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骨量减少和骨质疏松症筛查检测:跟骨定量超声(有无校准因子)与金标准双能 X 射线吸收法比较。

Osteopenia and Osteoporosis Screening Detection: Calcaneal Quantitative Ultrasound with and without Calibration Factor Comparison to Gold Standard Dual X-ray Absorptiometry.

机构信息

Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand.

Department of Radiology, Phyathai3 Hospital, Bangkok 10160, Thailand.

出版信息

J Clin Densitom. 2024 Apr-Jun;27(2):101470. doi: 10.1016/j.jocd.2024.101470. Epub 2024 Jan 27.

Abstract

BACKGROUND

osteoporosis is a worldwide major health problem that normally diagnosed in advanced stages. So, an early detection at preclinical stage is now an interesting issue. A key factor to early diagnosis the disease is the used of noninvasive bone densitometry. Dual energy x-ray absorptiometry (DXA) is the gold standard techniques for the proposed. However, the high cost, non-widely available and exposed to ionizing radiation are still a drawback of the machine. Therefore, a cheaper, smaller and non-ionizing device such quantitative ultrasound (QUS) is now a favor alternative method, but the possibility of used QUS measurement instead of DXA is still limited due to their uncertainties. So, the aim of our study was to calibrated the QUS with the DXA to allowing the possible to establish a calibration factor (CF) to improve the measured value closer to the standard method.

METHODOLOGY

135 healthy men and women aged 30-88 years were recruited for lumbar spine/femoral neck DXA and calcaneal QUS scanning. The Pearson's correlation between T- and Z-score from the two systems were studied. Moreover, the sensitivity, specificity and percentage of diagnosed accuracy for both with and without CF were calculated.

RESULTS

The significant correlation between the two systems showed a positive trajectory in highly correlation (r = 0.784-0.899). Analyses showed a higher sensitivity, specificity and reduced the misdiagnosed rates when applied the CF in QUS values.

CONCLUSIONS

QUS results showed a significantly correlated with DXA results for both lumbar spine and femoral neck sites with some percentage differences. These differences can be reduced by applied an individual specific machine CF to improve a QUS results. As identification of high risk of osteopenia and osteoporosis to reduce the demand of DXA propose, using a QUS alternative method can be a reliable that provide a cheaper and lack of ionizing radiation.

摘要

背景

骨质疏松症是一个全球性的重大健康问题,通常在晚期诊断。因此,现在一个有趣的问题是在临床前阶段进行早期检测。疾病早期诊断的一个关键因素是使用非侵入性骨密度测定法。双能 X 射线吸收法(DXA)是目前提出的黄金标准技术。然而,该机器的高成本、不易获得和易受电离辐射的影响仍然是一个缺点。因此,一种更便宜、更小、非电离的设备,如定量超声(QUS),现在是一种有利的替代方法,但由于其不确定性,使用 QUS 测量代替 DXA 的可能性仍然有限。因此,我们的研究目的是校准 QUS 与 DXA,以建立一个校准因子(CF),使测量值更接近标准方法。

方法

招募了 135 名年龄在 30-88 岁的健康男性和女性进行腰椎/股骨颈 DXA 和跟骨 QUS 扫描。研究了两种系统的 T 评分和 Z 评分之间的 Pearson 相关性。此外,还计算了有和没有 CF 的两种方法的敏感性、特异性和诊断准确率百分比。

结果

两种系统之间的显著相关性显示出高度相关的正轨迹(r=0.784-0.899)。分析表明,当在 QUS 值中应用 CF 时,灵敏度、特异性和误诊率都有所提高。

结论

QUS 结果与腰椎和股骨颈部位的 DXA 结果显著相关,存在一定的百分比差异。通过应用个体特定的机器 CF,可以减少这些差异,从而提高 QUS 结果的准确性。由于确定骨质疏松症和骨质疏松症的高风险可以减少对 DXA 的需求,因此使用 QUS 替代方法是一种可靠的方法,可以提供更便宜且缺乏电离辐射的方法。

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