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Measurement of bone mineral density in amenorrheic women with dual photon absorptiometry.

Bone mineral density (BMD) was measured in 17 patients with gonadal dysgenesis, 21 patients with premature ovarian failure, 14 patients with hyperprolactinemia, 23 patients postoophorectomy and 41 normal healthy women. Each group was divided into two subgroups, on the basis of whether or not they were receiving estrogen replacement therapy. Linear regression analysis showed a significant loss of BMD at a rate of 0.006 g/cm2 per year in the lumbar spine of normal healthy women. The distribution of individual values in each study group was near or within normal confidence limits, except for the group with gonadal dysgenesis. The mean BMD of each group without estrogen replacement therapy was significantly less than that of the control group. There was a significant correlation between the duration of amenorrhea and BMD values in the groups with premature ovarian failure and postoophorectomy. These results indicate that BMD, measured by dual photon absorptiometry, was reduced in amenorrheic patients, especially in patients with gonadal dysgenesis. Estrogen replacement therapy was able to decrease the severity of bone loss, but failed to increase the bone mass. Dual photon absorptiometry (DPA) is a simple, effective, and accurate tool for assessing the severity of osteoporosis and monitoring the effect of therapy.

Absorptiometry, Photon↗

Accuracy, precision, and homogeneity effects in the determination of the bone mineral content with dual photon absorptiometry in the heel bone.

In this work the distribution of bone mineral content (BMC) in the calcaneus has been studied by means of dual photon absorptiometry. The bone mineral content determined according to the described method is corrected for the amount of fat and lean soft tissue in the path of the radiation beam. It is found that the bone mineral content shows a large variation in the calcaneus. There does, however, exists a homogeneous region in the central part of the calcaneus. The in vitro precision of the technique has been determined to be 1.02%, and the in vivo precision has been found to be 2.8%. The correlation coefficient between ashed bone mass and measured BMC value was 0.97.

Absorptiometry, Photon↗

Lateral dual-photon absorptiometry: a new technique to measure the bone mineral density at the lumbar spine.

Bone mineral density (BMD) measurement of the lumbar spine by dual-photon absorptiometry (DPA) using a radioactive source and more recently an x-ray tube (DEXA) is a useful noninvasive technique to assess bone loss in vertebral osteoporosis. Because an anteroposterior (AP) projection is used, DPA measures not only the mainly trabecular bone of the vertebral body but also the cortical bone of the posterior processes, which does not contribute to the development of crushed fractures. Using a DPA apparatus equipped with a 153 Gd source coupled with an 18-detector system that provides better collection efficiency for the narrow beam of 153 Gd radiation, we have developed a technique measuring the BMD of the vertebral body of L2, L3, and L4 on a lateral projection based on previous studies using radiographic photodensitometry for lateral spine. The precision of the method-1.7% in vivo and 0.88% in vitro-is similar to that obtained with the AP projection (respectively, 1.7 and 1.0%). Lateral BMD decreased with age in 143 normal women and was best accounted for by a cubic curve (r = -0.51, p less than 0.001). The age-related bone loss between 30 and 80 years of age was much higher with the lateral (-44%) than with the AP (-22%) projection, a pattern consistent with the greater trabecular than cortical age-related bone loss. When osteoporotics (OP) were compared to age-matched normal women, the decreased in BMD was larger with the lateral (-30%) than with the AP projection (-23%), but in terms of Z scores, no difference could be found between both projections.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Measurement of composition changes using dual-photon absorptiometry in obese patients undergoing semistarvation.

The changes in total fat mass (TFM) and lean body mass (LBM) under semistarvation treatment were measured by dual-photon absorptiometry (DPA) in this study. Three females with massive obesity were followed over two periods consuming a very-low-calorie diet (VLCD). Although LBM changes attributed to water shifts related to sodium balance were observed, DPA proved sensitive enough to measure LBM and TFM changes in semistarvation treatment. LBM measured by DPA did not change significantly following 4 weeks of VLCD. However, TFM decreased significantly (70.9 +/0 24.1 kg to 62.4 +/- 21.7 kg) and paralleled body weight.

Absorptiometry, Photon↗

Bone mineral density in patients with Parkinson's disease measured by dual photon absorptiometry.

