J Korean Soc Radiol.  2010 Jun;62(6):555-561.

Feasibility of Peripheral Bone Densitometry for the Assessment of Bone Density: Comparison with Dual Energy X-ray Absorptiometry of the Axial Skeleton

• Park JS
• Jin W
• Park SY
• Bae MS
• Kim DY
• Choe BK
• Ryu KN

Abstract

PURPOSE
To evaluate the feasibility of peripheral bone densitometry for the assessment of bone density, and to compare it with dual energy X-ray absorptiometry (DXA).
MATERIALS AND METHODS
Radiographic absorptiometry (RA) of the middle phalange, peripheral DXA (pDXA) of the calcaneus, and the DXA were performed for two groups: Group 1 was a normal group of 54 healthy young women and group 2 was a group of 54 postmenopausal women considered to be at a high risk for osteoporosis. For the normal group, RA and pDXA were scanned twice to assess the repeatability of the methods. The Tscores were compared to determine whether there was a correlation between the peripheral and axial bone densitometries. The cutoff values of RA and pDXA for the diagnosis of osteopenia were determined.
RESULTS
Each examination showed different T-scores for a given person. The T-scores of RA were higher than those of pDXA for the normal group, whereas the T-scores of pDXA were higher for high-risk group. The coefficients of repeatability were 0.88 in RA and 1.53 in pDXA. The correlation coefficient for DXA was higher in RA than in pDXA. The cutoff values for osteopenia were -1.773 for RA and -1.75 for pDXA, as compared to -1.0 for DXA.
CONCLUSION
The data suggests that RA is a viable screening method for osteoporosis. However, there should be consideration for the fact that bone density depends on examination methods or sites.

MeSH Terms

Absorptiometry, Photon
Bone Density
Bone Diseases, Metabolic
Calcaneus
Densitometry
Female
Finger Phalanges
Humans
Mass Screening
Osteoporosis

Figure

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  Fig. 1 Automatic identification and measurement of bone density of 2nd-4th middle phalanges, with aluminum wedge (right on figure) as a reference value.

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  Fig. 2 Bland-Altman plot and coefficient of repeatability of the peripheral bone densitometry. A. Middle phalangeal RA (CR=0.88). B. Calcaneal pDXA (CR=1.53).

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  Fig. 3 Correlation between central DXA and peripheral bone densitometry. A. Lumbar DXA-middle phalangeal RA (r=0.6067). B. Lumbar DXA-calcaneal pDXA (r=0.1693).

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  Fig. 4 Receiver operating characteristic (ROC) curves and areas under the curves for the middle phalangeal RA and calcaneal pDXA for the diagnosis of osteopenia, using a T-score=-1.0 of lumbar DXA as a standard value. pdxat1=calcaneal pDXA, rat1=middle phalangeal RA, spinedxat=lumbar DXA.

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