Short-Term Precision and Repeatability of Radiofrequency Echographic Multi Spectrometry (REMS) on Lumbar Spine and Proximal Femur: An In Vivo Study

Abstract

To determine the short-term intra-operator precision and inter-operator repeatability of radiofrequency echographic multi-spectrometry (REMS) at the lumbar spine (LS) and proximal femur (FEM). All patients underwent an ultrasound scan of the LS and FEM. Both precision and repeatability, expressed as root-mean-square coefficient of variation (RMS-CV) and least significant change (LSC) were obtained using data from two consecutive REMS acquisitions by the same operator or two different operators, respectively. The precision was also assessed in the cohort stratified according to BMI classification. The mean (±SD) age of our subjects was 48.9 ± 6.8 for LS and 48.3 ± 6.1 for FEM. Precision was assessed on 42 subjects at LS and 37 subjects on FEM. Mean (±SD) BMI was 24.71 ± 4.2 for LS and 25.0 ± 4.84 for FEM. Respectively, the intra-operator precision error (RMS-CV) and LSC resulted in 0.47% and 1.29% at the spine and 0.32% and 0.89% at the proximal femur evaluation. The inter-operator variability investigated at the LS yielded an RMS-CV error of 0.55% and LSC of 1.52%, whereas for the FEM, the RMS-CV was 0.51% and the LSC was 1.40%. Similar values were found when subjects were divided into BMI subgroups. REMS technique provides a precise estimation of the US-BMD independent of subjects’ BMI differences.

The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine

“…Indeed, the comparison procedure identifies the spectral modifications introduced by the physical properties of the bone structure, as reflected in the backscattered ultrasound signals. This process leads to the estimation of BMD and subsequently allows for diagnostic classification as healthy, osteopenic, or osteoporotic [ 16 , 17 ]. The intra-operator precision of REMS was 0.47% at the spine and 0.32% at the proximal femur evaluation, whereas the inter-operator precision was 0.55% and 0.51% at the lumbar spine and proximal femur, respectively [ 20 ].…”

“…Through the comparison of spectral characteristics in the analyzed signals with established reference spectral models for both pathological and normal conditions, it becomes possible to ascertain bone density [ 15 , 16 ]. A recent study by Messina et al [ 17 ], using data from two consecutive REMS acquisitions by the same operator or two different operators, respectively, demonstrated that both precision (expressed as the root-mean-square coefficient of variation) and repeatability (expressed as the least significant change) of REMS were not inferior to those of DXA. Furthermore, REMS, since it does not use ionizing radiation, can be employed even in subsets of patients for which DXA is not recommended, such as pregnant women, breast-feeding women, and children.…”

Radiofrequency Echographic Multispectrometry (REMS): A New Option in the Assessment Bone Status in Adults with Osteogenesis Imperfecta

“…Several recent studies have shown a good diagnostic agreement between the BMD values obtained using the REMS technique compared to the DXA method. Moreover, REMS assessment was characterized by good repeatability and adequate precision but it was also able to predict the risk of fragility fractures [15][16][17]. In addition, REMS technology seems to be able to overcome some limitations of DXA, such as the overestimation of BMD in the presence of artifacts, osteophytes and fractures, and also to provide bone qualitative information [18,19].…”