Bone mineral density (BMD) in 22 patients (three females, 19 males, aged 58-76 years) with idiopathic Parkinson's disease (PD) was measured by dual photon absorptiometry (DPA) using a M&SE OsteoTech 300 scanner. The BMDs of the 2nd to 4th lumbar vertebrae were measured and the mean density was presented as g cm-2. The BMD of the PD patients was compared with normal BMD values within the same age groups, and the patients were interpreted as normal, suffering mild osteoporosis or severe osteoporosis. The patients were divided into two groups according to (a) the Hoehn and Yahr (H-Y) scale as high or low, or based on (b) the duration of the disease as long or short, for comparison. The prevalence of abnormal BMD in each subgroup of patients was calculated. The results show that the BMD of all the PD patients was lower than those of the normal controls. The PD patients with a high H-Y scale had a higher prevalence of severe osteoporosis. However, the difference between any two groups, separated by the two criteria, is not significant by Fisher's test. We find that PD patients have a higher incidence of severe osteoporosis.

Absorptiometry, Photon↗

Bone mineral analysis of the rat femur by direct photon absorptiometry.

This report describes a method using direct photon absorptiometry (DPA) for determination in vivo of the bone mineral content to bone width ratio (BMC/W) in the rat femur. A significant correlation was noted between measurements by DPA and whole femur dry weight and ash weight. Measurements were reproducible within repeated determinations of both the same and successive days. Soft tissue, rotation of the femur, or slight differences in the longitudinal positioning of the femur did not significantly affect usefulness of the measurements. A significant positive correlation was seen between body weight and the femur BMC/W, indicating that the method accurately reflected expected physiological changes in bone mineral. The method is suitable for the rapid, simple, accurate, and reproducible measurement of bone mineral in the anesthetized rat and is applicable to serial measurements.

Animals↗

[The accuracy and reproducibility of the measurement of bone mineral content by single-photon absorptiometry (125I). The effect of source strength].

This study was aimed at verifying whether accuracy and reproducibility of mineral content measurements of bone phantoms by single-photon absorptiometry change as a function of source strength, and whether these changes depend on the phantom's width. To these purposes, the Norland 2780 bone mineralometer was used. With this unit, the mineral contents of two cylindrical phantoms of different diameter and of known mineral content were measured every week, 5 times on the whole, up to exhaustion of the source. Both accuracy and reproducibility decreased as source strength decreased. The lowest reproducibility was observed for the measurement of the smaller phantom with low source strength. It was therefore concluded that when source strength reaches the threshold value of 2000 cps, the measurement is so much affected as to jeopardize the reliability of short-term longitudinal studies of bone mineral content in patients.

Absorptiometry, Photon↗

[The estimation of the effective dose in bone mineral measurements with photon absorptiometry and computed tomography].

There is still some uncertainty in the assessment and comparison of patient dose which results from bone mineral measurements on the lumbar spine by photon absorptiometry and x-ray computed tomography (CT). In the literature, skin dose values are offered in almost all cases. These are not meaningful, however, as the size of the irradiated volume and the radiation sensitivities of the respective organs are not taken into account. Here, the concept of effective dose has to be applied. An assessment of effective dose resulted in approximately 1 mu Sv for absorptiometry and approximately 30 mu Sv for computed tomography with low kV and mAs values. For lateral lumbar spine films which are often taken in connection with absorptiometry, at least 700 mu Sv have to be added. In CT, additional 30 mu Sv result from the lateral topogram which is required for positioning. The concept of effective dose, the data and assumptions used in its assessment and a comparison to other risk factors, as for example natural background radiation of approximately 2400 mu Sv per year, are discussed in detail.

Absorptiometry, Photon↗

[Bone mineral densitometry by dual photon absorptiometry in patients with urolithiasis--on the possibility of the differential diagnosis of idiopathic hypercalciuria].

Bone mineral density (BMD) of the 3rd lumbar spine was measured by dual photon absorptiometry (DPA) in 8 patients with primary hyperparathyroidism (PHP) and 39 patients with idiopathic urolithiasis (IU). Of the patients, 15 were classified into idiopathic hypercalciuria (IH) which were further classified into 2 types of IH--renal hypercalciuria (RH) and absorptive hypercalciuria (AH)--by Ca restriction and load test. BMD of the IH patients tended to be lower than patients with normocalciuria, but significantly higher than the PHP patients. BMD of the RH patients was significantly lower than the AH patients. In conclusion, DPA may be a simple method for classifying the types of idiopathic hypercalciuria.

Absorptiometry, Photon↗

Precision and accuracy of total body bone mass and body composition measurements in the rat using x-ray-based dual photon absorptiometry.

