Dual Energy X-ray Absorptiometry Reports Fail to Adhere to International Guidelines

Area of Science:

• Radiology
• Bone Densitometry
• Osteoporosis Diagnosis

Background:

• Dual X-ray absorptiometry (DXA) is crucial for osteoporosis diagnosis.
• The accuracy of DXA relies on scan quality, data interpretation, and report adequacy.
• International Society for Clinical Densitometry (ISCD) provides minimum reporting guidelines.

Purpose of the Study:

• To assess adherence of DXA reports to ISCD guidelines at an academic teaching hospital.
• To identify variations in DXA report quality based on patient factors and imaging service.

Main Methods:

• Retrospective review of 459 DXA reports from patients aged 18+ between 2018-2019.
• Manual scoring of reports based on ISCD criteria (14-18 points per scan).
• Analysis of report scores considering internal vs. external imaging services and patient demographics.

Main Results:

• Overall median DXA report score was 57.1%, indicating significant deficiencies.
• Lowest adherence was for recommendations on future DXA scans (1.1%) and investigating secondary osteoporosis causes (1.2%).
• Internal hospital reports scored significantly higher than external reports (IRR 1.83).

Conclusions:

• Significant deficiencies and variability exist in DXA report standards across imaging services.
• Adherence to ISCD guidelines is suboptimal, potentially impacting osteoporosis diagnosis and management.
• Internal reporting at academic centers may offer higher quality compared to external services.