Bone Mineral Density Measured by a Portable X-ray Device Agrees With Dual-Energy X-ray Absorptiometry at Forearm in Preschool Aged Children

Hazell, Tom J.; Vanstone, Catherine A.; Rodd, Celia; Rauch, Frank; Weiler, Hope A.

doi:10.1016/j.jocd.2012.07.005

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…In this pilot study, we showed that aBMD measurements in the proximal forearm derived from digital radiographs acquired with an external step phantom were comparable to DXA aBMD measurements at the same ROI. The correlation coefficient between digital X-ray estimated aBMD and iDXA measurements in the validation cohort was similar to the correlations (r: range, 0.469 to 0.97) of the forearm aBMD measures at middle and proximal sites amongst different peripheral DXA devices (15,16). Thus, RA has potential for application in a variety of medical settings to expand the use of existing X-ray devices.…”

Section: Discussionsupporting

confidence: 69%

Assessment of bone densitometry using radiography with a step-wedge phantom: a pilot study of the forearm

Huang¹,

Du²,

Geng³

et al. 2022

Quant Imaging Med Surg

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Background: Radiographic absorptiometry (RA) is one of the earliest methods of bone densitometry and has been used to measure the phalanges and metacarpals where soft tissue attenuation is minimal. The aim of this study was to determine whether the technique can be adapted to correct for soft tissue attenuation and measure areal bone mineral density (aBMD) in the forearm.Methods: A total of 51 patients referred for a clinical spine and hip dual-energy X-ray absorptiometry (DXA) examination and 8 young and middle-aged volunteers were recruited to this study. The first 29 participants (20 women, 9 men, aged 61±14 years) served as the training cohort, and the remaining 30 (20 women, 10 men, aged 55±16 years) comprised the validation cohort. All participants underwent a DXA scan of their non-dominant forearm, and a digital X-ray image of the same arm was acquired with a step phantom.Identical regions of interest (ROIs) in the radius and ulna at the one-third radius site were measured on the X-ray and DXA images, and a soft tissue ROI was measured on X-ray images between the radius and ulna. The X-ray measurements in the training cohort were expressed as equivalent step phantom thickness (Eq. SPT) and used to estimate forearm aBMD using a linear equation calibrated against the DXA scans.Estimates of forearm aBMD made from the digital X-ray images acquired in the validation cohort were compared with the results of the DXA scans.Results: Digital X-ray estimates of radius and ulna aBMD at the one-third radius site in the validation cohort showed a good correlation with GE-Lunar iDXA scanner measurements (r=0.795; P<0.001). The Bland-Altman plot had a mean bias of −0.002 g/cm 2 and 95% limits of agreement of −0.185 to +0.181 g/cm 2 .Conclusions: Digital X-ray estimates of proximal forearm aBMD corrected for soft tissue attenuation correlated with DXA measurements with correlation coefficients comparable to those seen for other peripheral bone densitometry technologies.

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Section: Discussionsupporting

confidence: 69%

Assessment of bone densitometry using radiography with a step-wedge phantom: a pilot study of the forearm

Huang¹,

Du²,

Geng³

et al. 2022

Quant Imaging Med Surg

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“…Our study argues against the use of forearm BMD as a proxy for central measures or as a fracture predictor in prepubertal children, suggesting a limited use for peripheral measures in population‐based research on skeletal development. Low agreement between peripheral and central measures has been reported in previous literature, either as wide limits of agreement or as kappa values below 0.6 . Our study extended the existing knowledge to a large population‐based sample of children before the growth spurt period.…”

Section: Discussionsupporting

confidence: 60%

Cohort study shows that peripheral dual‐energy X‐ray absorptiometry is of limited epidemiologic use in prepubertal children

et al. 2017

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Aim: Peripheral methods are increasingly used to assess bone health, despite little evidence on their predictive ability. We aimed to evaluate the usefulness of forearm dualenergy X-ray absorptiometry in prepubertal children, by estimating the agreement between peripheral and central measures and the ability to predict fracture history. Methods:In 2012/2014, we assessed 1177 seven-year-old children from the Generation XXI cohort who were recruited at birth in all five public hospitals with maternity wards in Porto, Portugal. Subtotal and lumbar spine bone mineral density (BMD) and content, leftarm BMD and peripheral forearm BMD were measured. Parents reported the child's lifetime fracture history. We estimated agreement using Bland-Altman's method and Cohen's kappa. Fracture prediction ability was calculated using area under the receiver operator characteristic curve (ROC-AUC).Results: The limits of agreement were very wide, ranging from À2.20/2.20 to À1.87/ Conclusion:This study suggests that forearm BMD has limited use for bone health research or as a basis for clinical decisions in prepubertal children. INTRODUCTIONIn both clinical and research settings, dual-energy X-ray absorptiometry (DXA) remains the gold standard method for assessing bone physical properties -bone mineral density (BMD) and bone mineral content (BMC) -in adults and children (1). In clinical settings, paediatric DXA has mostly been used to assist in the diagnosis and monitoring of primary and secondary osteoporosis. In research, paediatric DXA scans have been increasingly used due to their tempting availability, safety, ease of use and ability to estimate body composition. Conceptually, investigating bone quality in generally healthy children follows the life course premise that childhood and adolescence are sensitive periods for bone mass acquisition and consequent bone health in adulthood (2).

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“…The dimensions are: height, 144 mm; length, 148 mm; width 258 mm, without the skin guard or hand strap. [2][3][4][5] However, there have been no reports of X-ray studies using portable X-ray systems under transportation by a physician-staffed helicopter in a prehospital setting. The system requires a special cassette and notebook-type personal computer to operate and display Xray images (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Special cars have already been equipped with X-ray instruments in order to undertake medical checkups outside of medical facilities. [2][3][4][5] However, there have been no reports of X-ray studies using portable X-ray systems under transportation by a physician-staffed helicopter in a prehospital setting. Our hospital is a base of the physician-staffed helicopter (called a doctor helicopter [DH] in Japan) of eastern Shizuoka Prefecture.…”

Section: Introductionmentioning

confidence: 99%

Experience using a portable X‐ray system at the scene transported by a physician‐staffed helicopter

Omori

Yanagawa

Muramatsu

et al. 2019

Acute Medicine & Surgery

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Background Fujifilm (Tokyo, Japan) developed a portable X‐ray system called the CALNEO Xair, which can be carried by a physician. The X‐ray radiation machine weighs 3.5 kg. The dimensions are: height, 144 mm; length, 148 mm; width, 258 mm. Case Presentation When a 33‐year‐old woman driving a car made a right turn at a crossroad, her car hit another car, causing her vehicle to tip onto its side. Staff of the doctor helicopter checked her at the scene, and the findings of chest and pelvic X‐ray were all negative. She received a diagnosis of cervical sprain and pelvic contusion and was transferred to a local hospital by ambulance. Conclusion This is the first report of a case evaluated by a portable X‐ray system at the scene, under transportation by a doctor helicopter. This system could be useful for undertaking prehospital assessment and medical treatment.

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Bone Mineral Density Measured by a Portable X-ray Device Agrees With Dual-Energy X-ray Absorptiometry at Forearm in Preschool Aged Children

Cited by 11 publications

References 19 publications

Assessment of bone densitometry using radiography with a step-wedge phantom: a pilot study of the forearm

Assessment of bone densitometry using radiography with a step-wedge phantom: a pilot study of the forearm

Cohort study shows that peripheral dual‐energy X‐ray absorptiometry is of limited epidemiologic use in prepubertal children

Experience using a portable X‐ray system at the scene transported by a physician‐staffed helicopter

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