J Bone Metab.  2021 Feb;28(1):67-77. 10.11005/jbm.2021.28.1.67.

Does Bone Mineral Density Differ between Fan-Beam and Pencil-Beam?: A Meta-Analysis and Systemic Review

Affiliations
  • 1Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
  • 2Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
  • 3Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
  • 4Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea
  • 5Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea

Abstract

Background
Dual energy X-ray absorptiometry (DXA) has evolved from pencil-beam (PB) to narrow fan-beam (FB) densitometers. We performed a meta-analysis of the available observational studies to determine how different modes of DXA affect bone mineral density (BMD) measurements.
Methods
A total of 1,233 patients (808 women) from 14 cohort studies were included. We evaluated the differences in BMD according to the DXA mode: PB and FB. Additionally, we evaluated the differences in BMD between the 2 types of FB mode: FB (Prodigy) and the most recent FB (iDXA). Pairwise meta-analysis was performed, and weighted mean differences (WMD) were calculated for (total lumbar, total hip, and total body).
Results
No significant difference was observed in total lumbar (pooled WMD, -0.013; P=0.152) and total hip BMD (pooled WMD, -0.01; P=0.889), between PB and FB. However, total body BMD was significantly lower in the PB compared to the FB group (pooled WMD, -0.014; P=0.024). No significant difference was observed in lumbar BMD (pooled WMD, -0.006; P=0.567), total hip (pooled WMD, -0.002; P=0.821), and total body (pooled WMD, 0.015; P=0.109), between Prodigy and iDXA.
Conclusions
The results of this study warrant the recommendation that correction equations should not be used when comparing BMD from different modes. Further research is still needed to highlight the ways in which differences between DXA systems can be minimized.

Keyword

Absorptiometry, photon · Bone density · Densitometry · Osteoporosis
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