Cross calibration between two dual energy X-ray absorptiometry systems: Horizon A and Discovery A

Authors

  • Sasivimol Promma
  • Sasithorn Amnuaywattakorn
  • Tanawat Tawonwong
  • Suchawadee Musikarat
  • Ratanaporn Toengkhuntod
  • Saowanee Wipuchwongsakorn

Keywords:

DXA, cross calibration, precision, GLSC

Abstract

Background: When the department installed the new dual energy X-ray absorptiometry (DXA) system, cross calibration as the international society for clinical densitometry (ISCD) recommendation has to be implemented. The generalized least significant change (GLSC) and percentage of generalized least significant change (%GLSC) value must be determined for comparing the bone mineral density (BMD) values between 2 systems.

Objective: To determine the generalized least significant change (GLSC) and %GLSC values and compare the BMD relationship between Hologic Horizon A and Discovery A through the cross calibration.

Methods: Thirty women subjects (56 - 67 years) were scanned at the lumbar spine and femur on both systems. The linear regression and Bland-Altman analysis were used to reveal the relationship and agreement. The least significant change (LSC) was calculated on the individually DXA system and for cross-calibration between the two systems, the GLSC and %GLSC were presented.

Results: The relationship was highly correlated in BMD. Bland-Altman analysis presented good agreement. The LSC values in lumbar spine, femoral neck, and total femur were 1.6%, 2.8% and 1.2% for Horizon A and 2.1%, 2.6% and 1.8% for Discovery A, respectively. The LSC of both systems in all sites were within the minimum acceptable precision according to the recommendation from ISCD. The GLSC and %GLSC values between two systems in lumbar spine, femoral neck, and total femur were 0.015 g/cm2 and 1.8%, 0.017 g/cm2 and 2.6%, and 0.013 g/cm2 and 1.6%, respectively.

Conclusion: The stated GLSC from two different systems could be used to interpret the true change of the BMD, when the magnitude of the difference of BMD between systems is greater than the GLSC value.

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References

World Health Organization. WHO scientific group on the assessment of osteoporosis at primary health care level [Internet]. 2004 [cited 2021 May 10]. Available from: https://www.who.int/chp/topics/Osteoporosis.pdf.

Morgan SL, Prater GL. Quality in dual-energy X-ray absorptiometry scans. Bone 2017;104:13-28.

https://doi.org/10.1016/j.bone.2017.01.033

Reitshamer E, Barrett K, Shea K, Dawson-Hughes B. Cross-calibration of prodigy and Horizon A densitometers and precision of the Horizon A densitometer. J Clin Densitom 2021;24:474-80.

https://doi.org/10.1016/j.jocd.2021.02.003

Lewiecki EM, Binkley N, Morgan SL, Shuhart CR, Camargos BM, Carey JJ, et al. Best practices for dual-energy X-ray absorptiometry measurement and reporting: International society for clinical densitometry guidance. J Clin Densitom 2016;19:127-40. https://doi.org/10.1016/j.jocd.2016.03.003

Shepherd JA, Lu Y. A generalized least significant change for individuals measured on different DXA systems. J Clin Densitom 2007;10:249-58. https://doi.org/10.1016/j.jocd.2007.05.002

Saarelainen J, Hakulinen M, Rikkonen T, Kröger H, Tuppurainen M, Koivumaa-Honkanen H, et al. Cross-calibration of GE healthcare lunar prodigy and iDXA dual-energy X-Ray densitometers for bone mineral measurements. J Osteoporos 2016;2016: 1424582. https://doi.org/10.1155/2016/1424582

Hologic I. MAN-03283 "QDR technical reference. Bedford, MA2016.

Kevin E. Wilson TLK. Horizon™ DXA System: Technical and clinical advantages [Internet]. 2013 [cited 2021 Jun 15]. Available from: https://hologiced. com/library/horizon-dxa-system-technical-andclinical-advantages/.

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10. https://doi.org/10.1016/S0140-6736(86)90837-8

Kim HS, Yang SO. Quality control of DXA system and precision test of radio-technologists. J Bone Metab 2014;21:2-7. https://doi.org/10.11005/jbm.2014.21.1.2

Rosner B, Glynn RJ, Lee ML. The Wilcoxon signed rank test for paired comparisons of clustered data. Biometrics 2006;62:185-92. https://doi.org/10.1111/j.1541-0420.2005.00389.x

ISCD. ISCD DXA machine cross calibration tool. [Internet]. 2021 [cited 2021 Jul 15]. Available from: https://iscd.org/learn/resources/calculators/.

ISCD. 2019 ISCD Official Positions Adults [Internet]. 2019 [cited 2021 Aug 8]. Available from: https://iscd. org/learn/official-positions/adult-positions/.

Whittaker LG, McNamara EA, Vath S, Shaw E, Malabanan AO, Parker RA, et al. Direct comparison of the precision of the new hologic horizon model with the old discovery model. J Clin Densitom 2018;21:524-8. https://doi.org/10.1016/j.jocd.2017.11.001

McNamara EA, Kilim HP, Malabanan AO, Whittaker LG, Rosen HN. Enhanced precision of the new hologic horizon model compared with the old discovery model is less evident when fewer vertebrae are included in the analysis. J Clin Densitom 2018;21:125-9. https://doi.org/10.1016/j.jocd.2016.06.003

Jankowski L, Mayers A. Long term stability of hologic horizon-a bone densitometer. J Clin Densitom 2015;18:430. https://doi.org/10.1016/j.jocd.2015.05.024

El Maghraoui A, Roux C. DXA scanning in clinical practice. QJM 2008;101:605-17.

https://doi.org/10.1093/qjmed/hcn022

Krueger D, Vallarta-Ast N, Libber J, Gangnon R, Binkley N. Does the precision of dual-energy X-ray absorptiometry for bone mineral density differ by sex? J Clin Densitom 2014;17:505-9.

https://doi.org/10.1016/j.jocd.2013.07.003

Shuhart CR, Yeap SS, Anderson PA, Jankowski LG, Lewiecki EM, Morse LR, et al. Executive summary of the 2019 ISCD position development conference on monitoring treatment, DXA cross-calibration and least significant change, spinal cord injury, peri-prosthetic and orthopedic bone health, transgender medicine, and pediatrics. J Clin Densitom 2019;22:453-71. https://doi.org/10.1016/j.jocd.2019.07.001

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Published

2023-07-17

How to Cite

1.
Promma S, Amnuaywattakorn S, Tawonwong T, Musikarat S, Toengkhuntod R, Wipuchwongsakorn S. Cross calibration between two dual energy X-ray absorptiometry systems: Horizon A and Discovery A. Chula Med J [Internet]. 2023 Jul. 17 [cited 2024 Oct. 8];66(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/67