title: Comparison of DXA Scans and Conventional X-rays for Spine Morphometry and Bone Age Determination in Children.
abstract: Conventional lateral spine and hand radiographs are the standard tools to evaluate vertebral morphometry and bone age in children. Beside bone mineral density analyses, dual-energy X-ray absorptiometry (DXA) measurements with lower radiation exposure provide high-resolution scans which are not approved for diagnostic purposes. Data about the comparability of conventional radiographs and DXA in children are missing yet. The purpose of the trial was to evaluate whether conventional hand and spine radiographs can be replaced by DXA scans to diminish radiation exposure. Thirty-eight children with osteogenesis imperfecta or secondary osteoporosis or short stature (male, n=20; age, 5.0-17.0 yr) were included and assessed once by additional DXA (GE iDXA) of the spine or the left hand. Intraclass correlation coefficients (ICCs) were used to express agreement between X-ray and iDXA assessment. Evaluation of the spine morphometry showed reasonable agreement between iDXA and radiography (ICC for fish-shape, 0.75; for wedge-shape, 0.65; and for compression fractures, 0.70). Bone age determination showed excellent agreement between iDXA and radiography (ICC, 0.97). IDXA-scans of the spine in a pediatric population should be used not only to assess bone mineral density but also to evaluate anatomic structures and vertebral morphometry. Therefore, iDXA can replace some radiographs in children with skeletal diseases.
authors.affiliation: Children's Hospital, University of Cologne, Cologne, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Hoyer-Kuhn
authors.affiliation: Children's Hospital, University of Cologne, Cologne, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Knoop
authors.affiliation: Children's Hospital, University of Cologne, Cologne, Germany. Electronic address: joerg.semler@uk-koeln.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Semler
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Kuhr
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.affiliation: Children's Hospital, University of Cologne, Cologne, Germany.
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schoenau
authors.affiliation: Department of Radiology, University of Cologne, Cologne, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Koerber
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods; D001827:Body Height; D015519:Bone Density; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D010013:Osteogenesis Imperfecta / Q000175:diagnosis*; D010024:Osteoporosis / Q000175:diagnosis*; D011859:Radiography / Q000379:methods*; D011870:Radiologic Health / Q000379:methods; D015203:Reproducibility of Results; D013131:Spine / Q000000981:diagnostic imaging*
keywords: Bone age; DXA; children; osteogenesis imperfecta; spine morphometry