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Pitfalls in the measurement of bone mineral density by dual energy x-ray absorptiometry
M D Antonacci1, D S Hanson, M H Heggeness
1Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas, USA.
Study Design:
Fifty-three human thoracic and lumbar vertebrae were analyzed by dual energy x-ray absorptiomety to obtain projectional (g/cm2) and volumetric (g/cm3) bone mineral density.
Objectives:
To determine the effect of volume on the measurement of bone mineral density by DEXA.
Summary Of Background Data:
Despite the widespread use of dual energy x-ray absorptiomety to measure bone mineral density expressed as grams per projectional unit area (g/cm2), the effect of volume has been ignored in many published biomechanical studies.
Methods:
Projectional bone mineral density (g/cm2) of fifty-three human vertebrae was obtained by dual energy x-ray absorptiometry measurement. This was compared to bone mineral density expressed as grams per unit volume.
Results:
Many specimens with near equal projectional bone mineral density were demonstrated to have significantly different true densities when measured by dual energy x-ray absorptiomety in grams per unit volume. The difference in true bone mineral density for these specimens ranged from 24.1% to 139%.
Conclusion:
The effect of volume on bone mineral density data based on projectional areas can cause very significant perturbations of the data in biomechanical studies.