Keywords:
Neuroradiology spine, Musculoskeletal spine, Conventional radiography, Absorptiometry / Bone densitometry, Diagnostic procedure, Observer performance, Comparative studies, Metabolic disorders, Demineralisation-Bone, Osteoporosis
Authors:
A. Bazzocchi1, F. Fuzzi1, P. Spinnato1, D. Diano1, G. Guglielmi2, C. Sassi1, G. Battista1, E. Salizzoni1; 1Bologna/IT, 2Foggia/IT
DOI:
10.1594/ecr2012/C-1943
Purpose
Vertebral fractures (VFs) are the most common fractures related to osteoporosis (50%) and represent a hallmark of the disease; these fractures are also associated with increased morbidity,
mortality,
impaired quality of life for patients and also increased health costs.
Although many VFs are clinically silent,
it has been shown that they are associated with increased risk for subsequent osteoporotic fractures; moreover,
the detection of VFs strongly predicts the future fracture risk independently from bone density criteria.
Several techniques were born and developed to identify spine deformities.
The visual semiquantitative (VSQ) assessment on conventional spine radiograph proposed in 1993 by Genant et al.
remains the most validated and used in the clinical practice.
However,
a combination of semiquantitative visual and quantitative morphometric methods has been proposed to be the best approach to fracture definition and detection.
A spine assessment for the detection of VFs may be performed on both conventional radiography and dual-energy X-ray absorptiometry (DXA) images.
Spine radiography is considered the "gold standard" for vertebral fracture identification but some important advantages can be found in densitometric technologies.
The aim of this study was to investigate the diagnostic performance of new dual-energy x-ray absorptiometry (DXA) technologies in the detection of VFs (Fig. 1).
The analysis also considered intra- and inter-observer agreement for densitometric methods and for radiographic ones with remarks on experience-related performance.