Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Bone Mineral Assessment Of The Axial Skeleton: Technical Aspects

T. Lang
Published 2010 · Materials Science

Save to my Library
Download PDF
Analyze on Scholarcy
The goal of this chapter is to describe the underlying principles and error sources associated with X-ray based bone densitometry methods used to assess the central skeleton. The first portion of the chapter focuses on projectional densitometry measurements which are most widely used in the clinical setting. The concepts of single and dual photon absorptiometry are used to provide a simple and clear explanation of the physical principles underlying dual X-ray absorptiometry (DXA). The section then describes the error sources associated with DXA, including precision errors, bone size dependence and the effect of adipose tissue distribution. The second portion of the chapter describes quantitative X-ray computed tomography (QCT), an adaptation of clinical computed tomography imaging for assessment of skeletal integrity. This section describes how CT images are acquired and the physical meaning of the image units as they relate to bone mineral content and density. The section then describes the use of QCT of the hip and spine to assess cortical and trabecular bone mineral density, the physical errors associated with those assessments, and the application of QCT to assess measures of bone quality such as bone geometry and whole bone strength.
This paper references
A Preliminary Evaluation of the Lunar Expert‐XL for Bone Densitometry and Vertebral Morphometry
T. Lang (1997)
Dual energy radiography versus quantitative computer tomography for the diagnosis of osteoporosis.
R. Pacifici (1990)
Axial and Total-Body Bone Densitometry Using a Narrow-Angle Fan-Beam
R. Mazess (2000)
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group.
L. Alexeeva (1994)
Cross-calibration of liquid and solid QCT calibration standards: Corrections to the UCSF normative data
K. Faulkner (2005)
Quantitative digital radiography for bone mineral analysis
J Stein (1988)
Short Term In Vivo Precision of Proximal Femoral Finite Element Modeling
Dianna D. Cody (2004)
Quantitative histological studies on age changes in bone.
M. Dunnill (1967)
New approaches for interpreting projected bone densitometry data
D. Carter (1992)
An accurate method for direct dual-energy calibration and decomposition.
H. Cardinal (1990)
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report
J. Kanis (2005)
Dual-Energy X-Ray Absorptiometry
T. Lohman (2005)
Changes to Osteoporosis Prevalence According to Method of Risk Assessment
J. Richards (2007)
Dual energy x-ray absorptiometry: the effects of beam hardening on bone density measurements.
G. Blake (1992)
Proximal femoral density and geometry measurements by quantitative computed tomography: association with hip fracture.
X. Cheng (2007)
Femoral strength is better predicted by finite element models than QCT and DXA.
D. Cody (1999)
Accuracy and Precision of 62 Bone Densitometers Using a European Spine Phantom
S. Kolta (1999)
Population‐Based Study of Age and Sex Differences in Bone Volumetric Density, Size, Geometry, and Structure at Different Skeletal Sites
B. Riggs (2004)
Dual-energy X-ray absorptiometry in early life.
A. Lapillonne (1997)
Correcting the Magnification Error of Fan Beam Densitometers
M. R. Griffiths (1997)
Linearity and accuracy errors in bone densitometry.
S. Pors Nielsen (1998)
Radiation dose and in vitro precision in paediatric bone mineral density measurement using dual X-ray absorptiometry.
C. F. Njeh (1997)
A New Dual-energy X-ray Bone Densitometer Incorporating an Internal Reference System
F. Verlaan (1989)
Instrument performance in bone density testing at five Australian centres.
K. Khan (1997)
Opposite bone remodeling effects of teriparatide and alendronate in increasing bone mass.
M. Mcclung (2005)
Absorbed dose measurements in dual energy X-ray absorptiometry (DXA).
E. Bezakova (1997)
Estimates of volumetric density from projectional estimates improve the discriminatory capability of dual X-ray absorptiometry
M Jergas (1995)
Differences between dual X-ray absorptiometry using pencil beam and fan beam modes and their determinants in vivo and in vitro.