Lean body mass (LBM), total body bone mineral mass (BMC), total body bone areal density (BMD), and body fat mass (FM) were measured in rats by dual photon absorptiometry (DXA), using two different instruments. The coefficients of variation for repeated measurements of LBM and FM were about 0.4 and 2.5%, respectively, over an animal body weight range of 150 to 600 g. For BMC and BMD, the coefficients of variation were less than 2%. The correlation coefficients for LBM, FM, BMC, and BMD measured on the two densitometers were all greater than 0.94. The slope of the regression line relating LBM measured by DXA and LBM measured by carcass analysis was 0.999, and the correlation coefficient was 0.99. For FM the slope was 1.05, and the correlation coefficient was 0.98. BMC measures by DXA were falsely low in small animals. For larger animals, the correlation between BMC and ash weight was 0.93, but the slope of the regression line was 0.78. DXA measures of LBM and FM were accurate and reproducible for rats weighing between 150 and 600 g. There was a size-dependent error in BMC, which will be significant in longitudinal measurements of bone mass.

Absorptiometry, Photon↗

Photon absorptiometry for non-invasive measurement of bone mineral content.

Bone mineral content of the distal radius was determined in 106 patients by single photon absorptiometry using iodine-125 monochromatic source. The technique provided a reliable means to assess the degree of mineral loss in conditions such as osteoporosis, renal osteodystrophy in patients on chronic maintenance dialysis, subjects on long-term steroid therapy, and those with diabetes mellitus. It is more sensitive than conventional radiography and completely noninvasive compared to bone biopsy. It is suggested that photon absorptiometry is a simple, sensitive, and reliable technique for assessment and follow-up of the bone mineral content in a host of disorders associated with bone demineralization.

Adult↗

Fracture strength prediction in rat femoral shaft and neck by single photon absorptiometry of the femoral shaft.

The bone mineral content (BMC) and bone mineral density (BMD) of the femoral midshaft from 15 skeletally mature male rats were measured by Single Photon Absorptiometry (SPA), and comparisons made to fracture strength of the femoral diaphysis and the femoral neck. In stepwise regression the factors contributing significantly to the ultimate bending moment of the shaft were BMC and femoral length. BMC correlated strongly with the ultimate bending moment of the femoral diaphysis (r2 = 0.63, P < 0.01). The correlation between BMC and ultimate moment of the femoral neck was moderate (r2 = 0.51, P < 0.01). The correlations between BMD and mechanical parameters were lower than the corresponding values for BMC, with a significant result only for the bending moment of the femoral diaphysis (r2 = 0.48, P < 0.01). In conclusion, BMC rather than BMD, is most predictive for fracture strength of the femur in rats.

Absorptiometry, Photon↗

Effects of nonmineral tissues on measurement of bone mineral content by dual-photon absorptiometry.

Computer simulations were performed to investigate the effects of nonmineral tissue (overlying soft tissue and nonmineral components of bone) on the measurement of bone mineral content by dual-photon absorptiometry (DPA). Selected experimental studies were performed to test the predictions of the simulations. The results indicate that variations in the composition of nonmineral tissue can significantly affect measurement precision and accuracy at the levels achievable with modern x-ray based absorptiometry systems (0.5%). Thus biological variables may limit further improvements in measurement precision and accuracy. Biological variables also can affect intercalibration of systems that use different radiation sources and/or calibration techniques.

Absorptiometry, Photon↗

Total and regional bone mineral density by dual photon absorptiometry in patients on maintenance hemodialysis.

To evaluate bone loss in renal osteodystrophy, we measured total and regional (head, trunk, pelvis, leg and arm) bone mineral density (BMD) by dual photon absorptiometry in 72 patients on maintenance hemodialysis (HD). We also examined the validity of serum carboxy-terminal parathyroid hormone (C-PTH) and intact-PTH as an indicator of secondary hyperparathyroidism. Total BMD correlated inversely with age in female patients (r = -0.57, p less than 0.01), but not in male patients. Female patients older than 50 years were omitted from analysis to exclude the effect of menopause on bone. Among clinical and biochemical parameters, only trunk BMD correlated inversely with the duration of HD (r = -0.26, p less than 0.05). Head, trunk and total BMD correlated inversely with serum alkaline phosphatase, C-PTH and intact-PTH, while pelvis BMD did not. Leg and arm BMD also correlated inversely with serum intact-PTH, but not with serum C-PTH. The serum level of C-PTH correlated positively with the duration of HD (r = 0.40, p less than 0.005), while intact-PTH did not. As compared with 18 control male volunteers aged 25-42 years, trunk, pelvis, leg, arm and total BMD were significantly lower in male patients on HD aged 22-49 years, whereas head BMD did not differ significantly between the two groups. The percent decrease of BMD was most prominent in the trunk (-19.6%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Limited precision of lumbar spine dual-photon absorptiometry by variations in the soft-tissue background.

The estimation error due to variations in soft-tissue baseline in lumbar bone mineral content (BMC) measured by dual-photon absorptiometry (DPA) was calculated with a new method of automatic baseline subtraction. In water phantom measurements, the s.d. of the soft-tissue (ST) baseline matched closely (r = 0.98) to the random error, calculated using 44 keV and 100 keV count rates and the directly determined baseline variations. In 21 volunteers and in 70 patients with osteoporosis, the ST variations were larger than the expected random error, revealing a source of error related to the inhomogeneity of soft tissue. The estimation error in BMC caused by ST variations was 0.7% in healthy subjects (mean BMC 40.5 gHA) and 1.5% in patients (mean BMC = 26.4 gHA). These results indicate that ST-related errors are an important limit to the precision of lumbar DPA measurements.

Absorptiometry, Photon↗

Bone mineral status measured by direct photon absorptiometry in childhood renal disease.

Bone width (BW), bone mineral content (BMC), and their ration (BMC/BW ratio) were measured in renal patients using direct photon absorptiometry. Serial measurements were made on the radius and ulna in 74 children with renal diseases. Values were compared to age-, sex-, height-, and weight-matched controls. The SD from the mean in normal subjects is +/- 10%. Significant demineralization (greater than -2 SD) was found in 42% of all patients and in 75% with tubulointerstitial disease. Twelve patients with nephrotic syndrome and two with systemic lupus erythematosus, all of whom were receiving prednisone therapy and had a serum creatinine level less than 1.0 mg/dl, and three treated with anticonvulsants had significant demineralization. Severe demineralization (greater than -3 SD) was found in four rachitic patients with tubulointerstitial disease. Normal mineralization was present in 32 patients with various primary glomerular diseases, seven of whom had a serum creatinine level greater than 1.5 mg/dl. BMC declined with daily prednisone therapy but increased with alternate-day dosage in seven patients. This study suggests that demineralization is more common in patients with tubulointerstitial disease and in patients with primary glomerular disease who are receiving prednisone (16 patients) or anticonvulsants. Photon absorptiometry appeared more useful than conventional radiographic evaluation in assessing skeletal involvement in childhood renal disease.

Adolescent↗

[Normal ranges of bone mineral content of the distal radius determined with single photon absorptiometry. Study of 1521 cases].

The normal ranges and mathematical equations of bone mineral content (BMC), normalized to radial width (BMC/W) vs. age at the distal radius, were obtained by single photon absorptiometry (SPA), and compared in two different normal populations, one of postmenopausal females and the other of control males. The female population included 1359 postmenopausal women, aged 35 to 75 years; normal control males were 162, of the same age. The results obtained in the two groups of patients show a statistically significant (p less than 0.001) correlation between age and BMC/W, expressed in a polinomial third-degree regression. The slope of the regression curves is quite different between males and females: the mean decrement, evaluated from regression polinomial fits, results 0.5% per year for normal females, and 0.3% per year for normal males. The maximum decrement (1% per year) is observed at the mean age of 51 years, which is the average age of peri-menopausal women in our province (Ferrara). The authors believe SPA to be a simple and reliable technique in measuring peripheral bone loss rate. SPA may be useful in the diagnosis and treatment of postmenopausal women, but is not recommended in the short-term follow-up of osteoporosis.

Absorptiometry, Photon↗

Bone ultrasonic attenuation in women: reproducibility, normal variation and comparison with photon absorptiometry.

The reproducibility of two methods of measuring broadband ultrasonic attenuation (BUA) in the calcaneus have been studied. An improvement in reproducibility in vivo from 9.6% to 2.8% between old and new techniques has been observed. Measurements of the calcaneus using BUA were correlated with measurements of bone mineral density measured by dual energy x-ray absorptiometry in the lumbar spine, femur and total body and bone mineral content in the distal and proximal forearm measured by single photon absorptiometry. For the older BUA technique the correlation coefficients ranged between r = 0.27 and r = 0.34. For the newer BUA technique the correlation coefficients ranged between r = 0.49 and r = 0.62 and were all significant (P less than 0.001).

Absorptiometry, Photon↗