Use of high resolution dual‐energy x‐ray absorptiometry‐region free analysis (DXA‐RFA) to detect local periprosthetic bone remodeling events

Abstract

Dual-energy x-ray absorptiometry (DXA) is the gold standard method for measuring periprosthetic bone remodeling, but relies on a region of interest (ROI) analysis approach. While this addresses issues of anatomic variability, it is insensitive to bone remodeling events at the sub-ROI level. We have validated a high-spatial resolution tool, termed DXA-region free analysis (DXA-RFA) that uses advanced image processing approaches to allow quantitation of bone mineral density (BMD) at the individual pixel (datapoint) level. Here we compared the resolution of bone remodeling measurements made around a stemless femoral prosthesis in 18 subjects over 24 months using ROI-based analysis versus that made using DXA-RFA. Using the ROI approach the regional pattern of BMD change varied by region, with greatest loss in ROI5 (20%, p < 0.001), and largest gain in ROI4 (6%, p < 0.05). Analysis using DXA-RFA showed a focal zone of increased BMD localized to the prosthesis-bone interface (30-40%, p < 0.001) that was not resolved using conventional DXA analysis. The 20% bone loss observed in ROI5 with conventional DXA was resolved to a focal area adjacent to the cut surface of the infero-medial femoral neck (up to 40%, p < 0.0001). DXA-RFA enables high resolution analysis of DXA datasets without the limitations incurred using ROI-based approaches. ß

Influence of Femoral Component Design on Proximal Femoral Bone Mass After Total Hip Replacement

“…However, DXA analysis using the conventional Gruen zone region of interest (ROI) approach has limited ability to resolve spatially-complex patterns of bone remodeling around prostheses 10 . To address this, DXA-Region Free Analysis (DXA-RFA) was developed, allowing resolution of bone mineral density (BMD) at the individual pixel level [11][12][13][14] and because it does not average the pixel-level data into ROIs, there is no loss of resolution and interpretation variations associated with conventional DXA studies 15 .…”

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

“…Body mass index, fat mass, lean body mass, abdominal adipose tissue and bone mineral density will also be assessed by conducting Dual-energy X-ray absorptiometry (DXA, Discovery densitometer from HOLOGIC, QDR 4500 W) using protocols reported in previous studies [43, 44]. This assessment tool has previously been used in breast cancer patients [45, 46].…”

Graduate Student Literature Review: The milk behind the mustache: A review of milk and bone biology

“…Considered a silent disease, osteoporosis affects approximately 35 million Americans and results in $17 to $20 billion in health care costs annually due to osteoporosis-related injuries (Nanes and Kallen, 2014). Diagnosis of osteoporosis can be achieved through dual-energy X-ray absorptiometry, the gold standard for measuring bone mineral density that provides a simple, noninvasive method of pinpointing individuals who may be at an increased risk for fracture (Nanes and Kallen, 2014;Wilkinson et al, 2015). Dual-energy X-ray absorptiometry uses high-and low-energy photons to differentiate between hard and soft tissue.…”

“…Dual-energy X-ray absorptiometry uses high-and low-energy photons to differentiate between hard and soft tissue. Photons are absorbed by the bone, and the remaining photons not absorbed are used to determine bone mineral density; higher absorption means greater bone mineral density (Wilkinson et al, 2015). Although dual-energy X-ray absorptiometry is a very powerful tool in osteoporosis diagnosis, it is only a 2-dimensional analysis of a 3-dimensional problem (Wilkinson et al, 2015).…”