Wwk. Koo et al., TECHNICAL CONSIDERATIONS OF DUAL-ENERGY X-RAY ABSORPTIOMETRY-BASED BONE-MINERAL MEASUREMENTS FOR PEDIATRIC STUDIES, Journal of bone and mineral research, 10(12), 1995, pp. 1998-2004
Dual-energy X-ray absorptiometry (DXA) measurements have been shown to
provide useful information on bone mineral status in young pediatric
subjects. The purpose of this study was to challenge this system under
various conditions to determine the clinical and experimental paramet
ers that may be encountered,which could interfere with DXA-based bone
mineral content (BMC) and bone mineral density (BMD) measurements. Var
iations in data acquisition, including the covering of step phantom (e
xternal calibration standard) with a cotton blanket or partial exclusi
on of step phantom in the scan field, tissue freezing, or the presence
of small nonmetallic objects, did not significantly alter DXA BMC or
BMD measurements. By contrast, the presence of movement artifact, radi
ographic contrast media, and nonmetallic orthopedic casts significantl
y interfered with DXA BMC and BMD measurements. Variability in operato
r-dependent analysis of DXA scans occurred with regional analysis of w
hole body scans for DXA BMC and BMD measurements (average coefficient
of variation was 2.9% and 1%, respectively, depending on the region an
alyzed) but did not affect the total (whole body) result. A minor adju
stment in the manual delineation of the step phantom during data analy
sis may result in almost a 30% difference in DXA BMC and BMD. We concl
ude that movement artifact, radiographic contrast media, nonmetallic o
rthopedic cast, and variations in operator-dependent data analysis may
interfere with DXA BMC and BMD measurement in young pediatric subject
s. Therefore, appropriate care should be taken to reduce or eliminate
such interference.