Dual energy X-ray absorptiometry of the knee in spinal cord injury

Methodology and correlation with quantitative computed tomography

J. G. McPherson, W. B. Edwards, A. Prasad, K. L. Troy, James W Griffith, Thomas J Schnitzer*

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Study Design: Comparison of diagnostic tests; methodological validation. Objectives: Primary: to investigate the precision and reliability of a knee bone mineral density (BMD) assessment protocol that uses an existing dual energy X-ray absorptiometry (DXA) forearm acquisition algorithm in individuals with spinal cord injury (SCI). Secondary: to correlate DXA-based knee areal BMD with volumetric BMD assessments derived from quantitative computed tomography (QCT). Setting: Academic medical center, Chicago, IL, USA. Methods: Participants: a convenience sample of 12 individuals with acute SCI recruited for an observational study of bone loss and 34 individuals with chronic SCI who were screened for a longitudinal study evaluating interventions to increase BMD. Main outcome measures: root-mean-square standard deviation (RMS-SD) and intrainter-rater reliability of areal BMD acquired at three knee regions using an existing DXA forearm acquisition algorithm; correlation of DXA-based areal BMD with QCT-derived volumetric BMD. Results: The RMS-SD of areal BMD at the distal femoral epiphysis, distal femoral metaphysis and proximal tibial epiphysis averaged 0.021, 0.012 and 0.016 g cm-2, respectively, in acute SCI and 0.018, 0.02 and 0.016 g cm-2 in chronic SCI. All estimates of intra/inter-rater reliability exceeded 97% and DXA-based areal BMD was significantly correlated with QCT-derived volumetric BMD at all knee regions analyzed. Conclusions: Existing DXA forearm acquisition algorithms are sufficiently precise and reliable for short-term assessments of knee BMD in individuals with SCI. Future work is necessary to quantify the reliability of this approach in longitudinal investigations and to determine its ability to predict fractures and recovery potential.

Original languageEnglish (US)
Pages (from-to)821-825
Number of pages5
JournalSpinal Cord
Volume52
Issue number11
DOIs
StatePublished - Nov 13 2014

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Photon Absorptiometry
Spinal Cord Injuries
Bone Density
Knee
Tomography
Forearm
Epiphyses
Cone-Beam Computed Tomography
Thigh
Routine Diagnostic Tests
Observational Studies
Longitudinal Studies
Outcome Assessment (Health Care)
Bone and Bones

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

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title = "Dual energy X-ray absorptiometry of the knee in spinal cord injury: Methodology and correlation with quantitative computed tomography",
abstract = "Study Design: Comparison of diagnostic tests; methodological validation. Objectives: Primary: to investigate the precision and reliability of a knee bone mineral density (BMD) assessment protocol that uses an existing dual energy X-ray absorptiometry (DXA) forearm acquisition algorithm in individuals with spinal cord injury (SCI). Secondary: to correlate DXA-based knee areal BMD with volumetric BMD assessments derived from quantitative computed tomography (QCT). Setting: Academic medical center, Chicago, IL, USA. Methods: Participants: a convenience sample of 12 individuals with acute SCI recruited for an observational study of bone loss and 34 individuals with chronic SCI who were screened for a longitudinal study evaluating interventions to increase BMD. Main outcome measures: root-mean-square standard deviation (RMS-SD) and intrainter-rater reliability of areal BMD acquired at three knee regions using an existing DXA forearm acquisition algorithm; correlation of DXA-based areal BMD with QCT-derived volumetric BMD. Results: The RMS-SD of areal BMD at the distal femoral epiphysis, distal femoral metaphysis and proximal tibial epiphysis averaged 0.021, 0.012 and 0.016 g cm-2, respectively, in acute SCI and 0.018, 0.02 and 0.016 g cm-2 in chronic SCI. All estimates of intra/inter-rater reliability exceeded 97{\%} and DXA-based areal BMD was significantly correlated with QCT-derived volumetric BMD at all knee regions analyzed. Conclusions: Existing DXA forearm acquisition algorithms are sufficiently precise and reliable for short-term assessments of knee BMD in individuals with SCI. Future work is necessary to quantify the reliability of this approach in longitudinal investigations and to determine its ability to predict fractures and recovery potential.",
author = "McPherson, {J. G.} and Edwards, {W. B.} and A. Prasad and Troy, {K. L.} and Griffith, {James W} and Schnitzer, {Thomas J}",
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Dual energy X-ray absorptiometry of the knee in spinal cord injury : Methodology and correlation with quantitative computed tomography. / McPherson, J. G.; Edwards, W. B.; Prasad, A.; Troy, K. L.; Griffith, James W; Schnitzer, Thomas J.

