title: Advanced Analysis Techniques Improve Infant Bone and Body Composition Measures by Dual-Energy X-Ray Absorptiometry.
abstract: To evaluate a novel technique designed to reduce the negative impact of motion artifacts in infant dual-energy X-ray absorptiometry (DXA) scans.
  
  
  
  Using cross-sectional data from a large multicenter study, we developed and tested advanced methods for infant scan analysis. Newborns (n = 750) received spine and whole-body DXA scans with up to 3 attempts to acquire a motion free scan. Precision of infant DXA was estimated from visits with multiple valid scans. Accuracy of regional reflection, fusion, and omission techniques was estimated by comparing modified scans to unmodified valid scans. The effectiveness of the acquisition and analysis protocol was represented by the reduction in rate of failure to acquire valid results from infant visits.
  
  
  
  For infant whole-body DXA, arm reflection and all fusion techniques caused no significant changes to bone mineral content, bone mineral density, bone area, total mass, fat mass, lean mass, and percentage fat. Leg reflection and arm/leg dual-reflection caused significant changes to total mass, but the percentage change remained small. For infant spine DXA, fusion and omission caused no significant changes. Advanced analysis techniques reduced the failure rate of whole-body scanning from 20.8% to 9.3% and the failure rate of spine scanning from 8.9% to 2.4%.
  
  
  
  Advanced analysis techniques significantly reduced the impact of motion artifacts on infant DXA scans. We suggest this protocol be used in future infant DXA research and clinical practice.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA. Electronic address: John.Shepherd@ucsf.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Sommer
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA.
authors.forename: Bo
authors.initials: B
authors.lastname: Fan
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA.
authors.forename: Cassidy
authors.initials: C
authors.lastname: Powers
authors.affiliation: College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Lynda
authors.initials: L
authors.lastname: Stranix-Chibanda
authors.affiliation: Frontier Science and Technology Research Foundation, Amherst, NY.
authors.forename: Amanda
authors.initials: A
authors.lastname: Zadzilka
authors.affiliation: Frontier Science and Technology Research Foundation, Amherst, NY.
authors.forename: Michael
authors.initials: M
authors.lastname: Basar
authors.affiliation: Frontier Science and Technology Research Foundation, Amherst, NY.
authors.forename: Kathy
authors.initials: K
authors.lastname: George
authors.affiliation: College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Mukwasi-Kahari
authors.affiliation: Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
authors.forename: George
authors.initials: G
authors.lastname: Siberry
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D001823:Body Composition; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015203:Reproducibility of Results
keywords: body composition; bone mineral density; precision