ARTIFACTS AFFECTING DUAL-ENERGY X-RAY ABSORPTIOMETRY MEASUREMENTS.

Area of Science:

• Radiology
• Medical Imaging
• Bone Densitometry

Background:

• Dual-energy X-ray absorptiometry (DXA) is a standard for measuring bone mineral density (BMD).
• Accurate BMD assessment is vital for diagnosing and managing osteoporosis.
• Artifacts can compromise the reliability of DXA scan results.

Observation:

• Case 1: A spinal cord stimulator artifactually elevated lumbar BMD in a premenopausal woman.
• Case 2: Iodine-based contrast material in the colon created an artifact, altering a patient's osteoporosis diagnosis.
• Case 3: Laparoscopic adjustable gastric banding (LAGB) components were misinterpreted as bone, increasing BMD readings.

Findings:

• Artifacts from medical implants, contrast agents, and surgical devices can lead to inaccurate DXA BMD measurements.
• These artifacts can falsely increase or decrease perceived bone density, potentially misclassifying skeletal status.
• The presented cases highlight diverse sources of artifacts impacting lumbar spine BMD assessments.

Implications:

• Healthcare providers must recognize and account for potential artifacts during DXA interpretation.
• Failure to identify artifacts can result in incorrect osteoporosis diagnosis and inappropriate treatment decisions.
• Improved artifact recognition protocols are needed to ensure the clinical utility of DXA scans.