Description
In this presentation, Foundation Year Two doctor Madeleine Young discusses her research on densitometry discordance in the context of osteoporosis, which affects a significant proportion of the elderly population. Currently, Dual-Energy X-ray Absorptiometry (DXA) is the gold standard for diagnosing osteoporosis, typically measuring bone density at the hip and spine. However, new imaging technologies, particularly Radiofrequency Echographic Multi-Spectrometry (REMS), offer advanced bone density assessment capabilities.
Maddy explains that REMS utilizes ultrasound to provide both traditional images and raw radiofrequency signals, which can be analyzed to yield detailed information about bone density and microarchitecture. She highlights previous studies that suggested REMS demonstrates strong agreement with DXA results, reporting 93-94% concordance in diagnostic findings.
Maddy outlines the concept of discordance, illustrating how discrepancies can arise in T-scores from DXA assessments at different reference sites. Minor and major discordance, as well as numerical discordance (larger than 1 standard deviation differences), indicate potential inaccuracies in assessing bone health, which could lead to misplaced diagnoses and treatment approaches.
Through a retrospective study of 1855 patients who underwent REMS, her team's findings revealed a minor discordance rate of only 15.4% with no instances of major discordance, suggesting 84.6% concordance—significantly better than previously published DXA data. Interestingly, results show that higher BMI correlates with increased rates of discordance.
Maddy concludes that the superior performance of REMS over DXA could be attributed to reduced human error and automated analyses that exclude anomalous readings, enhancing diagnostic accuracy and potentially improving patient outcomes. She invites questions from the audience at the end of her talk.