Bone densitometry

Conventional radiographic methods allow physicians to visualize bone structure. However, they do not offer information on the bone mineral density (BMD), which can facilitate early diagnosis and treatment of osteoporosis. Bone densitometry, by contrast, helps to detect bone mineral loss at an early stage because it provides accurate quantitative measurement of BMD. With an emphasis on quantification, shorter scanning time and precision, scientists have been developing BMD measurement devices that use absorption technique. They first developed single-energy absorptiometry (single-photon absorptiometry) by using I-125, which could measure BMD of peripheral bones. Single-photon absorptiometry was replaced by dual-energy absorptiometry (dual photon absorptiometry [DPA]) that used gadolinium-153. DPA had greater accuracy in measuring the BMD of central skeletal bones. Single-energy x-ray absorptiometry was also developed but it had limitations in measuring central skeletal BMD. In the mid-1980s, dual-energy x-ray absorptiometry (DXA) was introduced and widely accepted for the early detection, treatment, and follow-up study of osteoporosis. There are several reasons for the popularity. DXA can measure BMD of posteroanterior spine and hip in a much shorter time than DPA while being capable of measuring BMD of peripheral bones. Other advantages include very low radiation doses to the patients, high image resolution, precision, and stable calibration of the instruments. In recent years, DXA has also been applied to lateral spine for the density of trabecular bone, to the whole body for the measurement of total body bone density and for the body composition, and to the spine for the vertebral fracture assessment. Still, posteroanterior spine and hip scans remain the most common applications of DXA because data on the normal range of BMD of the skeletal sites for different age, sex, and ethnic groups are compiled and made available with the devices, which gives the physician the advantage of an immediate diagnosis.