Reference curve and diagnostic sensitivity for a new ultrasound device for the phalanges [correction of 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 information on bone quality. The DBMsonic 1200 (IGEA, Carpi) is such a new ultrasound device that measures mean amplitude-dependent speed of sound through the distal metaphyses of the four proximal phalanges (nondominant hand). We determined the standarded precision and constructed a reference curve for Belgian women. The diagnostic sensitivity was tested in established osteoporotic patients with at least one vertebral fracture, expressed as area under the curve (ROC) and compared with other bone mass measurement techniques such as dual-energy X-ray absorptiometry (DXA) and US of the heel. For a group of 93 women with different pathologies, the standardized precision obtained 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 that obtained with spinal DXA and proximal femur results of the same individuals, as well as with ultrasound measurements of the calcaneus, and investigated in the osteoporotic patients older than 50 years and in age-matched controls. 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 femoral neck and 70.1% (SE 4.9%) for US of the heel. Our data show an acceptable and comparable standardized precision in relation to other available data for the same device. In the group of osteoporotic women over 50 years of age 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 minor, but no significantly higher diagnostic sensitivity than for ultrasound of the calcaneus. We conclude that this tool is promising for discriminating normal and osteoporotic female patients.