Precision of dual-energy x-ray absorptiometry in determining bone mineral density and content of various skeletal sites

Abstract

Repeated measurements of bone mineral density (BMD) by dual-energy x-ray absorptiometry (DEXA) reliably indicate changes in the bone mineral content (BMC) of the lumbar spine and proximal femur, but its applicability to other sites has not been properly determined. The in-vivo day-to-day precision of DEXA (Norland XR-26) for lumbar spine, femoral neck, distal femur, patella, proximal tibia, calcaneus and distal radius was evaluated for 15 subjects who were scanned three times for 2 wk. Intra- and interobserver errors were also determined for image analysis. For clearly defined regions of interest, the following precision values were obtained for BMD with low intra- and interobserver error: 1.7% (lumbar spine), 1.3% (femoral neck), 1.2% (distal femur), 1.0% (patella), 0.7% (proximal tibia), 1.3% (calcaneus) and 1.9% (distal radius). The precision for BMC was lower. The results indicate that DEXA can successfully and precisely measure BMD of sites not commonly assessed by this technique.