A. G. Ruetsche (2000)
Geometric structure of the femoral neck measured using dual‐energy X‐ray absorptiometry
T. Yoshikawa (1994)
S. Beer (2002)
Paired AP and lateral supine dual X-ray absorptiometry of the spine: initial results with a 32 detector system
P Steiger (1991)
Effective dose values in bone mineral measurements by photon absorptiometry and computed tomography
W. Kalender (2005)
Factors Influencing Long‐Term in vivo Reproducibility of QCT (Vertebral Densitometry)
A. Laval-Jeantet (1993)
Quantitative dual-energy radiographic absorptiometry of the lumbar spine: in vivo comparison with dual-photon absorptiometry.
J. Borders (1989)
Accuracy and the influence of marrow fat on quantitative CT and dual-energy X-ray absorptiometry measurements of the femoral neck in vitro
J. W. Kuiper (2005)
Mammographic dual-screen-dual-emulsion-film combination: visibility of simulated microcalcifications and effect on image contrast.
C. Kimme-Smith (1987)
Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation.
W. Kalender (1990)
Lean R value for DXA two-component soft-tissue model: influence of age and tissue or organ type.
A. Pietrobelli (1998)
Comparisons of Noninvasive Bone Mineral Measurements in Assessing Age‐Related Loss, Fracture Discrimination, and Diagnostic Classification
S. Grampp (1997)
Problems of bone analysis in childhood and adolescence
E. Schoenau (1998)
Errors in dual-energy X-ray absorptiometry of the lumbar spine owing to fat distribution and soft tissue thickness during weight change.
P. Tothill (1994)
The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis.
D. Black (2003)
Vertebral Morphometry: Repeat Scan Precision Using the Lunar Expert-XL and the Hologic 4500A. A Study for the “WISDOM” RCT of Hormone Replacement Therapy
N. Crabtree (2000)
Factors influencing short-term precision of dual X-ray bone absorptiometry (DXA) of spine and femur
K. Engelke (2004)
Racial differences in hip axis lengths might explain racial differences in rates of hip fracture
S. Cummings (2005)
Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures.
D. Marshall (1996)
Bone mineralization in the distal forearm of hemiplegic patients.
N. Naftchi (1975)
Comparative assessment of dual-photon absorptiometry and dual-energy radiography.
C. Glüer (1990)
Generalized image combinations in dual KVP digital radiography.
L. Lehmann (1981)
A PC program for estimating organ dose and effective dose values in computed tomography
W. Kalender (1999)
Improved prediction of proximal femoral fracture load using nonlinear finite element models.
J. Keyak (2001)
Bone mineral measurements by photon absorptiometry : methodological problems
J. Dequeker (1988)
Body Composition Measurements during Infancy
W. Koo (2000)
Quantitative computed tomography for vertebral mineral determination
HK Genant (1983)
In Situ Femoral Dual-Energy X-ray Absorptiometry Related to Ash Weight, Bone Size and Density, and its Relationship with Mechanical Failure Loads of the Proximal Femur
E. Lochmüller (2000)
Differences in hip quantitative computed tomography (QCT) measurements of bone mineral density and bone strength between glucocorticoid-treated and glucocorticoid-naïve postmenopausal women
Kuo-Chiang Lian (2004)
Adaptation of the Proximal Femur to Skeletal Reloading After Long‐Duration Spaceflight
T. Lang (2006)
Predicting Proximal Femoral Strength Using Structural Engineering Models
J. Keyak (2005)
Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength.
T. Lang (1997)
Low-dose CT scanning for quantitative spinal mineral analysis.
C. Cann (1981)
Spinal bone mineral density by quantitative computed tomography : effect of region of interest , vertebral level , and technique
P Steiger (1990)
Increasing sex difference in bone strength in old age: The Age, Gene/Environment Susceptibility-Reykjavik study (AGES-REYKJAVIK).
G. Sigurdsson (2006)
Vertebral and peripheral bone mineral content by photon absorptiometry.
M. Madsen (1977)
Factors influencing long-term in vivo reproducibility of QCT overtebral densitometry).
A. Laval-Jeantet (1993)
Spinal bone mineral density measured with quantitative CT: effect of region of interest, vertebral level, and technique.
