A portable dual energy x-ray absorptiometry technique for the measurement of bone mineral in preterm infants.

A dual energy x-ray absorptiometry technique has been developed for the measurement of bone mineral in preterm infants. Two films are taken of the infant's forearm using a standard mobile x-ray set on the ward at two x-ray energies. Included in the field of view is a double step wedge made of aluminum and Perspex. The images are digitized by viewing them on a light box with a TV camera. The bone mineral content in the forearm can then be mapped by the measurement of light intensity in matching pixels of the two films and comparison with the intensities in the step wedge. The bone mineral concentration in the radius, expressed as bone mineral per unit length (mg/mm), is calculated. The technique has been tested using phantoms of calcium hydroxylapatite set in a tissue equivalent material and in Perspex. It has been shown that the reproducibility of the technique is approximately 7% and that there is a systematic underestimate of bone mineral of about 17%. The technique has been shown to be linear up to a bone mineral concentration of 8 mg.mm-1. Longitudinal studies for 14 infants that show an initial 6-wk period of demineralization after birth with a subsequent mineralization phase are reported.