Background and objectives: Dual X ray absorptiometry (DXA) is the preferred method for bone mineral density (BMD) studies. Quantitative ultrasonography (QUS), however, has the advantage in that it is less expensive, portable and does not expose the individuals to radiation. These advantages have proposed a role in screening studies to QUS. In this study, we aimed to assess relationship between these two methods.Material and methods: 420 menopausal women were recruited. BMD values were determined with both QUS and DXA methods. The association between BMD measurements and T scores calculated by the two methods and the relationship between the two T scores measured in each participants were assessed. The agreement between the two T scores calculated by the QUS and DXA was assessed by Kappa test in lumbar and femoral neck region. Results: With QUS, the prevalence of osteoporosis (T scores < -2.5) in calcaneus was 8%. With DXA, the prevalence of osteoporosis in lumbar and femoral neck regions was 31.1% and 13.6%, respectively. Kappa as measure of agreement between the two methods was 0.29-0.35. The association between crude data obtained from the two methods was 0.34 and 0.59.Conclusion: A moderate correlation was found between the two methods. Though QUS could not replace DXA in definitive diagnosis of osteoporosis, it may be used in screening studies.

QUS (Quantitative Ultrasound) of phalanx is a noninvasive, inexpensive and portable method for bone mineral densitometry. It seems it measures some other parameters in addition to BMD, like elasticity and micro architecture. This study designed to determine the agreement of DXA and QUS of phalanx in Defining Osteoporosis in Healthy Postmenopausal Women Using DXA, BMD of lumbar spine and Different areas of left femur and using QUS, BMD of phalanx was measured in 180 healthy postmenopausal women. The diagnostic agreement between the two techniques in identifying osteoporosis was assessed using kappa scores. According to the World Health Organization definitions, Osteoporosis found in 28.8% of cases with DXA method (18.3% in L2-L4 and 3.9%-7.8% in different region of femur) and in 28.9% of cases with Phalanx ultrasonography). Kappa score was 0.317 for lumbar region and 0.036-0.068 for different regions femur. Results of this study show a weak to moderate agreement of two methods in diagnosis of osteoporosis. It means QUS of phalanx can’t be used as a replacement for DXA method but could be used as a screening method for finding osteoporotic cases.

BACKGROUND: Using soft-tissue composition in conventional regional dual-energy X-ray absorptiometry (DXA) scans of the spine and hip to predict whole body composition (whole-body fat mass, whole-body lean mass and trunk-fat mass) instead of a whole body DXA scan.METHODS: We identified 143 adult patients who underwent DXA evaluation of the whole body. Anthropometric indices were also measured. Datasets were split randomly into two parts; the derivation set including a sample of 100 subjects, and the validation set including a sample of 43 subjects. Multiple regression analysis with the backward stepwise elimination procedure was used for the derivation set and the estimates were then compared with the actual measurements from the whole-body scans for the validation set. The Ra2 (adjusted coefficient of multiple determination) and SSE (error sum of squares) criteria were applied to compare regression models.RESULTS: Using multiple linear regression analyses, the best equation for predicting whole-body fat mass (Ra2= 0. 945) included gender, height, weight, waist circumference (WC), spine fat fraction and hip fat fraction; the best equation for predicting whole-body lean mass (Ra2 = 0. 970) included gender, weight, WC, spine fat fraction and hip fat fraction; and the best equation for predicting trunk-fat mass (Ra2 = 0. 944) included gender, weight, spine fat fraction and hip fat fraction.CONCLUSION: The results of this study show that regional DXA scans of the spine and hip can be used to accurately predict body composition.

Background: Cortical deceleration is the main reason for bone loss at peripheral sites. It was suggested that when peripheral bones were assessed for osteoporosis, management and therapy can be administered early. The main aim of this study was to assess the relationships between the central and peripheral measurements at different skeleton bone sites (spine, femur, forearm, tibia, and calcaneus) with available modalities: DXA, QUS, and MDCT-QCT. Methods: The volunteers recruited in this study did not have any history or evidence of metabolic bone disease. Blood test and DXA measurements were used as inclusion criteria to select 40 healthy participants. The selected volunteers underwent 3 imaging modalities: QCT, DXA, and QUS. DXA-based measurements were made on 3 sites, including spine, femur, and forearm. QCT and QUS measurements were done for distal of tibia and calcaneus bones, respectively. The extracted parameters from the 3 modalities were analyzed using a bivariate (Pearson) correlation (r) in statistical software. Results: The results showed moderate to good correlations between spongy bones in central and peripheral sites from all the modalities. However, there was no correlation between MDCT measures and central bone values. According to correlations between different peripheral sits, aBMD of 33% radius and trabecular vBMD in 38% distal tibia showed weak but significant relationship between peripheral bones (r=-0. 342, p=0. 044). Conclusion: The findings demonstrated how bones in central and peripheral sites were correlated. Multimodality imaging was used in this group of healthy volunteers. Also, it was found that QCT-based MDCT needs more optimization and requires further investigations.