P. Steiger (1990)
A new accurate and precise 3-D segmentation method for skeletal structures in volumetric CT data
Yan Kang (2003)
Accuracy and Precision of In Vivo Bone Mineral Measurements in Sheep Using Dual-Energy X-ray Absorptiometry
J. Pouillès (2000)
The assessment of fracture risk.
A. Unnanuntana (2010)
Hip fracture in women without osteoporosis.
Stacey A Wainwright (2005)
Performance evaluation of a dual-energy X-ray bone densitometer
R. Mazess (2007)
Bone Densitometry and Osteoporosis
C. V. van Kuijk (1998)
Physical performance of spiral CT scanning
WA Kalender (1991)
Cortical thickness measurements and photon absorptiometry for determination of bone quantity.
E. Cameron (1977)
Single and dual energy X-ray absorptiometry
J. Adams (1997)
Switching from DXA pencil-beam to fan-beam. II: Studies in vivo.
P. Eiken (1994)
Effect of bone distribution on vertebral strength: assessment with patient-specific nonlinear finite element analysis.
K. Faulkner (1991)
Inhomogeneity in body fat distribution may result in inaccuracy in the measurement of vertebral bone mass
C. Formica (1995)
Individual Smallest Detectable Difference in Bone Mineral Density Measurements
P. Ravaud (1999)
Total body bone mineral and lean body mass by dual-photon absorptiometry
B. Mazess (2006)
Dual Energy X-Ray Absorptiometry of the Forearm in Preterm and Term Infants: Evaluation of the Methodology
H. Sievänen (1999)
Vertebral bone mineral analysis: an integrated approach with CT.
W. Kalender (1987)
Dimensions and Volumetric BMD of the Proximal Femur and Their Relation to Age Among Older U.S. Men
L. Marshall (2006)
Quantitative computed tomography-based finite element models of the human lumbar vertebral body: effect of element size on stiffness, damage, and fracture strength predictions.
R. Crawford (2003)
Effects of Teriparatide and Alendronate on Vertebral Strength as Assessed by Finite Element Modeling of QCT Scans in Women With Osteoporosis
T. M. Keaveny (2007)
Young-elderly differences in bone density, geometry and strength indices depend on proximal femur sub-region: a cross sectional study in Caucasian-American women.
M. Meta (2006)
An anatomic coordinate system of the femoral neck for highly reproducible BMD measurements using 3D QCT.
Yan Kang (2005)
Estimates of volumetric bone density from projectional measurements improve the discriminatory capability of dual X‐ray absorptiometry
M. Jergas (1995)
Physical performance characteristics of spiral CT scanning.
W. Kalender (1991)
Prediction of fracture location in the proximal femur using finite element models.
J. Keyak (2001)
Does estimating volumetric bone density of the femoral neck improve the prediction of hip fracture? A prospective study
S. Cummings (1994)
Bilateral measurement of femoral bone mineral density.
R. Mazess (2000)
Precise measurement of vertebral mineral content using computed tomography.
C. Cann (1980)
Prediction of hip fractures from pelvic radiographs: The study of osteoporotic fractures
C. Glüer (1994)
Cortical and Trabecular Bone Mineral Loss From the Spine and Hip in Long‐Duration Spaceflight
T. Lang (2004)
Spinal bone mineral density by quantitative computed tomography: effect of region of interest, vertebral level, and technique. Radiology 1990;175:537–543
P Steiger (1990)
Assessment of vertebral bone mineral density using volumetric quantitative CT.
T. Lang (1999)
Impact of soft tissue on in vivo accuracy of bone mineral measurements in the spine, hip, and forearm: A human cadaver study
O. Svendsen (1995)
Total body bone mineral and lean body mass by dualphoton absorptiometry. III. Comparison with trunk calcium by neutron activation analysis
RB Mazess (1981)
Long-Term Precision of DXA Scanning Assessed over Seven Years in Forty Postmenopausal Women
R. Patel (2000)
Accurate assessment of precision errors: How to measure the reproducibility of bone densitometry techniques
C. Glüer (2005)

This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar