Precision assessment and radiation safety for dual-energy X-ray absorptiometry

position paper of the International Society for Clinical Densitometry.

Sanford Baim, Charles R. Wilson, E. Michael Lewiecki, Marjorie M. Luckey, Robert W. Downs, Brian C. Lentle

Research output: Contribution to journalArticle

183 Citations (Scopus)

Abstract

Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis, assess the risk of fracture, and monitor changes in BMD over time. Because biological changes in BMD are usually small in proportion to the error inherent in the test itself, interpretation of serial BMD tests depends on knowledge of the smallest change in BMD that is beyond the range of error. This value, called the least significant change (LSC), varies according to the instrument used, the patient population being tested, the measurement site, the skill of the technologist at positioning the patient and analyzing the test, and the confidence interval used in the calculation. The precision and LSC values provided by the manufacturer cannot be applied to clinical bone densitometry centers because of the differences in the patients being tested and the technologist performing the test. Because harmful errors in clinical management may occur from incorrectly interpreting serial BMD tests, it is recommended that every DXA technologist conduct a precision assessment and calculate the LSC for each measurement site and DXA instrument used. Precision assessment provides direct benefit to patients by allowing clinicians to make clinical decisions based on genuine change or stability of BMD. The patient-care benefits of precision assessment outweigh the risk of exposure to trivial doses of ionizing radiation.

Original languageEnglish
Pages (from-to)371-378
Number of pages8
JournalJournal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.
Volume8
Issue number4
StatePublished - Dec 1 2005

Fingerprint

Photon Absorptiometry
Bone Density
Radiation
Safety
Patient Positioning
Densitometry
Ionizing Radiation
Osteoporosis
Patient Care
Confidence Intervals
Bone and Bones
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

Cite this

Precision assessment and radiation safety for dual-energy X-ray absorptiometry : position paper of the International Society for Clinical Densitometry. / Baim, Sanford; Wilson, Charles R.; Lewiecki, E. Michael; Luckey, Marjorie M.; Downs, Robert W.; Lentle, Brian C.

In: Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry., Vol. 8, No. 4, 01.12.2005, p. 371-378.

Research output: Contribution to journalArticle

@article{1859d2b63f8143c28585f1a43c39db7b,
title = "Precision assessment and radiation safety for dual-energy X-ray absorptiometry: position paper of the International Society for Clinical Densitometry.",
abstract = "Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis, assess the risk of fracture, and monitor changes in BMD over time. Because biological changes in BMD are usually small in proportion to the error inherent in the test itself, interpretation of serial BMD tests depends on knowledge of the smallest change in BMD that is beyond the range of error. This value, called the least significant change (LSC), varies according to the instrument used, the patient population being tested, the measurement site, the skill of the technologist at positioning the patient and analyzing the test, and the confidence interval used in the calculation. The precision and LSC values provided by the manufacturer cannot be applied to clinical bone densitometry centers because of the differences in the patients being tested and the technologist performing the test. Because harmful errors in clinical management may occur from incorrectly interpreting serial BMD tests, it is recommended that every DXA technologist conduct a precision assessment and calculate the LSC for each measurement site and DXA instrument used. Precision assessment provides direct benefit to patients by allowing clinicians to make clinical decisions based on genuine change or stability of BMD. The patient-care benefits of precision assessment outweigh the risk of exposure to trivial doses of ionizing radiation.",
author = "Sanford Baim and Wilson, {Charles R.} and Lewiecki, {E. Michael} and Luckey, {Marjorie M.} and Downs, {Robert W.} and Lentle, {Brian C.}",
year = "2005",
month = "12",
day = "1",
language = "English",
volume = "8",
pages = "371--378",
journal = "Journal of Clinical Densitometry",
issn = "1094-6950",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Precision assessment and radiation safety for dual-energy X-ray absorptiometry

T2 - position paper of the International Society for Clinical Densitometry.

AU - Baim, Sanford

AU - Wilson, Charles R.

AU - Lewiecki, E. Michael

AU - Luckey, Marjorie M.

AU - Downs, Robert W.

AU - Lentle, Brian C.

PY - 2005/12/1

Y1 - 2005/12/1

N2 - Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis, assess the risk of fracture, and monitor changes in BMD over time. Because biological changes in BMD are usually small in proportion to the error inherent in the test itself, interpretation of serial BMD tests depends on knowledge of the smallest change in BMD that is beyond the range of error. This value, called the least significant change (LSC), varies according to the instrument used, the patient population being tested, the measurement site, the skill of the technologist at positioning the patient and analyzing the test, and the confidence interval used in the calculation. The precision and LSC values provided by the manufacturer cannot be applied to clinical bone densitometry centers because of the differences in the patients being tested and the technologist performing the test. Because harmful errors in clinical management may occur from incorrectly interpreting serial BMD tests, it is recommended that every DXA technologist conduct a precision assessment and calculate the LSC for each measurement site and DXA instrument used. Precision assessment provides direct benefit to patients by allowing clinicians to make clinical decisions based on genuine change or stability of BMD. The patient-care benefits of precision assessment outweigh the risk of exposure to trivial doses of ionizing radiation.

AB - Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis, assess the risk of fracture, and monitor changes in BMD over time. Because biological changes in BMD are usually small in proportion to the error inherent in the test itself, interpretation of serial BMD tests depends on knowledge of the smallest change in BMD that is beyond the range of error. This value, called the least significant change (LSC), varies according to the instrument used, the patient population being tested, the measurement site, the skill of the technologist at positioning the patient and analyzing the test, and the confidence interval used in the calculation. The precision and LSC values provided by the manufacturer cannot be applied to clinical bone densitometry centers because of the differences in the patients being tested and the technologist performing the test. Because harmful errors in clinical management may occur from incorrectly interpreting serial BMD tests, it is recommended that every DXA technologist conduct a precision assessment and calculate the LSC for each measurement site and DXA instrument used. Precision assessment provides direct benefit to patients by allowing clinicians to make clinical decisions based on genuine change or stability of BMD. The patient-care benefits of precision assessment outweigh the risk of exposure to trivial doses of ionizing radiation.

UR - http://www.scopus.com/inward/record.url?scp=33644878009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644878009&partnerID=8YFLogxK

M3 - Article

VL - 8

SP - 371

EP - 378

JO - Journal of Clinical Densitometry

JF - Journal of Clinical Densitometry

SN - 1094-6950

IS - 4

ER -