European semi-anthropomorphic phantom for the cross-calibration of peripheral bone densitometers: assessment of precision accuracy and stability

Pearson, J; Rüegsegger, P.; Dequeker, Jan; Henley, Michael V.; Bright, J.E.; Reeve, J.; Kalender, Willi A.; Felsenberg, Dieter; Laval-Jeantet, A. M.; Adams, Judith E.; Birkenhäger, J. C.; Fischer, M.; Geusens, Piet; Hesch, R. D.; Hyldstrup, Lars; Jaeger, P; Jonson, R.; Kröger, Heikki; Lingen, A. van; Mitchell, Angela M.; Reiners, Christoph; Schneider, Peter

doi:10.1016/s0169-6009(08)80213-9

Cited by 61 publications

(52 citation statements)

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“…Due to small numbers in some centres, the primary analyses were done with the centres combined by country. To enable a comparison with NHANES 3 US data, all the ESP standardised BMD values were transformed to Hologic QDR 1000W equivalents using ESP cross-calibration parameters [10]. Comparison was then made with the young normal values published by the NHANES III study [4].…”

Section: Discussionmentioning

confidence: 99%

“…This was done as described by Pearson et al [3], Kalender et al [5], and Lunt et al [6]. The minimum acceptable data for inclusion in the study was BMD at one measurement site (from femoral neck, trochanter, or L2-L4 spine), age, weight, and height at/or near the scan date.…”

Section: Dxa Proceduresmentioning

confidence: 99%

“…The two multicentre studies were: a concerted action of the European Community's COMAC-BME FP2 programme (5 centres) [2,3] and the Polish EPOLOS osteoporosis study (6 centres). Principal investigators in Coimbra (Portugal), Ghent (Belgium), Kuopio (Finland), Prague (Czech Republic), and Odense (Denmark) contributed further population-based young normal BMD data.…”

Section: Introductionmentioning

confidence: 99%

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Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Kaptoge¹,

Silva²,

Brixen³

et al. 2008

Bone

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Edited by: Harry Genant Keywords:Bone mineral density (BMD) Dual energy X-ray absorptiometry (DXA) Europe T-score Osteoporosis Young normalWe collected population-based young normal hip and spine BMD data from 17 centres across Europe to assess between centre differences and to compare reference values with the US NHANES-III data. There was strong evidence of between country heterogeneity, but not between centres within countries. Hip BMD mean values were lower in European women, but SD's differed little from the NHANES-III USA results in both sexes. It may be necessary to adjust NHANES-III based T-scores by adding/subtracting a country-specific adjustment factor. Introduction: It remains unclear whether young normal BMD reference values specific to an American population can be validly used for T-score calculation in Europeans. Methods: We collected population based BMD data from 1163 men and 329 women aged 19-29 years from 17 centres across Europe to compare mean and SD values with the NHANES-III study USA results. BMD(g/cm 2 ) was measured at the hip and spine using DXA densitometers cross-calibrated with the European Spine Phantom (ESP). The only exclusions were for technically inadequate scans. A linear regression model was used to derive reference values. To allow for direct comparison with published NHANES III study data, the cross-calibrated BMD values were converted using the ESP equations to Hologic QDR 1000 units. Results: In men, the overall mean(SD) BMD values expressed in Hologic-QDR1000 units of measurement, were: femoral neck 0.912(0.132); trochanter 0.793(0.124); and L2-L4 spine 1.027(0.123). The respective estimates in women were: 0.826(0.115); 0.670(0.093); and 0.983(0.107). However the I 2 statistic for heterogeneity indicated moderate to strong evidence of between-centre heterogeneity. There was, however, no significant heterogeneity observed between centres within countries, suggesting that this variation arose from national differences. Compared to the NHANES III population-based US data, the mean values in women were significantly lower at both sites due to some lower national European means. However, at all sites and in both sexes the SD's were very similar between the US and Europe. There was some evidence that recruiting volunteers resulted in biased values in women. Conclusion: Our T-score normal values for the lumbar spine (L2-L4) should be more reliable for spine-specific risk assessment than some non-representative normal ranges, and should be evaluated for that purpose in Europe. If Tscores are to be used to compare individual data with ranges seen in normal young subjects of the same nationality, it may be necessary to adjust femoral NHANES III-based T-scores by adding (or subtracting) a country-specific adjustment factor. In risk assessment it is probably sufficient to use NHANES III-based hip T-scores, as supplied for the hip by densitometer manufacturers, interpreting them in light of recent international meta-analysis data on the relationship between BMD and fracture risk.

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Section: Discussionmentioning

confidence: 99%

Section: Dxa Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Kaptoge¹,

Silva²,

Brixen³

et al. 2008

Bone

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“…The results were cross-calibrated with the European Spine Phantom. (23) We updated our calibrations with the definitive phantom compared with our previous calibrations (24) with the prototype. These measurements were made either at the time of the first X-ray (13 centers) or at the time of the second X-ray (remaining centers).…”

Section: Determinants Of the Size Of Incident Vertebral Deformitiesmentioning

confidence: 99%

“…The machines used were Lunar (Madison, WI, USA), Hologic (Waltham, MA, USA), or Norland (Minster, OH, USA) pencil beam machines, or in one case, a Sopha fan-beam machine. The results were cross-calibrated with the European Spine Phantom.(23) We updated our calibrations with the definitive phantom compared with our previous calibrations (24) with the prototype. These measurements were made either at the time of the first X-ray (13 centers) or at the time of the second X-ray (remaining centers).…”

mentioning

confidence: 99%

Determinants of the Size of Incident Vertebral Deformities in European Men and Women in the Sixth to Ninth Decades of Age: The European Prospective Osteoporosis Study (EPOS)

Reeve¹

2003

Journal of Bone and Mineral Research

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More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture.Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions:In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush Ͼ bi-concave Ͼ uni-concave Ͼ wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified. J Bone Miner Res 2003;18:1664 -1673Key words: osteoporosis, vertebral fractures, cohort study, radiological morphometry, fracture risk INTRODUCTION T HE IMPACT OF osteoporotic vertebral fractures has become the subject of increasing attention.(1-4) Because nonspecific or mechanical back pain is common, it has proved sometimes difficult to show the impact of osteoporotic fractures in the vertebral bodies. These are relatively uncommon in populations but were thought to have a large impact on affected individuals. In more recent work, better instruments have been used to measure impact in terms of activities of daily living, bodily function, and pain. (3,5,6) It has become clear t...

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Chapter 30. Quantitative Computed Tomography in Children and Adults

Glüer¹

2008

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism

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European semi-anthropomorphic phantom for the cross-calibration of peripheral bone densitometers: assessment of precision accuracy and stability

Cited by 61 publications

References 10 publications

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Determinants of the Size of Incident Vertebral Deformities in European Men and Women in the Sixth to Ninth Decades of Age: The European Prospective Osteoporosis Study (EPOS)

Chapter 30. Quantitative Computed Tomography in Children and Adults

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