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. 2021 Feb;28(1):67-77.
doi: 10.11005/jbm.2021.28.1.67. Epub 2021 Feb 28.

Does Bone Mineral Density Differ between Fan-Beam and Pencil-Beam?: A Meta-Analysis and Systemic Review

Byung-Ho Yoon  1 , Young Do Koh  2 , Jun-Il Yoo  3 , Sujin Kim  4 , Guen Young Lee  4 , Sung Bin Park  4 , Yong-Chan Ha  5
Affiliations

Does Bone Mineral Density Differ between Fan-Beam and Pencil-Beam?: A Meta-Analysis and Systemic Review

Byung-Ho Yoon et al. J Bone Metab. 2021 Feb.

Abstract

Background: Dual energy X-ray absorptiometry (DXA) has evolved from pencil-beam (PB) to narrow fan-beam (FB) densitometers. We performed a meta-analysis of the available observational studies to determine how different modes of DXA affect bone mineral density (BMD) measurements.

Methods: A total of 1,233 patients (808 women) from 14 cohort studies were included. We evaluated the differences in BMD according to the DXA mode: PB and FB. Additionally, we evaluated the differences in BMD between the 2 types of FB mode: FB (Prodigy) and the most recent FB (iDXA). Pairwise meta-analysis was performed, and weighted mean differences (WMD) were calculated for (total lumbar, total hip, and total body).

Results: No significant difference was observed in total lumbar (pooled WMD, -0.013; P=0.152) and total hip BMD (pooled WMD, -0.01; P=0.889), between PB and FB. However, total body BMD was significantly lower in the PB compared to the FB group (pooled WMD, -0.014; P=0.024). No significant difference was observed in lumbar BMD (pooled WMD, -0.006; P=0.567), total hip (pooled WMD, -0.002; P=0.821), and total body (pooled WMD, 0.015; P=0.109), between Prodigy and iDXA.

Conclusions: The results of this study warrant the recommendation that correction equations should not be used when comparing BMD from different modes. Further research is still needed to highlight the ways in which differences between DXA systems can be minimized.

Keywords: Absorptiometry, photon; Bone density; Densitometry; Osteoporosis.

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Conflict of interest statement

Conflict of interest

Byung-Ho Yoon has been the associate editor of the Journal of Bone Metabolism since 2018. Yong-Chan Ha has been the editor-in-chief of the Journal of Bone Metabolism since 2017. No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram details the process of relevant study selection.
Fig. 2
Fig. 2
Forest plots of the changes of bone mineral density (BMD) determined between pencil-beam mode and fan-beam mode: (A) Total lumbar area. (B) Total hip area. (C) Total body. Effect sizes are indicated as Hedges’ g weighted mean differences and 95% confidence interval (CI).
Fig. 3
Fig. 3
Forest plots of the changes of bone mineral density (BMD) determined between fan-beam (FB) mode (Prodigy) and most recent FB mode (iDXA): (A) Total lumbar area. (B) Total hip area. (C) Total body. Effect sizes are indicated as Hedges’ g weighted mean dif ferences and 95% confidence interval (CI).
Fig. 4
Fig. 4
Publication bias of included studies. SMD, standard mean difference.
See this image and copyright information in PMC

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