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Open Access 01-09-2019 | Digital Imaging in Dentistry | Original Article

Can digital X-ray radiogrammetry be an alternative for dual-energy X-ray absorptiometry in the diagnosis of secondary low bone quality in children?

Authors: Alex D. Leijten, Brieke Hampsink, Marcel Janssen, Willemijn M. Klein, Jos M. T. Draaisma

Published in: European Journal of Pediatrics | Issue 9/2019

Abstract

Bone quality in children is generally measured with dual-energy X-ray absorptiometry (DXA). Digital X-ray radiogrammetry (DXR) uses BoneXpert to measure cortical bone quality on hand radiographs. This prospective study compared DXR and DXA results in children with high probability of secondary low bone quality, defined as DXA of the lumbar spine (DXA_LS) Z-score ≤ − 2.0. One hundred one children underwent both DXA and DXR assessment. DXA_LSZ-scores were also adjusted for bone age. DXR Z-scores were compared with both DXA_LSZ-scores, using Pearson correlations, Bland-Altman analysis, and sensitivity-specificity analysis. Mean bone age, DXR, and both DXA Z-scores were significantly impaired. Pearson correlation coefficients were significant between DXR Z-scores and both DXA_LSZ-scores 0.507–0.564 (p < 0.001). Bland-Altman analysis showed a mean difference of 0.05–0.48 between DXR and both DXA Z-scores and showed more than 90% similarity for both DXA_LSZ-scores ≤ − 2.0. DXR had a sensitivity of 67–71% and specificity of 77–83% compared to both DXA_LSZ-scores.

Conclusion: DXR correlates well with as well DXA_LS as bone age-adjusted DXA_LSZ-scores and shows good agreement with as well DXA_LS as bone age-adjusted DXA_LSZ-scores ≤ − 2.0. DXR shows best results when compared with DXA_LSZ-scores.

What is Known: • Digital X-ray radiogrammetry (DXR) may correlate well with dual-energy X-ray absorptiometry (DXA) in pediatric, adolescent, and adult patients. • DXR is a feasible method for assessment of bone quality in children.
What is New: • This is the first prospective study in children with suspected secondary low bone quality that illustrates correlation between DXR and bone age-adjusted DXA Z-scores and that shows good agreement between DXR and DXA as bone age-adjusted DXA Z-scores ≤ −2.0. • Our results suggest DXR to be a good alternative for DXA for determining low bone quality.

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Title: Can digital X-ray radiogrammetry be an alternative for dual-energy X-ray absorptiometry in the diagnosis of secondary low bone quality in children?
Authors: Alex D. Leijten
Brieke Hampsink
Marcel Janssen
Willemijn M. Klein
Jos M. T. Draaisma
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Digital Imaging in Dentistry
Osteoporosis
Osteoporosis
Published in: European Journal of Pediatrics / Issue 9/2019
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-019-03425-5

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Can digital X-ray radiogrammetry be an alternative for dual-energy X-ray absorptiometry in the diagnosis of secondary low bone quality in children?

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