Elsevier

Journal of Clinical Densitometry

Volume 16, Issue 4, October–December 2013, Pages 520-536
Journal of Clinical Densitometry

2013 Position Development Conference on Bone Densitometry
The Official Positions of the International Society for Clinical Densitometry: Acquisition of Dual-Energy X-Ray Absorptiometry Body Composition and Considerations Regarding Analysis and Repeatability of Measures

https://doi.org/10.1016/j.jocd.2013.08.007Get rights and content

Abstract

In preparation for the International Society for Clinical Densitometry Position Development Conference of 2013 in Tampa, Florida, Task Force 2 was created as 1 of 3 task forces in the area of body composition assessment by dual-energy X-ray absorptiometry (DXA). The assignment was to review the literature, summarize the relevant findings, and formulate positions covering (1) accuracy and precision assessment, (2) acquisition of DXA body composition measures in patients, and (3) considerations regarding analysis and repeatability of measures. There were 6 primary questions proposed to the task force by the International Society for Clinical Densitometry board and expert panel. Based on a series of systematic reviews, 14 new positions were developed, which are intended to augment and define good clinical practice in quantitative assessment of body composition by DXA.

Section snippets

Background

Task Force 2 was charged with the research and analysis of the published literature covering questions related to the performance and calibration of the dual-energy X-ray absorptiometry (DXA) systems in relationship to body composition measurements. A total of 8 literature searches were performed in PubMed, with major key words related to DXA whole-body phantoms, fat tissue accuracy and precision, lean tissue accuracy and precision, region definition and analysis procedures, artifacts, and

Questions

  • What phantoms and procedures should be used for quality control (QC) monitoring and cross-calibration for whole-body outcomes?

    • What phantoms should be used to assure a DXA system is working within specifications and with stable calibration over time?

    • How can measures be cross-calibrated between systems from different manufacturers?

    • How to cross-calibrate measures between systems of the same manufacturer?

  • How should the accuracy of percent fat, fat mass, and lean mass be ascertained in the clinical

Questions

  • What is the optimal way to prepare and position a patient for whole body scans?

    • How should the hands, arms, legs, and feet be positioned?

    • How should very obese or patients that do not fit within the scan limits be positioned?

Questions

  • How should whole body scans be analyzed?

    • How should arms, legs, and head be sectioned from the trunk?

    • If observed in the scan at the time of analysis, how should removable artifacts be addressed?

    • If observed in the scan at the time of analysis, how should nonremovable artifacts be addressed?

  • How should precision be assessed for body composition measures?

  • What is the minimum precision acceptable for a DXA site?

    • What is the minimum precision for fat tissue assessment?

    • What is the minimum precision for

Acknowledgments

We appreciate the comments received from representatives of instrument manufacturers, including Kevin Wilson, Tom Sanchez, and David Ergun.

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