• Nuclear Engineering and Technology
• /
• 제52권10호
• /
• pp.2346-2352
• /
• 2020

Dual-energy x-ray absorptiometry (DXA) is the noninvasive method to diagnose osteoporosis disease characterized by low bone mass and deterioration of bone tissue. Many global companies and research groups have developed the various DXA detectors using a direct photon-counting detector such as a cadmium zinc telluride (CZT) sensor. However, this approach using CZT sensor has some drawback such as the limitation of scalability by high cost and the loss of efficiency due to the requirement of a thin detector. In this study, a SiPM based DXA system was developed and its performance evaluated experimentally. The DXA detector was composed of a SiPM sensor coupled with a single LYSO scintillation crystal (3 × 3 × 2 ㎣). The prototype DXA detector was mounted on the dedicated front-end circuit consisting of a voltage-sensitive preamplifier, pulse shaping amplifier and constant fraction discriminator (CFD) circuit. The SiPM based DXA detector showed the 34% (at 59 keV) energy resolution with good BMD accuracy. The proposed SiPM based DXA detector showed the performance comparable to the conventional DXA detector based on CZT.

• Clinical and Experimental Pediatrics
• /
• 제53권3호
• /
• pp.286-293
• /
• 2010

Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD) of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD) Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.

• 대한영상의학회지
• /
• 제82권1호
• /
• pp.173-181
• /
• 2021

목적 대퇴골 경부 골절 환자를 대상으로 골다공증 평가를 위해 다중검출 전산화단층촬영(multidetector computed tomography; 이하 MDCT)에서의 감쇠 계수(Hounsfield unit; 이하 HU)와 이중 에너지 X선 흡수 계측법(dual energy X-ray absorptiometry; 이하 DXA)을 비교하였다. 대상과 방법 2016년 6월부터 12월까지 MDCT와 DXA를 모두 시행한 42명의 대퇴골 경부 골절 환자가 본 연구의 대상으로 포함되었다. MDCT에서는 정상 대퇴골 경부의 해면골에서 HU를 측정하였으며 DXA에서는 동 부위의 골밀도 및 T 값을 얻었다. HU와 골밀도 및 T 값의 상관관계를 Spearman 상관계수를 이용하여 분석하였다. 결과 대퇴골 경부 골절 환자의 골밀도와 T 값의 평균은 각각 0.650 g/cm²과 -2.4이었다. 정상, 골감소증, 골다공증 환자 군의 HU의 평균은 각각 131.9, 98.9, 41.3이었다. HU는 골밀도(r² = 0.670; p < 0.001) 및 T 값(r² = 0.676; p < 0.001) 모두와 양의 상관관계를 보였다. 결론 다중검출 전산화단층촬영에서 감쇠계수의 측정은 골다공증 선별검사를 위한 유용한 진단적 도구가 될 수 있다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제41권4호
• /
• pp.351-360
• /
• 2018

In recent years, demand for examination of bone mineral density (BMD) is increasing in Korea according aging society. Therefore, it is required to develop an efficient management program that can increase the safety and reliability of Dual Energy X-ray Absorptiometry (DXA) that can be applied to the criteria of the World Health Organization. It is necessary to develop a management program that can design a program to improve the accuracy and precision of the results of the analysis and to improve the accuracy of diagnosis of osteoporosis by development a high quality DXA report. It is recommended to prepare the examination manuals and to establish procedures of standard operating including the program to prevent the pitfalls during the examination, the compatibility evaluation of the examination data, and the contents of the radiation safety. In addition, relevant regulations on the production of high-quality DXA reports are required and government and related agencies should introduce individual and facility recognition programs through DXA measurement and education programs and training. It is considered that efforts should be made to prepare high quality DXA report by guidelines on all aspects of BMD for preparation about aging society.

