Some Physical and Clinical Factors Influencing the Measurement of Precision Error, Least Significant Change, and Bone Mineral Density in Dual-Energy X-Ray Absorptiometry

Frimeth, Jeffrey; Galiano, Eduardo; Webster, Dave

doi:10.1016/j.jocd.2009.09.004

Cited by 10 publications

(8 citation statements)

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“…To create a categorical variable for BMD change, the least significant change (LSC) was used as a cutoff to define BMD gain and loss. Use of the LSC is a recognized approach to determining meaningful BMD change (). The LSC is calculated as a BMD change exceeding 2√2 times the precision error of a technique ().…”

Section: Methodsmentioning

confidence: 99%

Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

Lee

Harvey

Price

et al. 2013

Arthritis & Rheumatism

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Objective We sought to evaluate the longitudinal relationship of bone mineral density (BMD) and its change to knee osteoarthritis (OA) progression measured by cartilage outcomes. Methods We used observational cohort data from the Vitamin D for Knee Osteoarthritis trial. We obtained bilateral femoral neck BMDs as well as knee MRIs in each subject at baseline and subsequently at 12 and 24 months. We measured change in total cartilage volume, tibial and femoral cartilage thickness by manual cartilage segmentation of two sequential knee MRIs in each subject. Multivariable linear regression models were used to examine the associations of baseline BMD and BMD change with the cartilage outcomes, adjusting for baseline age, gender, BMI, malalignment and vitamin D treatment. We validated model fit and assumptions. Results 127 subjects were eligible for analysis. Longitudinal BMD loss was associated with loss of cartilage volume (β=1.25 per 0.1g/cm2, p=0.02) and tibial cartilage thickness (β=0.028, p=0.03). BMD loss of a magnitude greater than least significant change (≤ −4.7%) was associated with 1.02% cartilage volume loss per year (p=0.005), 0.014mm femoral cartilage thickness loss (p=0.04) and 0.021mm tibial cartilage thickness loss per year (p=0.009). There were no significant associations between baseline BMD and any of the cartilage outcomes. Conclusions Longitudinal BMD loss is associated with progressive cartilage loss in knees with OA. Further work to clarify the basis of this relationship could uncover novel therapeutic targets for knee OA.

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Section: Methodsmentioning

confidence: 99%

Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

Lee

Harvey

Price

et al. 2013

Arthritis & Rheumatism

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“…This distance is due to the very strong anticorrelation (r = -0.7895) in the control group bivariation and the strong positive correlation (r = 0.8497) observed in the experimental group bivariation. As explained by Frimeth et al, the (BMD) method is exquisitely sensitive to the presence of any high atomic number elements, especially heavy metals [34]. Furthermore, Pietrobelli and collaborators communicated results in which iron-overloaded humans presented elevated (BMD) indices, compared to normal control subjects [35].…”

Section: Resultsmentioning

confidence: 98%

The Use of Different Statistical Metrics to Detect Physiological Changes in Metal-Overloaded Avian Bone

Lapointe¹,

Galiano²

2020

JESPR

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Slag from nickel smelting operations in the Sudbury basin in Ontario, Canada, has become ubiquitous. This material rich in heavy metals -particularly iron -upon ingestion has the potential to effect changes in physiology. In previous work, we analyzed the effects of dietary slag ingestion on several quantitative parameters of the tibio-tarsal bones in pigeons, including density, cortical thickness, bone mineral density, calcium and iron concentrations, Young's Moduli, and breaking strength. In the present work, we compute the Pearson correlation coefficients for all possible sets of bivariations of the measured parameters for a control group fed a normal diet, and an experimental group fed a slag-based diet. Furthermore, the Pearson distance, which is a metric associated with the degree of "clustering" between two independent sets of bivariate correlations, was calculated for all corresponding pairs of bivariations. A new metric -the Distance correlation R -is a measure of multivariate correlation which tests for any type of correlation, including linear correlation (or anticorrelation). In analogy to the Pearson distance, we introduce in this work the Distance correlation dR, and a criterion for its statistical significance. On the existing data set, the Distance correlation R was also calculated for all 42 bivariations, and the associated 21 values of dR were computed. In the control group, the Pearson correlation revealed an anticorrelation between cortical thickness and breaking strength. In the experimental group, the metric revealed a correlation between breaking strength and bone mineral density, and an anticorrelations between: i) Young's Moduli and iron concentration, and ii) between cortical thickness and bone mineral density. Significant Pearson distances between: i) cortical thickness vs. breaking strength, ii) cortical thickness vs. bone mineral density, iii) density vs. bone mineral density, and iv) breaking strength vs. bone mineral density, were indicative of fundamental changes in bone physiology in the experimental group. The Pearson distance metric was thus effective in detecting physiological changes associated with the presence of metal overload in bone. The Distance correlation R revealed a significant correlation between cortical thickness and breaking strength in the control group, and between the calcium and iron concentrations in the experimental group. The dR metric revealed significant loss in correlation between calcium concentration and bone mineral density in the experimental group. In summary, the statistical metrics used -and introduced in this work -are efficacious in detecting physiological changes in metaloverloaded bone.