Objective(s): Osteoporosis remains a major problem following kidney transplantation. Radiographic measures of bone mass are of limited predictive value after transplantation and are complicated by preexisting renal osteopathy. Quantitative ultrasound (QUS) is a new and noninvasive method to assess skeletal status; however, limited data exist on ultrasonic bone parameters of phalanx after renal transplantation. We evaluated the potential of this method in osteoporsis diagnosis in renal allograft recipients in comparison to DXA and for better study of QUS results in these patients, we compared them to results of normal matched controls.Methods: Forty-two patients (age 40.17±11.9 years) were studied 2.8±2.9 years after transplantation. We used 49 healthy persons matched for age and sex as controls. A Lunar device (DPM-MD) was used for DXA scanning and QUS of phalanx was done in all of them using a DBM-Sonic 1200 device.Results: Osteoporosis found in 19% of all patients (9.5% in femoral neck, 9.5% in total region of femur and 9.5% in spinal region). Sensitivity of Ad-SOS( parameter measured with DBM-Sonic 1200) for osteoporosis diagnosis in above regions was respectively 100%, 75% and 25% and its specificity for that diagnosis in above regions was respectively 45%, 43% and 37% (there was not significant relation between them). Mean of Ad-SOS (amplitude dependent speed of sound, the parameter measured in QUS of phalanx) was 2036±79 in transplanted patients and 2060±86, in controls. There was no significant difference between them. Age, height and BMI were significantly related to Ad-SOS. Age and BMI had negative relation with Ad-SOS ( P-values 0.027 and 0.001).Ad-SOS had a positive relation with height (P-value = 0.013).There was no correlation between Ad-SOS and weight, dialysis time, time after transplantation, cumulative steroid dose and cumulative cyclosporine in transplanted patients.Conclusion: Our data suggests that QUS of phalanx is not a good way for assessing the changes of bone in renal transplanted patients in comparison to healthy persons, but may be used as a screening technique for osteoporisis in them. For establishment of diagnosis patient must be examined with DXA.

Background: An excessive accumulation of the adipose tissue in women’ s organism is a frequent and important medical problem which should be monitored. The aim of this study was to explore correlations between the selected parameters of body composition assessed using DXA and anthropometric methods. Materials and Methods: The study group consisted of 50 women aged 51– 85. Both adipose mass and fat‑ free mass were assessed with the DXA method, and the nutritional status of the participants was evaluated with the anthropometric methods. Results: The mean body mass index (BMI) value assessed with the DXA method amounted to 28. 4 (± 5. 12). The Spearman’ s Rho correlation indicated the presence of a moderate association (0. 27– 0. 50) between: (1) right arm lean and the circumference of the arm (P = 0. 020), forearm (P = 0. 011), and transverse cross‑ section of the arm (P = 0. 020), (2) right leg fat and circumference of the thigh (P = 0. 003), shin (P = 0. 009), and also the musculature index of the lower extremity (P = 0. 034), (3) visceral adipose tissue (VAT) mass and BMI (P = 0. 050), Waist to HeightRatio (WtHR) (P = 0. 031), (4) Android fat and WHtR (P = 0. 044), and (5) gynoid fat and Š kerlj index (P = 0. 025). Conclusion: The selected parameters assessed with DXA were significantly correlated with the selected parameters assessed with anthropometric methods. WHtR anthropometric parameter is significantly correlated with DXA parameters: VAT mass, gynoid region % fat and android region % fat.

INTRODUCTION: Trabecular bone has a high turnover rate about 8 times that of cortical bone. The aim of this study was to establish a dual energy x-ray absorptiometry (DXA)t echnique for measuring os calcis bone mineral density (BMD).METHODS: An os calcis phantom was used for in-vitro precision. Precision was estimated from repeat studies in ten subjects. Thirty-one female subjects who were referred for spine femur BMD assessment had their os calcis measured. T-scores for the spine and femur were calculated. The T-score for the os calcis was calculated using twenty-one young normal females. Patient BMD was classified according to the World Health Organization (WHO) criteria for assessing patient BMD relative to young reference data.RESULTS: In-vitro and in-vivo precise (CV ≤ 1.1 %) results were achieved. Moderate correlations between the os calcis, spine and femur were found. Using the T-score values, the number of patients defined as osteoporotic varied from 16% for the total femur to 29% for neck of femur and 45% for os calcis. The combination of spine and total femur diagnosed a higher number of patients at fracture risk. Adding the os calcis to spine/total femur Measurements a further number of subjects at fracture risk were identified.DISCUSSION: from our findings it can be concluded that assessment of os calcis may predict risk of fracture at other sites at an earlier stage.

Introduction: This study is used to compare the bone mineral density (BMD) of lumbar spine (LS) and femur neck (FN) for premenopausal women.Material and Methods: The BMD measurements using dual energy x-ray absorptiometry technique (DXA) have been performed at Isfahan Osteoporosis Diagnosis Center since March 2002. Among the referred subjects 185 premenopausal women who had no known history of disease or taking any medication that affects BMD were selected. The long-term reproducibility (coefficient of variation, CV) of the DXA scanner for BMD measurements during the study period was assessed, using the phantom provided by the manufacturer. A Norland XR46 system was used for the investigations. Results: The mean BMD for the FN and LS were found to be 0.859±0.136 and 1.012±0.161, respectively. The long-term BMD for LS and FN had a coefficient of variation of 1.0 and 1.2%, respectively. Discussion and Conclusion: Although a lower BMT T-score has been reported for LS compared to FN for women, the result obtained in this study shows a significantly lower BMT mean T-score (t = -9.02, p<0.0001) for FN. The BMD T-score of -0.551±0.99 SD and -1.09±1.17 SD was found for LS and FN, respectively. This finding is inconsistent with the previously reported results, which may be due to the physiological and life-style factors. Therefore, further research is required to determine the reason(s).