The ability of calcaneal and multisite quantitative ultrasound variables in the identification of osteoporosis in women and men

Oral, Aydan; Esmaeilzadeh, Sina; Yalıman, Ayşe; Sindel, Dilşad; Koseoglu, Pinar Kursuz; Aydın, Tuğba

doi:10.5606/tftrd.2019.1894

Cited by 14 publications

(8 citation statements)

References 46 publications

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“…An AUC greater than 0.7 re ects an acceptable level of accuracy of QUS. The AUCs of all the QUS parameters in this study determined using the AOS-100 device were comparable to those reported in previous studies using QUS devices from other manufacturers 21,22 . SOS had the highest AUC compared to the other QUS parameters in discriminating osteoporosis at any site and the femoral neck.…”

Section: Discussionsupporting

confidence: 88%

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients

Chanprasertpinyo

Punsawad

Sukkriang

et al. 2021

Preprint

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IntroductionOsteoporosis is a prevalent comorbidity in patients with COPD that is usually underrecognized and hence undertreated. Compared to the gold standard dual-energy X-ray absorptiometry (DXA), calcaneus quantitative ultrasound (QUS) is less expensive, more portable, and more accessible, especially in less developed countries. The aim of this study was to investigate the ability of calcaneus QUS to detect osteoporosis in patients with COPD.MethodsThis cross-sectional study enrolled 67 males older than 50 years with clinically stable COPD. DXA scans of the lumbar spine (L2-4) and femoral neck were performed. QUS of the right calcaneus (AOS-100) were used to assess the broadband ultrasound attenuation (BUA), speed of sound (SOS), osteo sono-assessment index (OSI), and T-score. When the T-score was ≤ − 2.5, osteoporosis was diagnosed by both DXA and QUS.ResultsForty-eight patients (71.6%) had DXA T-scores ≤ − 2.5 at either the lumbar spine or femoral neck. All QUS parameters (BUA, SOS, OSI, and T-score) could discriminate DXA-determined osteoporosis (the area under the curve varied from 0.64 to 0.83). The QUS T-score was significantly moderately correlated with the DXA T-score at both the femoral neck (r = 0.62) and lumbar spine (r = 0.53). The sensitivity and specificity of QUS in identifying osteoporosis were 10.4% and 94.7%, respectively. The positive and negative predictive values were 83.3% and 29.5%, respectively.ConclusionThe calcaneus QUS T-score had the ability to identify osteoporosis with an acceptable level of accuracy. However, the sensitivity and specificity of the QUS T-score were not sufficiently high to serve as an alternative diagnostic tool to DXA.

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Section: Discussionsupporting

confidence: 88%

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients

Chanprasertpinyo

Punsawad

Sukkriang

et al. 2021

Preprint

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“…Several studies have explored the relationship between QUS and DXA measures in different study populations. Among post-menopausal women, for instance, a strong correlation has consistently been found between calcaneal QUS and DXA at multiple body sites [ 8 , 26 ]. Similarly, a study of adult patients living with HIV identified more moderate correlations between calcaneal QUS and DXA, particularly whole body DXA measurements, which is consistent with the present study [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV

Roberts

Shen²,

Strehlau³

et al. 2022

PLoS ONE

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Children living with HIV (CLHIV) have decreased bone mineral content (BMC) and density (BMD), increasing risk for fracture and future osteoporosis. While DXA is the gold-standard for bone assessments, it lacks availability in resource-constrained settings (RCS). Quantitative ultrasound (QUS) offers an alternative owing to its portability, low cost, ease of handling, and lack of ionizing radiation. While QUS has detected reduced bone quality in CLHIV, the relationship between QUS and DXA in this population remains unexplored. At baseline and 12 months, BMC and BMD of the whole body, lumbar spine, and radius were measured by DXA in a longitudinal cohort of CLHIV in Johannesburg, South Africa. Calcaneal speed of sound (SOS) and broadband ultrasound attenuation (BUA) and radius SOS were obtained by QUS, and calcaneal stiffness index (SI) was calculated. Spearman correlations, with and without HIV stratification, were performed between QUS and DXA measurements at each visit and for absolute difference in measurements between visits. At baseline and 12-months, calcaneal BUA and SI displayed strong positive correlations with DXA, with only modest correlations between radial QUS and DXA at baseline. Longitudinal measures of QUS did not correlate with DXA. At both baseline and 12-months, individuals with DXA whole-body BMD z-score < -1 displayed significantly lower calcaneal BUA and SI. Cross-sectionally, calcaneal QUS correlates strongly with whole body DXA and may represent a viable diagnostic alternative in RCS. Longitudinally, the two methods do not correlate well, possibly reflecting that each method assesses distinct aspects of bone architecture.

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“…Some of the previous studies have applied modified QUS T-score to determine the optimal performance of QUS in identifying subjects at risk of osteoporosis [21,[42][43][44]. Oral et al (2019) found that at the modified QUS T-scores of −1.68 and −1.53 for men (mean age: 57.8 ± 13.7 years) and women (mean age: 53.7 ± 11.9 years), respectively, the sensitivity and specificity values obtained were around 70% [40]. Nevertheless, it should be emphasized that the comparison of the performance and cut-off values across QUS devices from different manufacturers is not recommended due to different algorithms or reference database used.…”

Section: Discussionmentioning

confidence: 99%

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

et al. 2020

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Background: Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. Methods: The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden’s index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <−1) showed a sensitivity of 82.1% (95% CI: 77.9–85.7%), specificity of 51.5% (95% CI: 46.5–56.6%) and AUC of 0.668 (95% CI: 0.630–0.706) in identifying subjects with suboptimal bone health (DXA T-score <−1) (p < 0.001). At QUS T-score ≤−2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤−2.5) (sensitivity 14.4% (95% CI: 8.1–23.0%); specificity 96.1% (95% CI: 94.4–97.4%); AUC 0.553 (95% CI: 0.488–0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8–72.3%); specificity 72.8% (95% CI: 68.1–77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666–0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0–86.9%); specificity 61.8% (95% CI: 58.1–65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654–0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.

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The ability of calcaneal and multisite quantitative ultrasound variables in the identification of osteoporosis in women and men

Cited by 14 publications

References 46 publications

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients

Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

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The ability of calcaneal and multisite quantitative ultrasound variables in the identification of osteoporosis in women and men

Cited by 14 publications

References 46 publications

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in&nbsp;COPD Patients

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in&nbsp;COPD Patients

Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

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Product

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Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients

Comparison Between Calcaneus Quantitative Ultrasound and the Gold Standard DXA In the Ability to Detect Osteoporosis in COPD Patients