title: Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance.
abstract: Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.
authors.affiliation: New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com.
authors.forename: E Michael
authors.initials: EM
authors.lastname: Lewiecki
authors.affiliation: Osteoporosis Clinical Center and Research Program, University of Wisconsin, Madison, WI, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Binkley
authors.affiliation: Division of Clinical Immunology and Rheumatology, Department of Medicine, UAB Osteoporosis Prevention and Treatment Clinic, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Morgan
authors.affiliation: Swedish Medical Group, Seattle, WA, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Shuhart
authors.affiliation: Rede Mater Dei de Saúde - Densimater, Belo Horizonte, Brazil.
authors.forename: Bruno Muzzi
authors.initials: BM
authors.lastname: Camargos
authors.affiliation: Galway University Hospitals, National University of Ireland, Galway, Ireland.
authors.forename: John J
authors.initials: JJ
authors.lastname: Carey
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
authors.affiliation: Illinois Bone and Joint Institute, LLC., Morton Grove, IL, USA.
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Jankowski
authors.affiliation: JK Lee Orthopaedics & Traumatology, Petaling Jaya, Malaysia.
authors.forename: Joon-Kiong
authors.initials: JK
authors.lastname: Lee
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: William D
authors.initials: WD
authors.lastname: Leslie
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods / Q000592:standards; D015519:Bone Density; D002138:Calibration; D003951:Diagnostic Errors / Q000517:prevention & control*; D006801:Humans; D010024:Osteoporosis / Q000175:diagnosis*; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000517:prevention & control; D058996:Quality Improvement; D018570:Risk Assessment / Q000379:methods
keywords: Accreditation; DXA; certification; osteoporosis; quality