Comparative study of the results of radiofrequency echographic multispectrometry and dual-energy X-ray absorptiometry in determining bone mineral density

BACKGROUND: Osteoporosis is a systemic metabolic skeletal disease characterized by decreased bone mass and impaired bone microarchitecture, leading to bone fragility and low-trauma fractures. Osteoporotic fractures represent a significant public health concern in the Russian Federation, reducing patients' quality of life and being associated with disability and high mortality. Timely diagnosis of a high fracture risk is crucial in the management of osteoporosis.

AIM: To investigate the comparability of the results from dual-energy X-ray absorptiometry (DXA) and radiofrequency echographic multi-spectrometry (REMS) in assessing bone status in postmenopausal women.

METHODS: A cross-sectional study was conducted on the basis of the Clinical Rheumatology Hospital No. 25 named after V.A. Nasonova and the North-Western State Medical University named after I.I. Mechnikov. DXA of the lumbar spine (L1–L4) and proximal femur (femoral neck and total hip) was performed using a Lunar Prodigy Advance machine (USA). REMS was carried out using a specialized echographic device EchoStation (Echolight Spa, Italy).

RESULTS: The study included 50 women with postmenopausal osteoporosis, the median age was 73.0 [48.0; 77.0] years. The mean T-score values for the spine and femoral neck assessed by DXA and REMS were comparable and amounted to: –2.4 standard deviations (95% confidence interval from –2.7 to –1.8) versus –2.2 standard deviations (95% confidence interval from –2.7 to –2.0) and –0.045 ± 0.084 g/cm² (95% CI from –0.069 to –0.021) versus –0.210 ± 0.084 g/cm² (95% CI from –0.233 to –0.186), respectively. When assessing the correlation between REMS and DXA in the spine, a high positive correlation was found between the T-scores of REMS and DXA (r = 0.769; high strength of association according to the Chaddock scale; p < 0.001). A high positive correlation was also found between the T-scores of REMS and DXA for the femoral neck (r = 0.873; high strength of association according to the Chaddock scale; p < 0.001). When evaluating the DXA and REMS results using the Bland-Altman method, a sufficiently high degree of comparability of the two methods was found, although a small proportional bias was observed in both areas. REMS on average showed higher bone mineral density values than those with DXA.

CONCLUSION: The results of REMS and DXA are comparable, which allows their use for the diagnosis of osteoporosis.