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DXA Technology
X-ray Source (two energies with different attenuation profiles) Collimator (pinhole for pencil beam, slit for
fan beam)
Interpretation of DXA Scans and VFA Deborah Sellmeyer, MD Director, - - PowerPoint PPT Presentation
Interpretation of DXA Scans and VFA Deborah Sellmeyer, MD Director, - - PowerPoint PPT Presentation
Interpretation of DXA Scans and VFA Deborah Sellmeyer, MD Director, Johns Hopkins Metabolic Bone Center Dept of Medicine, Division of Endocrinology Page 1 DXA Technology Detector (detects 2 tissue types - bone and soft tissue) Very low
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Lumbar Spine Positioning
- Straight spine
- Equal soft tissue on
both sides of vertebra
- Correct labeling
- No artifacts
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Hip Positioning
- Femoral shaft vertical
- Small amount lesser trochanter
- Rotation decreases lesser trochanter and
apparent femoral neck BMD
- No ischium in femoral neck ROI
Femoral Neck ROI different between Hologic and GE Lunar Lunar Hologic
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DXA #1
Name, contact info for facility Name, contact info for facility
Patient Name Med Record number DOB Patient Name Med Record number DOB
Demo- graphics
Date Software Technologist Machine Measured directly Calculated = BMC (g) area (cm2)
T-score = SD’s above (+) or below (-) young reference population Z-score = SD’s above or below age matched reference population
Reference population
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DXA #2
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DXA #3
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DXA #4
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DXA #5
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DXA #6
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DXA #7
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DXA #8
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DXA #9
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DXA #9
10 20 30 40 50 60 70 BONE MASS AGE 50% during adolescence
Using pediatric reference, Z-score = -0.1 http://www.bcm.edu/bodycomplab/mainbodycomp.htm
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DXA #10
Lunar Hologic
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DXA #11
Hologic Lunar
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DXA #12
2017 2016
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DXA #13
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DXA #13
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DXA #13
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DXA #14
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DXA #15
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DXA #15
2017 2016
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DXA #16
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DXA #16
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DXA #17
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DXA #17
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DXA #17
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Radius styloid process excluded Ultradistal line where radius and ulna meet 1/3 forearm site determine by radius length Size of ROI box ROI should extend beyond soft tissue
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2015 DXA #18 2014
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DXA #19
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DXA #19
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DXA #20
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Vertebral Fracture Assessment (VFA)
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Grading Vertebral Deformities
Grade 1 Sensitivity = 52%-96% Grade 2 or higher Sensitivity = 96% Specificity = 90%
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Indications for VFA
- Women age 65-70 years and men age 70-80 years if T-score is
- 1.5 or below.
- Women age 70 years and men age 80 and older regardless of
T-score.
- Postmenopausal women and men age 50 and older with a low
trauma fracture.
- Postmenopausal women and men age 50-69 with:
– historical height loss of 1.5 inches or more – prospective height loss of 1.5 inches or more – recent or ongoing long-term glucocorticoid treatment.
- F. Cosman, et. al. Osteoporos Int. 2015; 26(7): 2045–2047.
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