXA) is the most common modality for quantitative measurements of bone mineral density. Nevertheless, errors related to this exam are still very common, and may significantly impact on the final diagnosis and therapy. Operator-related errors may occur during each DXA step and can be related to wrong patient positioning, error in the acquisition process or in the scan analysis. The aim of this review is to provide a practical guide on how to recognize such errors in spine and hip DXA scan and how to avoid them, also presenting some of the most common artifacts encountered in clinical practice.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milano 20161, Italy; Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 127, 90127 Palermo, Italy
| | - Paulo Moraes Agnollitto
- Radiology Division / CCIFM, Ribeirão Preto Medical School, Av. Bandeirantes 3900, Ribeirão Preto, SP, Brazil
| | - Marcello Petrini
- Department of Radiology, Ospedale Guglielmo da Saliceto, via Taverna 49, Piacenza 29121, Italy
| | - Andrea Biacca
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milano 20161, Italy
| | - Fabio Massimo Ulivieri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Medicina Nucleare, Milano, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milano 20161, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano 20122, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milano 20161, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano 20122, Italy.
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Morgan SL, Krueger D, Bassler J, Burroughs L, Borchardt G, Yester M, Binkley N, Redden D. "Effect of very dense artifacts on Hologic and general electric bone densitometry results". Arch Osteoporos 2020; 15:77. [PMID: 32436138 DOI: 10.1007/s11657-020-00742-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/22/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Very dense artifacts confound bone density measurement. Hologic and GE densitometers exclude artifact density and GE also excludes associated area. Consequently, BMD is decreased with Hologic software. Despite different manufacturers' approaches, when dense artifacts overlay the spine, the affected vertebral body should be excluded from the reported BMD. PURPOSE Very dense objects, such as lead bullets are described as "black hole" artifacts on Hologic densitometers. Whether similar results occur on GE scanners is not reported. We hypothesized that dense artifacts confound both brands of densitometers. METHODS Three lead bullets of varying size were placed overlying or adjacent to L3 on anthropomorphic and encapsulated aluminum spine phantoms. Three scans were acquired with and without projectiles on a Hologic Discovery W, GE iDXA, and Prodigy densitometer. RESULTS Lead bullets are measured as having high bone mineral content (BMC); they appear black in dual-energy mode on Hologic scanners and are colored blue on GE scanners. On Hologic scanners, BMC of a dense artifact over bone is excluded, but the bone area is not altered. Consequently, bone mineral density (BMD) of the affected vertebra, and of L1-4, is decreased. For example, a .45 caliber bullet over L3 decreased BMD (p < 0.05) by 48.3% and L1-4 by 9.1%. GE scanners excluded associated BMC and area covered by the artifact, thereby minimizing impact on BMD. Dense artifacts over soft tissue on a phantom do not substantially affect BMD on either manufacturer's densitometer when scanned. CONCLUSION Densitometer manufacturers handle very dense artifacts differently. GE software removes artifact BMC and area with resultant minimal impact on BMD, Hologic removes only BMC, not area, thereby decreasing BMD. Regardless of this difference, when dense artifacts overlay the spine, it is best to exclude the affected vertebral body. Finally, the BMD stability observed with artifacts over soft tissue may not be replicated in humans.
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Affiliation(s)
- Sarah L Morgan
- University of Alabama at Birmingham, Osteoporosis Prevention and Treatment Clinic and DXA Facility, Birmingham, AL, USA
| | - Diane Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - John Bassler
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Leandria Burroughs
- University of Alabama at Birmingham, Osteoporosis Prevention and Treatment Clinic and DXA Facility, Birmingham, AL, USA
| | - Gretta Borchardt
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - Michael Yester
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Neil Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - David Redden
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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Martineau P, Morgan SL, Leslie WD. Bone Mineral Densitometry Reporting: Pearls and Pitfalls. Can Assoc Radiol J 2020; 72:490-504. [PMID: 32309998 DOI: 10.1177/0846537120919627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Dual-energy X-ray absorptiometry (DXA) is the method of choice for assessing bone mineral density (BMD). Unfortunately, the performance and interpretation of DXA can be challenging and errors are common. In fact, it has been reported that up to 90% of BMD reports contain at least 1 error. Errors can be the result of technique or interpretative in nature or both and can result in inappropriate diagnosis and management. In this article, we review the various types of pitfalls frequently encountered by physicians interpreting DXA studies. Being aware of these pitfalls will help readers recognize and avoid them when encountered in clinical practice.
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Affiliation(s)
- Patrick Martineau
- Department of Radiology, 12359University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarah L Morgan
- Department of Medicine, 9968University of Alabama, Birmingham, Alabama, USA
| | - William D Leslie
- Department of Medicine, 12359University of Manitoba, Winnipeg, Manitoba, Canada
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Spiro AJ, Hoang TD, Shakir MKM. ARTIFACTS AFFECTING DUAL-ENERGY X-RAY ABSORPTIOMETRY MEASUREMENTS. AACE Clin Case Rep 2019; 5:e263-e266. [PMID: 31967049 PMCID: PMC6873828 DOI: 10.4158/accr-2019-0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/21/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To present 3 cases in which the presence of artifacts altered the dual-energy X-ray absorptiometry (DXA) measurements of bone mineral density (BMD) in the lumbar field. METHODS Clinical presentation and literature review. RESULTS The first patient was a 49-year-old premenopausal woman with a spinal cord stimulator implanted in her lumbar spine. The implant increased the measured BMD in the lumbar region from osteopenia to normal range. The second patient was a 56-year-old man who had a DXA scan after he was administered oral and intravenous iodine-based contrast earlier the same day. The oral contrast in the patient's colon created a dense artifact, which overlapped the lumbar spine and adjacent soft tissue. The effect almost changed his DXA diagnosis from osteoporosis to osteopenia. The third patient was a 64-year-old woman who had undergone laparoscopic adjustable gastric banding (LAGB). A part of the LAGB system adjacent to lumbar vertebra 3 was mistakenly included as part of the vertebrae by the DXA scanner, causing an increase in the measured BMD. CONCLUSION There are numerous artifacts that can alter DXA BMD measurement. It is important for providers who interpret DXA scans to be familiar with the potential effects of artifacts and how to adjust for their presence, since erroneous measurements can lead to incorrect decisions regarding treatment and follow-up.
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Siglinsky E, Binkley N, Krueger D. Do Textiles Impact DXA Bone Density or Body Composition Results? J Clin Densitom 2018; 21:303-307. [PMID: 28988694 DOI: 10.1016/j.jocd.2017.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/25/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022]
Abstract
External artifacts can confound dual-energy X-ray absorptiometry (DXA) measurements. It is often accepted that garments free of metal do not affect DXA results; however, little data exist in this regard. It is plausible that some textiles absorb radiation and thereby alter DXA results. We hypothesized that some dense or synthetic textiles, for example, reflective materials, might alter DXA-measured bone and soft tissue mass. Hologic and GE Lunar spine phantoms and a Bioclinica prototype total body phantom were imaged on a GE Lunar iDXA and Prodigy densitometer. Each phantom was scanned 10 times to establish mean values. Subsequently, 2 layers of various fabrics were placed over the entire top surface of the phantom, and 10 scans were performed without repositioning. Samples of natural, synthetic, or embellished fabric (including those with reflective material) and of varying thickness were used. Wilcoxon signed rank tests were used to compare the means between bare phantom and textile-covered phantom. Significant differences were demonstrated often, depending on the scanner, phantom, and textile used. A polyester fabric with reflective strip consistently altered measurements. For example, this fabric increased measured mean lumbar spine bone mineral density and total body bone mineral content by 0.008 g/cm2 and 3.6 g, respectively (p < 0.01). Similarly, mean total body fat decreased (-173 g) and lean mass increased (+213 g; p < 0.01). Fat and lean mass were also affected by metallic thread, wool, blend denim, and shiny polyester (p < 0.05), and lean mass was affected by cotton denim and sweatshirt material (p < 0.0003). In conclusion, textiles can affect DXA-measured bone mineral density and body composition results. Even small amounts of reflective material could alter mass measurements by ~25% of the least significant change. Clothing made of dense textiles (e.g., wool and denim) or those with reflective material and metallic thread should be avoided during DXA scanning.
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Affiliation(s)
- E Siglinsky
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| | - N Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| | - D Krueger
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA.
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Lewiecki EM, Binkley N, Morgan SL, Shuhart CR, Camargos BM, Carey JJ, Gordon CM, Jankowski LG, Lee JK, Leslie WD. Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance. J Clin Densitom 2016; 19:127-40. [PMID: 27020004 DOI: 10.1016/j.jocd.2016.03.003] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 01/30/2023]
Abstract
Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.
