title: Prevalence and type of errors in dual-energy x-ray absorptiometry.
abstract: OBJECTIVE
  Pitfalls in dual-energy x-ray absorptiometry (DXA) are common. Our aim was to assess rate and type of errors in DXA examinations/reports, evaluating a consecutive series of DXA images of patients examined elsewhere and later presenting to our institution for a follow-up DXA.
  
  
  METHODS
  After ethics committee approval, a radiologist retrospectively reviewed all DXA images provided by patients presenting at our institution for a new DXA. Errors were categorized as patient positioning (PP), data analysis (DA), artefacts and/or demographics.
  
  
  RESULTS
  Of 2,476 patients, 1,198 had no previous DXA, while 793 had a previous DXA performed in our institution. The remaining 485 (20 %) patients entered the study (38 men and 447 women; mean age ± standard deviation, 68 ± 9 years). Previous DXA examinations were performed at a total of 37 centres. Of 485 reports, 451 (93 %) had at least one error out of a total of 558 errors distributed as follows: 441 (79 %) were DA, 66 (12 %) PP, 39 (7 %) artefacts and 12 (2 %) demographics.
  
  
  CONCLUSIONS
  About 20 % of patients did not undergo DXA at the same institution as previously. More than 90 % of DXA presented at least one error, mainly of DA. International Society for Clinical Densitometry guidelines are very poorly adopted.
  
  
  CONCLUSIONS
  • More than 90 % of DXA examinations/reports presented one or more errors. • About 80 % of errors are related to image data analysis. • Errors in DXA examinations may have potential implications for patients' management.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milano, Italy, carmelomessina.md@gmail.com.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Messina
authors.forename: Michele
authors.initials: M
authors.lastname: Bandirali
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
authors.forename: Nathascja Katia
authors.initials: NK
authors.lastname: D'Alonzo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.forename: Giacomo Davide Edoardo
authors.initials: GD
authors.lastname: Papini
authors.forename: Fabio Massimo
authors.initials: FM
authors.lastname: Ulivieri
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D016477:Artifacts; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D056888:Patient Positioning; D015995:Prevalence; D012189:Retrospective Studies