Radiofrequency echographic multi spectrometry (REMS) in the diagnosis and management of osteoporosis: state of the art

Abstract

Radiofrequency Echographic Multi Spectrometry (REMS) is a radiation-free, portable technology, which can be used for the assessment and monitoring of osteoporosis at the lumbar spine and femoral neck and may facilitate wider access to axial BMD measurement compared with standard dual-energy x-ray absorptiometry (DXA).There is a growing literature demonstrating a strong correlation between DXA and REMS measures of BMD and further work supporting 5-year prediction of fracture using the REMS Fragility Score, which provides a measure of bone quality (in addition to the quantitative measure of BMD).The non-ionising radiation emitted by REMS allows it to be used in previously underserved populations including pregnant women and children and may facilitate more frequent measurement of BMD.The portability of the device means that it can be deployed to measure BMD for frail patients at the bedside (avoiding the complications in transfer and positioning which can occur with DXA), in primary care, the emergency department, low-resource settings and even at home.The current evidence base supports the technology as a useful tool in the management of osteoporosis as an alternative to DXA.

Keywords: Diagnosis; Fracture; Osteoporosis; Radiofrequency echographic multi spectrometry (REMS); Screening.

Fig. 1

REMS basic principles: (a) Lumbar spine REMS scan. (b) Simultaneous acquisition of the native raw unfiltered signals of several scan lines considering all available tissue information. (c) Dedicated spectral processing of the acquired signals. (d) Comparison between ROI spectra specific for the patient and those of the reference model spectra of healthy and pathological patients, matched by age, sex, BMI and anatomical site. (e) Calculation of quantitative and qualitative parameters

Fig. 2

Example of REMS diagnostic report for a lumbar spine scan