In: Spinal Cord, Vol. 52, No. 11, 13.11.2014, p. 821-825.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dual energy X-ray absorptiometry of the knee in spinal cord injury

T2 - Methodology and correlation with quantitative computed tomography

AU - McPherson, J. G.

AU - Edwards, W. B.

AU - Prasad, A.

AU - Troy, K. L.

AU - Griffith, James W

AU - Schnitzer, Thomas J

PY - 2014/11/13

Y1 - 2014/11/13

N2 - Study Design: Comparison of diagnostic tests; methodological validation. Objectives: Primary: to investigate the precision and reliability of a knee bone mineral density (BMD) assessment protocol that uses an existing dual energy X-ray absorptiometry (DXA) forearm acquisition algorithm in individuals with spinal cord injury (SCI). Secondary: to correlate DXA-based knee areal BMD with volumetric BMD assessments derived from quantitative computed tomography (QCT). Setting: Academic medical center, Chicago, IL, USA. Methods: Participants: a convenience sample of 12 individuals with acute SCI recruited for an observational study of bone loss and 34 individuals with chronic SCI who were screened for a longitudinal study evaluating interventions to increase BMD. Main outcome measures: root-mean-square standard deviation (RMS-SD) and intrainter-rater reliability of areal BMD acquired at three knee regions using an existing DXA forearm acquisition algorithm; correlation of DXA-based areal BMD with QCT-derived volumetric BMD. Results: The RMS-SD of areal BMD at the distal femoral epiphysis, distal femoral metaphysis and proximal tibial epiphysis averaged 0.021, 0.012 and 0.016 g cm-2, respectively, in acute SCI and 0.018, 0.02 and 0.016 g cm-2 in chronic SCI. All estimates of intra/inter-rater reliability exceeded 97% and DXA-based areal BMD was significantly correlated with QCT-derived volumetric BMD at all knee regions analyzed. Conclusions: Existing DXA forearm acquisition algorithms are sufficiently precise and reliable for short-term assessments of knee BMD in individuals with SCI. Future work is necessary to quantify the reliability of this approach in longitudinal investigations and to determine its ability to predict fractures and recovery potential.

AB - Study Design: Comparison of diagnostic tests; methodological validation. Objectives: Primary: to investigate the precision and reliability of a knee bone mineral density (BMD) assessment protocol that uses an existing dual energy X-ray absorptiometry (DXA) forearm acquisition algorithm in individuals with spinal cord injury (SCI). Secondary: to correlate DXA-based knee areal BMD with volumetric BMD assessments derived from quantitative computed tomography (QCT). Setting: Academic medical center, Chicago, IL, USA. Methods: Participants: a convenience sample of 12 individuals with acute SCI recruited for an observational study of bone loss and 34 individuals with chronic SCI who were screened for a longitudinal study evaluating interventions to increase BMD. Main outcome measures: root-mean-square standard deviation (RMS-SD) and intrainter-rater reliability of areal BMD acquired at three knee regions using an existing DXA forearm acquisition algorithm; correlation of DXA-based areal BMD with QCT-derived volumetric BMD. Results: The RMS-SD of areal BMD at the distal femoral epiphysis, distal femoral metaphysis and proximal tibial epiphysis averaged 0.021, 0.012 and 0.016 g cm-2, respectively, in acute SCI and 0.018, 0.02 and 0.016 g cm-2 in chronic SCI. All estimates of intra/inter-rater reliability exceeded 97% and DXA-based areal BMD was significantly correlated with QCT-derived volumetric BMD at all knee regions analyzed. Conclusions: Existing DXA forearm acquisition algorithms are sufficiently precise and reliable for short-term assessments of knee BMD in individuals with SCI. Future work is necessary to quantify the reliability of this approach in longitudinal investigations and to determine its ability to predict fractures and recovery potential.

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