Will the New Ultrasound Gadget Change DEXA Bone Density Testing?

Did you ever stick your foot in a tool that measured your bone density on the heel? If that’s the case, this was an ultrasound machine that tried to detect bone density and bone energy by sending soundwaves by the bone. I’ve been watching the evolution of ultrasound testing over the many years and have seen a number of analysis articles  suggesting that bone ultrasound testing may nicely be capable of uncover the strength-determining qualities of bone along with bone density.

For instance, in 1998 European researchers urged that quantitative ultrasound (QUS) represented a promising approach for the prognosis of osteoporosis and that this radiation-free expertise supplied info not solely on bone density but additionally on bone high quality and bone energy. (1)

The brand new modern-day ultrasound bone density check

Now 20 years later Italian scientists have developed a contemporary ultrasound machine that’s able to measuring bone on the hip and the backbone. In depth testing achieved between 2013 and 2016 means that this new Radiofrequency Echographic Multi Spectrometry (REMS) machine could also be an efficient radiation-free strategy to assess bone density and, much more, to guage bone energy and fracture threat. The ultrasound machine generally known as Echolight was just lately authorised by the FDA and medical doctors within the US are starting to provide it a strive.

A number of days in the past my consumer Valerie reported that she was given a free check drive of this new ultrasound machine. She was supplied a free Echolight check whereas attending an train program, and though simply 3 days earlier than she had had her common DEXA bone density check, she accepted the supply. The machine is radiation-free, and the check is fast and simple, so she was sport for a strive. Because it turned out, nevertheless, the 2 bone density measuring units delivered fairly completely different outcomes. The brand new ultrasound machine reported considerably decrease readings than the DEXA.

This disparity in check outcomes impressed me to dig a little bit deeper into the Echolight (REMS) analysis. Taking a look at their printed articles and speaking to people educated on this new expertise confirmed my suspicion that there was an issue right here. (2, 3, 4)

We have now recognized for a very long time that many errors can happen utilizing the usual DEXA bone density testing machines. For instance, the DEXA is operator dependent and placement on the machine is a crucial variable. Complete articles have been written on widespread errors incurred with DEXA testing (5). Much more necessary to me is the truth that bone density testing by DEXA doesn’t precisely predict fracture threat, in that the overwhelming majority of people that fracture shouldn’t have an “osteoporotic bone density” by DEXA. (6)

So which bone density check was extra correct in Valerie’s case? And can REMS exchange DEXA?

My solutions to those questions are a piece in progress. I regarded on the analysis and contacted Dr. Kimberly Zambito, an orthopedic surgeon who was just lately educated in Echolight testing. Having achieved 25+ Echolight REMS scans to date, Dr. Zambito discovered the brand new Echolight scan reviews to be in keeping with DEXA when it comes to bone mineral density, aside from these sufferers who had poor high quality DEXA scans. I assume time will inform if cautious researchers will give you the identical outcomes. (7)

Whereas it’s nonetheless not clear how it will end up in Valerie’s case, or if the brand new ultrasound will exchange DEXA, I needed to share this new expertise with you. I’ve an intuitive feeling that ultrasound has the potential to supply a safer and much more correct strategy to assess bone density, and maybe it would even inform us a bit extra about bone energy and fracture threat.

In case you are supplied an Echolight check, and it occurs to be across the identical time as your DEXA bone density check, strive it out. I might like to see the outcomes. And I will likely be following this analysis and will possible interview just a few of the important thing scientists and physicians utilizing this expertise.

Keep robust, and keep tuned in.

References:

1. Prins, S. H., et al. 1998. The function of quantitative ultrasound within the evaluation of bone: A overview. Medical Physiology (Oxford, England) 18(1):3-17.
2. Di Paola, M., et al. 2019. Radiofrequency echographic multispectrometry in contrast with twin X-ray absorptiometry for osteoporosis prognosis on lumbar backbone and femoral neck. Osteoporosis Worldwide 30:391-402.
3. Adami, G., et al. 2020. Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up research. Bone 134:115297.
4. Cortet, B., et al. 2021. Radiofrequency echographic multi spectrometry (REMS) for the prognosis of osteoporosis in a European multicenter scientific context. Bone 143:115786.
5. Kaleta, M., and S. Wroń 2001. The commonest errors within the densitometric prognosis of osteoporosis. Ortopedia, Traumatologia, Rehabilitacja 3(3):338-344.
6. Brown, S. E. 2015. How can we inform who will fracture? Past bone mineral density to the brand new world of fracture threat evaluation. Higher Bones web site, accessed April 21, 2021.
7. Dea Tomai Pitinca, M., et al. 2021. Might radiofrequency echographic multi-spectrometry (REMS) overcome the restrictions of BMD by DXA associated to artifacts? A collection of three circumstances. Journal of Ultrasound in Medication. DOI: 10.1002/jum.15665 printed on-line 21 February 2021.