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The effect of patient positioning on measurements of bone mineral density of the proximal femur: a simulation study using computed tomographic images

The effect of patient positioning on measurements of bone mineral density of the proximal femur:... SummaryThe patient’s position may affect the bone mineral density (BMD) measurements; however, the extent of this effect is undefined. This CT image-based simulation study quantified changes in BMD induced by hip flexion, adduction, and rotations to recommend appropriate patient positioning when acquiring dual-energy x-ray absorptiometry images.PurposeSeveral studies have analyzed the effect of hip rotation on the measurement of bone mineral density (BMD) of the proximal femur by dual-energy x-ray absorptiometry (DXA). However, as the effects of hip flexion and abduction on BMD measurements remain uncertain, a computational simulation study using CT images was performed in this study.MethodsHip CT images of 120 patients (33 men and 87 women; mean age, 82.1 ± 9.4 years) were used for analysis. Digitally reconstructed radiographs of the proximal femur region were generated from CT images to calculate the BMD of the proximal femur region. BMD at the neutral position was quantified, and the percent changes in BMD when hip internal rotation was altered from −30° to 15°, when hip flexion was altered from 0° to 30°, and when hip abduction was altered from –15° to 30° were quantified. Analyses were automatically performed with a 1° increment in each direction using computer programming.ResultsThe alteration of hip angles in each direction affected BMD measurements, with the largest changes found for hip flexion (maximum change of 17.7% at 30° flexion) and the smallest changes found for hip rotation (maximum change of 2.2% at 15° internal rotation). The BMD measurements increased by 0.34% for each 1° of hip abduction, and the maximum change was 12.3% at 30° abduction.ConclusionThis simulation study quantified the amount of BMD change induced by altering the hip position. Based on these results, we recommend that patients be positioned carefully when acquiring DXA images. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Osteoporosis Springer Journals

The effect of patient positioning on measurements of bone mineral density of the proximal femur: a simulation study using computed tomographic images

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References (39)

Publisher
Springer Journals
Copyright
Copyright © International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
ISSN
1862-3522
eISSN
1862-3514
DOI
10.1007/s11657-023-01225-x
Publisher site
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Abstract

SummaryThe patient’s position may affect the bone mineral density (BMD) measurements; however, the extent of this effect is undefined. This CT image-based simulation study quantified changes in BMD induced by hip flexion, adduction, and rotations to recommend appropriate patient positioning when acquiring dual-energy x-ray absorptiometry images.PurposeSeveral studies have analyzed the effect of hip rotation on the measurement of bone mineral density (BMD) of the proximal femur by dual-energy x-ray absorptiometry (DXA). However, as the effects of hip flexion and abduction on BMD measurements remain uncertain, a computational simulation study using CT images was performed in this study.MethodsHip CT images of 120 patients (33 men and 87 women; mean age, 82.1 ± 9.4 years) were used for analysis. Digitally reconstructed radiographs of the proximal femur region were generated from CT images to calculate the BMD of the proximal femur region. BMD at the neutral position was quantified, and the percent changes in BMD when hip internal rotation was altered from −30° to 15°, when hip flexion was altered from 0° to 30°, and when hip abduction was altered from –15° to 30° were quantified. Analyses were automatically performed with a 1° increment in each direction using computer programming.ResultsThe alteration of hip angles in each direction affected BMD measurements, with the largest changes found for hip flexion (maximum change of 17.7% at 30° flexion) and the smallest changes found for hip rotation (maximum change of 2.2% at 15° internal rotation). The BMD measurements increased by 0.34% for each 1° of hip abduction, and the maximum change was 12.3% at 30° abduction.ConclusionThis simulation study quantified the amount of BMD change induced by altering the hip position. Based on these results, we recommend that patients be positioned carefully when acquiring DXA images.

Journal

Archives of Osteoporosis – Springer Journals

Published: Feb 24, 2023

Keywords: DRR; Dual-energy x-ray absorptiometry; Image acquisition; Osteoporosis; Quantitative CT

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