Radiation exposure in bone mineral density assessment
Section snippets
Osteoporosis and metabolic bone diseases
Osteoporosis is the most common metabolic bone disorder. It is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture (Anonymous, 1993). Such fractures can occur in any site but are most common in the spine, wrist and hip, and all regions of the skeleton with a high percentage of trabecular bone. Osteoporosis has frequently been called the silent epidemic because
Radiographic absorptiometry (RA)
This technique, also known as photo-densitometry, was the first quantitative technique to assess integral (trabecular and cortical) bone mass (Morgan et al., 1967). In RA, a standardized hand radiograph is taken with an aluminum step-wedge placed on the film and analyzed using an optical densitometer. The bone mineral density (BMD) is determined by comparison with the defined density of the aluminum step-wedge. The results are expressed in aluminum equivalent values or arbitrary units (Cosman
Radiation dose to the patient
Previous sections have demonstrated the usefulness of measuring BMD with the absorptiometric technique in the assessment of bone integrity. Studies of the radiation dose to patients from absorptiometry scans have confirmed that patient exposure is small compared to many other sources of exposure including most radiological investigations involving ionizing radiation (Kalender, 1992; Lewis et al., 1994; Huda and Morin, 1996; Njeh et al., 1996). Due to the low radiation doses encountered in BMD
Problems with measuring patient and staff dose from absorptiometric techniques
Various detectors have been used to measure skin entrance and depth doses from DXA. These include ionization chambers (Sorenson, 1991; Lewis et al., 1994; Njeh et al., 1997b), proportional counters (Waker et al., 1992) GM-Tubes (Pye et al., 1990), thermoluminescent dosimeters (such as LiF and LiBO) (Njeh et al., 1996; Njeh et al., 1997b) and film (Bezakova et al., 1997). Lithium borate (Li2B4O7:Mn) TLDs have an improved energy response compared with lithium fluoride (LiF). It also has better
Summary
Osteoporosis is a consequence of decrease in bone mass and leads to mechanical weakness of the bone. Management of this can be improved by assessment of bone mass using absorptiometric techniques such as RA, SXA, DXA and QCT. Availability and ease of use have made DXA the most widely used technique for measurements of bone density in clinical trials and epidemiological studies. Studies of radiation dose to patients from DXA confirms that patient dose is small compared to that given by many
References (86)
- et al.
Technical principles of dual energy X-ray absorptiometry
Semin. Nucl. Med.
(1997) - et al.
Vertebral morphometry studies using dual-energy X-ray absorptiometry
Semin. Nucl. Med.
(1997) - et al.
Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group
Lancet
(1993) - et al.
Peripheral measurement techniques for the assessment of osteoporosis
Semin. Nucl. Med.
(1997) - et al.
The ability of ultrasound velocity to predict the stiffness of cancellous bone in vitro
Bone
(1997) - et al.
Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength
Bone
(1997) Dual-energy X-ray absorptiometry and body composition
Nutrition
(1996)- et al.
Clinical utility of bone mass measurements in adults: consensus of an international panel. The Society for Clinical Densitometry
Semin. Arthritis Rheum.
(1996) - et al.
The amount of bone in the metacarpal and phalanx according to age and sex
Clin. Radiol.
(1967) - et al.
The clinical relevance of calcaneus bone mineral measurements: a review
Bone Miner.
(1988)
Single and dual energy X-ray absorptiometry
Eur. Radiol.
Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis
Am. J. Med.
Modified method of spinal computed tomography for trabecular bone mineral measurements
J. Comput. Assist. Tomogr.
Absorbed dose measurements in dual energy X-ray absorptiometry (DXA)
Br. J. Radiol.
Dual energy X-ray absorptiometry: the effects of beam hardening on bone density measurements
Med. Phys.
Measurement of bone mineral in vivo: an improved method
Science
Quantitative CT for determination of bone mineral density: a review
Radiology
Radiation doses to paediatric patients undergoing less common radiological procedures involving fluoroscopy
Br. J. Radiol.
Screening for vertebral osteoporosis using individual risk factors. The Multicentre Vertebral Fracture Study Group
Osteoporos. Int.
Radiographic absorptiometry: a simple method for determination of bone mass
Osteoporosis Int.
The primary role of steroids on the osteoporosis in juvenile rheumatoid patients evaluated by dual energy X-ray absorptiometry
J. Endocrinol. Invest.
Regional and total body bone mineral content, bone mineral density, and total body tissue composition in children 8–16 years of age
Calcif. Tissue Int.
Densitometry of the radius using single and dual energy absorptiometry
Calcif. Tissue Int.
Evaluation of dual-energy X-ray absorptiometry bone mineral measurement — comparison of a single-beam and fan-beam design: the effect of osteophytic calcification on spine bone mineral density
Calcif. Tissue Int.
Quantitative bone mineral analysis using dual energy computed tomography
Invest. Radiol.
Quantitative computed tomography of vertebral spongiosa: A sensitive method for detecting early bone loss after oophorectomy
Ann. Int. Med.
Noninvasive assessment of bone mineral and structure: state of the art
J. Bone Miner. Res.
Vertebral mineral determination by quantitative computed tomography (QCT): Accuracy of single and dual energy measurements
J. Comput. Assist. Tomogr.
Total body studies in normal British women using dual energy X-ray absorptiometry
Br. J. Radiol.
Patient doses in bone mineral densitometry
Br. J. Radiol.
3D-QCT at peripheral measuring sites
Osteoporosis Int.
Effective dose values in bone mineral measurements by photon absorptiometry and computed tomography
Osteoporos Int.
Bone mineral measurements: automated determination of the midvertebral CT section
Radiology
Quantitative computed tomography for bone mineral measurement: technical aspects, dosimetry, normal data and clinical applications
Br. J. Radiol.
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