• 한국방사선학회논문지
• /
• 제12권7호
• /
• pp.833-844
• /
• 2018

골다공증의 진단에서 이중에너지 X선 흡수계수법은 가장 빈번하게 사용되는 검사이다. 외국의 골밀도 장치 제조사인 지이나 홀로직 장치에 대한 교차분석 연구는 다양하나 국내 제조사 이중에너지 X선 흡수골밀도 장치에 대한 비교 분석이 부족하다. 이에 본 연구에서는 국내 제조사의 이중에너지 X선 흡수골밀도 장치와 해외 제조사의 이중에너지 X선 흡수 골밀도 장치의 교차분석을 시행하여 교차식을 수립하였다. 유럽인 척추 팬텀을 이용한 검사에서 가장 높은 표준 편차를 보인 Dexxum T 장치의 경우 상. 중. 하부 척추에서0.030, 0.029, 0.037를 보였고, 홀로직의 Horizon Ci에서는 0.005와 0.004로 하부와 중간 척추에서 가장 낮은 표준편차를 나타냈다. 오스테오 프로맥스 장치의 경우 상부 척추에서 0.005의 표준편자를 나타냈다. 본 연구에서 도출한 국내 외 이중에너지 흡수 골밀도 장치의 교차식은 임상환경에서 골밀도 검사의 추척검사에 유용한 사례가 될 것이다. 또한 본 연구에서 제시한 국산 이중에너지 X선골밀도 장치에 대해 설정된 교차 방정식에 기초로 임상환경에서 보다 정확한 골밀도 추적 관찰을 위해 보다 다양한 국산 이중에너지 X선 골밀도 장치의 교차 보정을 설정하는 것이 필요하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제25권6호
• /
• pp.473-480
• /
• 2022

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

• 방사선산업학회지
• /
• 제11권1호
• /
• pp.27-31
• /
• 2017

Reliable follow-up of bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) is essential in clinical practice. When there is a difference in the BMD values from DXA systems in the same patient, cross calibration equation is required for the reliable follow-up. Unfortunately, no equation is existed in BMD measure between GE Lunar Prodigy Advance (US, GE Healthcare; LPA) and Osteosys Dexxum T (Korea, Osteosys; ODT) DXA systems. In this study, we evaluate the agreement of BMD values between LPA and ODT and suggest the cross calibration equation using European spine phantom (ESP) with two systems. We performed BMD measurements using ten scans with ESP in each DXA systems. We compared BMD values and calculated cross calibration equation by linear regression analysis. The comparison between the LPA and ODT bone densitometers used the ESP. Compared to the ESP BMD values, ODT underestimated 14.36% and LPA overestimated 12.96%. The average of total BMD measurement values acquired with ODT were 21.44% lower than those from LPA. Cross-calibration equation for LPA and ODT was derived from ESP. We calculated simple cross calibration equation for LPA and ODT DXA systems. Cross-calibration equation is necessary for the reliable follow-up of BMD values in two different systems.

• Hip & pelvis
• /
• 제30권4호
• /
• pp.233-240
• /
• 2018

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

• Korean Journal of Radiology
• /
• 제24권12호
• /
• pp.1249-1259
• /
• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• 방사선산업학회지
• /
• 제12권4호
• /
• pp.317-324
• /
• 2018

The results of bone mineral density analysis using DXA were compared between automatic and manual methods. The purpose of this paper is to verify the range of errors of each analysis method in the same patient and select a proper method to minimize errors. Comparisons between automatic and manual analysis methods were made using BMD, BMC and AREA. Basal and follow up examinations were performed with the patients of normal, osteopenia and osteoporosis. In the basal examinations, the precision errors between automatic and manual method showed 1.9% in normal, 3.1% in osteopenia and 3.8% in osteoporosis. In case of follow up studies, the precision errors between automatic and manual method showed 2.3% in normal, 3.2% in osteopenia and 3.5% in osteoporosis. BMC and AREA also showed a tendency to increase precision errors on osteopenia and osteoporosis. Therefore, a manual method would be a better option to minimize errors in patients with osteopenia and osteoporosis.