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Densitometer-Specific Differences in the Correlation Between Body Mass Index and Lumbar Spine Trabecular Bone Score
Gillian Mazzetti1, Claudie Berger2, William D Leslie3
1Department of Medicine, McGill University, Montréal, Québec, Canada.
Summary
Body Mass Index (BMI) impacts Trabecular Bone Score (TBS) measurements on Hologic densitometers but not GE Lunar. This difference is crucial for consistent TBS analysis across various DXA machines.
Area of Science:
- Osteoporosis research
- Medical imaging analysis
- Biomechanical engineering
Background:
- Trabecular Bone Score (TBS) is a texture analysis of DXA scans predicting fractures independently of bone mineral density (BMD).
- Increased body mass index (BMI) can affect DXA image acquisition due to greater soft tissue, potentially influencing TBS.
- Different densitometer manufacturers may process soft tissue variations differently, leading to potential discrepancies in TBS measurements.
Purpose of the Study:
- To investigate whether the relationship between BMI and TBS differs between GE Lunar and Hologic densitometer manufacturers.
- To assess the impact of BMI on TBS measurements across different DXA machine types.
Main Methods:
- Analysis of lumbar spine DXA scans from 1919 women and 811 men (aged ≥40) from the Canadian Multicentre Osteoporosis Study.
- TBS calculated using TBS iNsight® software (version 2.1) on scans acquired from GE Lunar and Hologic densitometers.
- Statistical analysis including Pearson correlation and age-adjusted linear regression to evaluate BMI-TBS and BMI-BMD relationships by manufacturer.
Main Results:
- A significant negative correlation between TBS and BMI was found for both men and women using Hologic densitometers (r = -0.36 to -0.33, p < 0.0001).
- No significant correlation between TBS and BMI was observed with GE Lunar densitometers (r = 0.00 to -0.02).
- Significant interactions between BMI and densitometer manufacturer were confirmed (p < 0.0001), while BMI-BMD correlations were consistent across both manufacturers.
Conclusions:
- BMI significantly influences TBS values when measured on Hologic densitometers, but not on GE Lunar densitometers.
- These findings highlight the importance of considering densitometer manufacturer in TBS interpretation, especially for longitudinal studies or pooled analyses.
- Clinical and research applications of TBS require awareness of potential manufacturer-related biases in BMI-TBS relationships.