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Affiliation(s)
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
| | - Neil Binkley
- Osteoporosis Clinical Center and Research Program, University of Wisconsin, Madison, WI, USA
| | - Sarah L Morgan
- Division of Clinical Immunology and Rheumatology, Department of Medicine, UAB Osteoporosis Prevention and Treatment Clinic, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - John J Carey
- Galway University Hospitals, National University of Ireland, Galway, Ireland
| | - Catherine M Gordon
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Joon-Kiong Lee
- JK Lee Orthopaedics & Traumatology, Petaling Jaya, Malaysia
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Martineau P, Bazarjani S, Zuckier LS. Artifacts and Incidental Findings Encountered on Dual-Energy X-Ray Absorptiometry: Atlas and Analysis. Semin Nucl Med 2015; 45:458-69. [DOI: 10.1053/j.semnuclmed.2015.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mergler S, Rieken R, Tibboel D, Evenhuis HM, van Rijn RR, Penning C. Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors. Pediatr Radiol 2012; 42:574-83. [PMID: 22252145 PMCID: PMC3337401 DOI: 10.1007/s00247-011-2307-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 09/15/2011] [Accepted: 09/17/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with severe neurological impairment and intellectual disability (ID) are susceptible for developing low bone mineral density (BMD) and fractures. BMD is generally measured with dual-energy X-ray absorptiometry (DXA). OBJECTIVE To describe the occurrence of factors that may influence the feasibility of DXA and the accuracy of DXA outcome in children with severe neurological impairment and ID. MATERIALS AND METHODS Based on literature and expert opinion, a list of disrupting factors was developed. Occurrence of these factors was assessed in 27 children who underwent DXA measurement. RESULTS Disrupting factors that occurred most frequently were movement during measurement (82%), aberrant body composition (67%), small length for age (56%) and scoliosis (37%). The number of disrupting factors per child was mean 5.3 (range 1-8). No correlation was found between DXA outcomes and the number of disrupting factors. CONCLUSION Factors that may negatively influence the accuracy of DXA outcome are frequently present in children with severe neurological impairment and ID. No systematic deviation of DXA outcome in coherence with the amount of disrupting factors was found, but physicians should be aware of the possible influence of disrupting factors on the accuracy of DXA.
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Affiliation(s)
- S. Mergler
- Intellectual Disability Medicine/Department of General Practice, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - R. Rieken
- Intellectual Disability Medicine/Department of General Practice, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - D. Tibboel
- Department of Pediatric Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - H. M. Evenhuis
- Intellectual Disability Medicine/Department of General Practice, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - R. R. van Rijn
- Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands
| | - C. Penning
- Intellectual Disability Medicine/Department of General Practice, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Ott SM, Ichikawa LE, LaCroix AZ, Scholes D. Navel jewelry artifacts and intravertebral variation in spine bone densitometry in adolescents and young women. J Clin Densitom 2009; 12:84-8. [PMID: 18990595 PMCID: PMC2692464 DOI: 10.1016/j.jocd.2008.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 08/14/2008] [Accepted: 09/15/2008] [Indexed: 11/26/2022]
Abstract
Non-removable navel jewelry can increase the measured bone density of the underlying vertebra. We measured lumbar spine bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) in an observational study of 727 adolescents and young women aged 14-30 yr. We evaluated several methods of correcting BMD: manually erasing a small area, eliminating 1 or 2 vertebrae, estimating the BMD from 1 or 2 vertebrae using data from remaining vertebrae, and estimating the BMD using T-scores of the remaining vertebrae. Ten percent (n=71) of the subjects were wearing navel jewelry. The areal BMD by DXA of L1 and L2 was similar in those with jewels as in controls without jewels, but L3-L4 showed higher bone density in those with jewelry, and the spine BMD of L1-L4 was significantly higher in the bejeweled women (1.043+/-0.011 vs 1.006+/-0.004 g/cm2, p=0.01). The estimated errors in accuracy (g/cm2) were 0.034 due to the jewels; 0.005 from erasing a small area; 0.019 from eliminating L4; 0.044 from eliminating both L3 and L4; 0.016 from predicting BMD using L1-L3; and 0.028 using L1-L2. The T-scores using the Hologic database were progressively lower in the caudal vertebrae, even in 96 local women aged 30-35 yr, whose average T-score was 0.35 at L1 but -0.26 at L4. Thus, we found significant errors due to intravertebral variability. We suggest the optimal method of correcting for small artifacts is to erase the area under the artifact.
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Affiliation(s)
- Susan M Ott
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98195-6426, USA.
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Mann ML, Thornley-Brown D, Campbell R, Bell E, Burroughs L, Nunnally N, Feng R, Morgan SL. The effect of peritoneal dialysate on DXA bone densitometry results in patients with end-stage renal disease. J Clin Densitom 2008; 11:532-6. [PMID: 18809346 DOI: 10.1016/j.jocd.2008.08.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 08/11/2008] [Accepted: 08/11/2008] [Indexed: 11/28/2022]
Abstract
The bone mineral density of patients undergoing peritoneal dialysis (PD) is low compared to a healthy population. No studies have been conducted to investigate whether the presence of peritoneal dialysate affects dual-energy X-ray absorptiometry (DXA) results. We hypothesized that the presence of peritoneal dialysate would not affect the measurement of bone mineral density (BMD) or bone mineral content (BMC) in the spine. Thirty patients on PD had DXA scans of the lumbar spine and hip completed before and after the drainage of peritoneal dialysate. A paired t-test was used to compare the difference in area, BMC, and BMD before and after drainage of dialysate. A significant difference was found in the BMC of the spine before and after the drainage of dialyzate. We recommend that peritoneal dialyzate be removed prior to scanning patients on PD and that densitometry technologists should be observant about the presence of peritoneal dialysate.
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Affiliation(s)
- Merry Lynn Mann
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
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