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“…BMD is taken into account in the treatment of osteoporosis patients. DEXA is still the gold standard in the detection of BMD (13). This indisputable value of DEXA depends on the suitability of many stages.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, no data are available on the effect of the patient's demographics on positioning errors. Patient positioning during DEXA examination is known to affect BMD results (3,13,14). However, some studies on patient positioning are concentrated in the field of DEXA total body composition with regional analysis (15,16).…”

Section: Discussionmentioning

confidence: 99%

Is There an Effect of Patient’s Age, Weight, Height and Body Mass Index on Positioning Errors During Scan Acquisition of Dual X-ray Absorptiometry?

Tuna¹,

Kabayel²

2018

Tod

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Amaç: Dual enerji X-ışını absorbsiyometri tetkiki esnasında hastanın pozisyonlaması, kemik mineral yoğunluğu değerlendirmesinde önemlidir. Doğru pozisyonlama üzerine teknisyenin rolü önemli kabul edilirken, hastaya ait özelliklerin bu pozisyonlamaya etkisi yeterince açıklanmamaktadır. Bu araştırmadaki amacımız; postmenopozal kadınların yaş, boy, kilo ve vücut kitle indeksi gibi özelliklerinin pozisyonlama hatalarına etkileri olup olmadığını araştırmaktır. Gereç ve Yöntem: Post-menopozal kadınlara ait dual enerji X-ışını absorbsiyometri raporları ve dosyaları retrospektif olarak incelendi. Beden kitle indeksi değerlerine göre 3 grup oluşturuldu; normal, fazla kilolu ve obez. Her bir gruba 41 hasta dahil edildi. Yalnızca Hologic cihazına ait görüntüler değerlendirmeye katıldı. Dual enerji X-ışını absorbsiyometri çıktı raporlarındaki bel ve kalça bölgesi görüntüleri kullanılarak, pozisyonlama hatası olan hastalar tanımlandı. Vücut kitle indeksi grupları arasında pozisyonlama hata oranları arasındaki fark Pearson ki-kare testi ile belirlendi. Yaş, boy, ağırlık ve vücut kitle indeksinin pozisyonlama hataları üzerine etkisi basit doğrusal regresyon analizi ile incelendi. Bulgular: Normal, aşırı kilolu ve obez gruplar arasındaki pozisyonlama hataları dağılımı sırasıyla %35,3 (36), %29,4 (30) ve %35,3 (36) saptandı. Aynı gruplarda doğru pozisyonlanmış hastaların dağılımı sırasıyla; %23,8 (5), %52,4 (11) ve %23,8 (5) idi. Pozisyonlama hataları açısından gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (Pearson ki-kare, p=0,127). Sonuç: Yaş, boy, ağırlık ve beden kütle indeksi gibi hastaya ait özellikler pozisyonlama hatalarını istatistiksel olarak anlamlı düzeyde etkilemez.Objective: Patient positioning during dual energy X-ray absorptiometry examination is important in assessing bone mineral density. While the role of the technician is considered important on correct positioning, the effect of the patient characteristics on positioning is not adequately explained. The aim of this study is investigate whether postmenopausal women's characteristics such as age, weight, height, and body mass index affect the positioning errors. Materials and Methods: Dual energy X-ray absorptiometry reports and files of postmenopausal women were reviewed retrospectively. According to the values of body mass index three groups were formed; normal, overweight and obese. Forty one patients were included in each group. Only the images of the Hologic dual energy X-ray absorptiometry device were participated to assessment. Patients with positioning error were identified using the lumbar and hip region images in the dual energy X-ray absorptiometry output reports. The difference in positioning error rates between the body mass index groups was determined by Pearson's chi-square test. The effect of age, height, weight, and body mass index of patients on positioning errors was examined by simple linear regression analysis. Results: Distribution of positioning errors between normal, overweight and obese groups were determined as 35.3% (3...

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Some Physical and Clinical Factors Influencing the Measurement of Precision Error, Least Significant Change, and Bone Mineral Density in Dual-Energy X-Ray Absorptiometry

Cited by 10 publications

References 10 publications

Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

Relationship of Bone Mineral Density to Progression of Knee Osteoarthritis

The Use of Different Statistical Metrics to Detect Physiological Changes in Metal-Overloaded Avian Bone

Is There an Effect of Patient’s Age, Weight, Height and Body Mass Index on Positioning Errors During Scan Acquisition of Dual X-ray Absorptiometry?

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