Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 5/2015

01-05-2015 | Musculoskeletal

Prevalence and type of errors in dual-energy x-ray absorptiometry

Authors: Carmelo Messina, Michele Bandirali, Luca Maria Sconfienza, Nathascja Katia D’Alonzo, Giovanni Di Leo, Giacomo Davide Edoardo Papini, Fabio Massimo Ulivieri, Francesco Sardanelli

Published in: European Radiology | Issue 5/2015

Login to get access

Abstract

Objectives

Pitfalls in dual-energy x-ray absorptiometry (DXA) are common. Our aim was to assess rate and type of errors in DXA examinations/reports, evaluating a consecutive series of DXA images of patients examined elsewhere and later presenting to our institution for a follow-up DXA.

Methods

After ethics committee approval, a radiologist retrospectively reviewed all DXA images provided by patients presenting at our institution for a new DXA. Errors were categorized as patient positioning (PP), data analysis (DA), artefacts and/or demographics.

Results

Of 2,476 patients, 1,198 had no previous DXA, while 793 had a previous DXA performed in our institution. The remaining 485 (20 %) patients entered the study (38 men and 447 women; mean age ± standard deviation, 68 ± 9 years). Previous DXA examinations were performed at a total of 37 centres. Of 485 reports, 451 (93 %) had at least one error out of a total of 558 errors distributed as follows: 441 (79 %) were DA, 66 (12 %) PP, 39 (7 %) artefacts and 12 (2 %) demographics.

Conclusions

About 20 % of patients did not undergo DXA at the same institution as previously. More than 90 % of DXA presented at least one error, mainly of DA. International Society for Clinical Densitometry guidelines are very poorly adopted.

Key Points

• More than 90 % of DXA examinations/reports presented one or more errors.
• About 80 % of errors are related to image data analysis.
• Errors in DXA examinations may have potential implications for patients’ management.
Literature
1.
Consensus Development Conference (1993) Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650CrossRef
2.
Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY et al (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24(1):23–57CrossRefPubMedCentralPubMed
3.
Kanis JA, Oden A, Johnell O et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18(8):1033–1046CrossRefPubMed
4.
5.
Blake GM, Fogelman (2007) Role of dual-energy x-ray absorptiometry in the diagnosis and treatment of osteoporosis. J Clin Densitom 10(1):102–110CrossRefPubMed
6.
Bandirali M, Sconfienza LM, Aliprandi A et al (2014) In vivo differences among scan modes in bone mineral density measurement at dual-energy x-ray absorptiometry. Radiol Med 119(4):257–260CrossRefPubMed
7.
El Maghraoui A, Achemlal L, Bezza A (2006) Monitoring of dual-energy x-ray absorptiometry measurement in clinical practice. J Clin Densitom 9(3):281–286CrossRefPubMed
8.
Delnevo A, Bandirali M, Di Leo G et al (2013) Differences among array, fast array, and high-definition scan modes in bone mineral density measurement at dual-energy x-ray absorptiometry on a phantom. Clin Radiol 68(6):616–619CrossRefPubMed
9.
10.
Watts NB (2004) Fundamentals and pitfalls of bone densitometry using dual-energy x-ray absorptiometry (DXA). Osteoporos Int 15(11):847–854CrossRefPubMed
11.
Garg MK, Kharb S (2013) Dual energy x-ray absorptiometry: pitfalls in measurement and interpretation of bone mineral density. Indian J Endocrinol Metab 17(2):203–210CrossRefPubMedCentralPubMed
12.
Hologic (2000) QDR series user’s guide. Hologic, Bedford
13.
Bachrach LK (2000) Dual energy x-ray absorptiometry (DEXA) measurements of bone density and body composition: promise and pitfalls. J Pediatr Endocrinol Metab 13(Suppl):983–988PubMed
14.
Gafni RI, Baron J (2004) Overdiagnosis of osteoporosis in children due to misinterpretation of dual-energy x-ray absorptiometry (DEXA). J Pediatr 144(2):253–257CrossRefPubMed
15.
Leonard MB, Propert KJ, Zemel BS, Stallings VA, Feldman HI (1999) Discrepancies in pediatric bone mineral density reference data: potential for misdiagnosis of osteopenia. J Pediatr 135:182–188CrossRefPubMed
16.
Prentice A, Parsons TJ, Cole TJ (1994) Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. Am J Clin Nutr 60:837–842PubMed
17.
Preidler KW, White LS, Tashkin J et al (1997) Dual-energy x-ray absorptiometric densitometry in osteoarthritis of the hip. Acta Radiol 38:539–542PubMed
18.
Rand T, Seidl G, Kainberger F et al (1997) Impact of spinal degenerative changes on the evaluation of bone mineral density with dual energy x-ray absorptiometry (DXA). Calcif Tissue Int 60(5):430–433CrossRefPubMed
19.
Muraki S, Yamamoto S, Ishibashi H et al (2004) Impact of degenerative spinal diseases on bone mineral density of the lumbar spine in elderly women. Osteoporos Int 15(9):724–728CrossRefPubMed
20.
Lekamwasam S, Lenora RS (2003) Effect of leg rotation on hip bone mineral density measurements. J Clin Densitom Winter 6(4):331–336CrossRef
21.
US Preventive Services Task Force (2011) Screening for osteoporosis: US Preventive Services Task Force recommendation statement. Ann Intern Med 154(5):356–364CrossRef
Metadata
Title
Prevalence and type of errors in dual-energy x-ray absorptiometry
Authors
Carmelo Messina
Michele Bandirali
Luca Maria Sconfienza
Nathascja Katia D’Alonzo
Giovanni Di Leo
Giacomo Davide Edoardo Papini
Fabio Massimo Ulivieri
Francesco Sardanelli
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3509-y

Other articles of this Issue 5/2015

European Radiology 5/2015 Go to the issue

Gastrointestinal

Abdominal CT predictors of fibrosis in patients with chronic pancreatitis undergoing surgery

Gastrointestinal

Implications of Imaging Criteria for the Management and Treatment of Intraductal Papillary Mucinous Neoplasms – Benign versus Malignant Findings

Neuro

Cerebral computed tomography angiography using a 70 kVp protocol: improved vascular enhancement with a reduced volume of contrast medium and radiation dose

Radiological Education

Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

Emergency Radiology

Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis

Hepatobiliary-Pancreas

Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour