Spine Edge Detection Problem

 

This patient has low bone mineral density. In the left panel there is a problem with the edge detection in L2 and L3. The right panel shows the corrected scan.

Case Description:

In the left panel, there is a problem with edge detection in the lumbar spine, particularly along the left lateral aspects of L2 and L3. The bone mineral density is low. The right panel shows the corrected scan.

Credit:

Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham

References:
  • Watts, N.B., Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporos Int, 2004. 15(11): p. 847-54.
  • Choplin R.H., Lenchik L and S. Wuertzer, A practical approach to interpretation of Dual-Energy X-ray Absorptiometry (DXA) for assessment of bone density. . Curr Radiol Rep  2(48).
  • Dasher, L.G., C.D. Newton, and L. Lenchik, Dual X-ray absorptiometry in today’s clinical practice. Radiol Clin North Am, 2010. 48(3): p. 541-60.
  • Theodorou, D.J. and S.J. Theodorou, Dual-energy X-ray absorptiometry in clinical practice: application and interpretation of scans beyond the numbers. Clin Imaging, 2002. 26(1): p. 43-9.
  • Mergler, S., et al., Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors. Pediatr Radiol, 2012. 42(5): p. 574-83.
  • Choi, J.S., The influence of soft tissue recognition errors on BMD value-A case report: Recipient of Young Investigator Award J Clin Densitom, 2012. 15(4): p. 483
  • Fuleihan, G.E., et al., Reproducibility of DXA absorptiometry: a model for bone loss estimates. J Bone Miner Res, 1995. 10(7): p. 1004-14.
  • Fuerst, T., et al., Quality Assurance in Bone Densitometry in Bone Densitometry and Osteoporosis  K. Genant, G. Guglielmi, and M. Jergas, Editors. 1998, Springer Berlin.
  • Hansen, K., et al., DXA Errors are Common and Likely Adversely Affect Clinical Care: DXA Quality Improvement is Needed. J Bone Miner Res 2016. 31((Suppl 1) Available at http://www.asbmr.org/ItineraryBuilder/Presentationaspx?pid=83c01c31-237b-4f07-81a5-1eeb2a7968aa&ptag=AuthorDetail&aid=00000000-0000-0000-0000-000000000000. ).
  • Promma, S., et al., Errors in Patient Positioning for Bone Mineral Density Assessment by Dual x-ray Absorptiometry: Effect of Technologist Retraining. J Clin Densitom, 2018. 21(2): p. 252-259.
  • Cetin, A., et al., Evaluation of the patient positioning during DXA measurements in daily clinical practice. Clin Rheumatol, 2008. 27(6): p. 713-5.
  • Staron, R.B., et al., Computerized bone densitometric analysis: operator-dependent errors. Radiology, 1999. 211(2): p. 467-70.
  • Baniak, N., S. Grzybowski, and W.P. Olszynski, Dual-energy x-ray absorptiometry scan autoanalysis vs manual analysis. J Clin Densitom, 2014. 17(1): p. 97-103.