A COMPARISON OF BONE DENSITOMETRY MEASUREMENTS OF THE CENTRAL SKELETON IN POSTMENOPAUSAL WOMEN WITH AND WITHOUT VERTEBRAL FRACTURE

The purpose of this investigation was to compare the ability of two di fferent bone densitometry techniques (quantitative computed tomography and dual X-ray absorptiometry) to discriminate subjects without any v ertebral fracture from those with definite vertebral fractures. Bone m ineral density (BMD) was determined in 112 post-menopausal women. 83 w omen were classified free of vertebral fracture and 29 were considered to have definite vertebral fractures. Quantitative computed tomograph y (QCT) was performed using three different spinal regions of interest . Dual X-ray absorptiometry (DXA) was measured at the spine (both in p osteroanterior (PA) and lateral (L-DXA) projection, and at hip (total, neck and Ward regions). An additional estimated volumetric BMD was de rived from the PA and L-DXA spine scans. Individuals with definite ver tebral fractures had lower bone mineral density for each of the method s and regions of interest (ROI). Spinal QCT results, total and Ward hi p DXA results showed the greatest percentage decrement. Odds ratio est imates revealed a significant relationship between BMD and fracture wi th spinal QCT, hip, and volumetric spinal DXA. The greatest areas unde r the receiver operating characteristic (ROC) curves were found with r esults of spinal QCT, total and Ward hip DXA, and volumetric spinal DX A measurements. It is concluded that spinal QCT and femoral total DXA measurement map be preferred to PA and lateral L3 DXA measurements.