Icătoiu Elena, Vlădulescu-Trandafir Andreea-Iulia, Groșeanu Laura-Maria, Berghea Florian, Cobilinschi Claudia-Oana, Potcovaru Claudia-Gabriela, Bălănescu Andra-Rodica, Bojincă Violeta-Claudia
Department of Internal Medicine and Rheumatology, Sfanta Maria Clinical Hospital, 011172 Bucharest, Romania.
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020022 Bucharest, Romania.
Diagnostics (Basel). 2025 Feb 25;15(5):555. doi: 10.3390/diagnostics15050555.
Given the significant economic and social burden of osteoporosis, there is growing interest in developing an efficient alternative to the traditional dual-energy X-ray absorptiometry (DXA). Radiofrequency Echographic Multi Spectrometry (REMS) is an innovative, non-ionizing imaging technique that recently emerged as a viable tool to diagnose osteoporosis and estimate the fragility fracture risk. Nevertheless, its clinical use is still limited due to its novelty and continuing uncertainty of long-term performance. In order to evaluate the accuracy of the REMS, a systematic review of the English-language literature was conducted. Three databases were searched for relevant publications from 1 January 2015 until 1 December 2024 using the keyword combinations "(radiofrequency echographic multi spectrometry OR REMS) AND (dual-energy X-ray absorptiometry OR DXA)". The initial search yielded 602 candidate articles. After screening the titles and abstracts following the eligibility criteria, 17 publications remained for full-text evaluation. The reviewed studies demonstrated strong diagnostic agreement between REMS and DXA. Additionally, REMS showed enhanced diagnostic capabilities in cases where lumbar bone mineral density measurements by DXA were impaired by artifacts such as vertebral fractures, deformities, osteoarthritis, or vascular calcifications. REMS exhibited excellent intra-operator repeatability and precision, comparable to or exceeding the reported performance of DXA. The fragility score (FS), a parameter reflecting bone quality and structural integrity, effectively discriminated between fractured and non-fractured patients. Moreover, REMS proved to be a radiation-free option for bone health monitoring in radiation-sensitive populations or patients requiring frequent imaging to assess fracture risk. This current study underscores the robustness of REMS as a reliable method for diagnosing and monitoring osteoporosis and evaluating bone fragility via the FS. It also identifies critical knowledge gaps and emphasizes the need for further prospective studies to validate and expand the clinical applications of REMS across diverse patient populations.
鉴于骨质疏松症带来的巨大经济和社会负担，人们对开发一种替代传统双能X线吸收法（DXA）的有效方法的兴趣与日俱增。射频超声多光谱法（REMS）是一种创新的非电离成像技术，最近成为诊断骨质疏松症和评估脆性骨折风险的可行工具。然而，由于其新颖性以及长期性能仍存在不确定性，其临床应用仍然有限。为了评估REMS的准确性，我们对英文文献进行了系统综述。我们使用关键词组合“（射频超声多光谱法或REMS）和（双能X线吸收法或DXA）”在三个数据库中搜索了2015年1月1日至2024年12月1日期间的相关出版物。初步搜索产生了602篇候选文章。根据入选标准筛选标题和摘要后，剩下17篇出版物进行全文评估。综述的研究表明REMS和DXA之间具有很强的诊断一致性。此外，在DXA测量腰椎骨密度因椎体骨折、畸形、骨关节炎或血管钙化等伪影而受损的情况下，REMS显示出更强的诊断能力。REMS表现出出色的操作者内重复性和精度，与DXA报告的性能相当或超过DXA。脆性评分（FS）是一个反映骨质量和结构完整性的参数，有效地区分了骨折患者和未骨折患者。此外，对于辐射敏感人群或需要频繁成像以评估骨折风险的患者，REMS被证明是一种无辐射的骨骼健康监测选择。这项当前研究强调了REMS作为一种可靠方法在诊断和监测骨质疏松症以及通过FS评估骨脆性方面的稳健性。它还识别出关键的知识空白，并强调需要进一步进行前瞻性研究，以验证和扩展REMS在不同患者群体中的临床应用。
