Engelke Klaus, Adams Judith E, Armbrecht Gabriele, Augat Peter, Bogado Cesar E, Bouxsein Mary L, Felsenberg Dieter, Ito Masako, Prevrhal Sven, Hans Didier B, Lewiecki E Michael
Institute of Medical Physics, University of Erlangen, Germany; Synarc, Hamburg, Germany.
J Clin Densitom. 2008 Jan-Mar;11(1):123-62. doi: 10.1016/j.jocd.2007.12.010.
The International Society for Clinical Densitometry (ISCD) has developed Official Positions for the clinical use of dual-energy X-ray absorptiometry (DXA) and non-DXA technologies. While only DXA can be used for diagnostic classification according to criteria established by the World Health Organization, DXA and some other technologies may predict fracture risk and be used to monitor skeletal changes over time. ISCD task forces reviewed the evidence for clinical applications of non-DXA techniques and presented reports with recommendations at the 2007 ISCD Position Development Conference. Here we present the ISCD Official Positions for quantitative computed tomography (QCT) and peripheral QCT (pQCT), with supporting medical evidence, rationale, controversy, and suggestions for further study. QCT is available for bone mineral density measurements at the spine, hip, forearm, and tibia. The ISCD Official Positions presented here focus on QCT of the spine and pQCT of the forearm. Measurements at the hip may have clinical relevance, as this is an important fracture site; however, due to limited medical evidence, definitive advice on its use in clinical practice cannot be provided until more data emerge.
国际临床骨密度测量学会(ISCD)已经制定了关于双能X线吸收法(DXA)和非DXA技术临床应用的官方立场。虽然只有DXA可根据世界卫生组织制定的标准用于诊断分类,但DXA和其他一些技术可预测骨折风险,并用于监测骨骼随时间的变化。ISCD特别工作组审查了非DXA技术临床应用的证据,并在2007年ISCD立场制定会议上提交了带有建议的报告。在此,我们给出ISCD关于定量计算机断层扫描(QCT)和外周定量计算机断层扫描(pQCT)的官方立场,并提供支持性医学证据、原理、争议以及进一步研究的建议。QCT可用于测量脊柱、髋部、前臂和胫骨的骨密度。这里给出的ISCD官方立场聚焦于脊柱QCT和前臂pQCT。髋部测量可能具有临床意义,因为这是一个重要的骨折部位;然而,由于医学证据有限,在有更多数据之前,无法提供关于其在临床实践中应用的确切建议。