Reference curve and diagnostic sensitivity for a new ultrasound device forthe phalanages, the DBMsonic 1200, in Belgian women

Quantitative ultrasound (US) applied in bone mass measurements is promising because it is a radiation-free and cheap technique that may provide inform ation on bone quality. The DBMsonic 1200 (IGEA, Carpi) is such a new ultras ound device that measures mean amplitude-dependent speed of sound through t he distal metaphyses of the four proximal phalanges (nondominant hand). We determined the standarded precision and constructed a reference curve for B elgian women. The diagnostic sensitivity was tested in established osteopor otic patients with at least one vertebral fracture, expressed as area under the curve (ROC) and compared with other bone mass measurement techniques s uch as dual-energy X-ray absorptiometry (DXA) and US of the heel. For a gro up of 93 women with different pathologies, the standardized precision obtai ned was 4.2 +/- 4.3%. Within this group, the standardized precision was 3.7 +/- 3.1% for 28 normals and 5.8 +/- 4.9% for 12 osteoporotic patients. The reference curve was constructed in 310 normal women (age range 21-84 years ). The diagnostic sensitivity of this ultrasound device was compared with t hat obtained with spinal DXA and proximal femur results of the same individ uals, as well as with ultrasound measurements of the calcaneus, and investi gated in the osteoporotic patients older than 50 years and in age-matched c ontrols. The area under the curve was 80.3% (SE 3.9%) for the DBMsonic 1200 , 77.4% (SE 1.4%) for DXA of the spine, 79.5% (SE 3.9%) for DXA of the femo ral neck and 70.1% (SE 4.9%) for US of the heel. Our data show an acceptabl e and comparable standardized precision in relation to other available data for the same device. In the group of osteoporotic women over 50 years of a ge we have found similar diagnostic sensitivity for the US measurements of the phalanges as for DXA of the lumbar spine and femoral neck. There is a m inor, but no significantly higher diagnostic sensitivity than for ultrasoun d of the calcaneus. We conclude that this tool is promising for discriminat ing normal and osteoporotic female patients.