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Radiology, Vol 192, 845-850, Copyright © 1994 by Radiological Society of North America

ARTICLES

Osteoporosis: diagnosis with lateral and posteroanterior dual x-ray absorptiometry compared with quantitative CT

G Guglielmi, SK Grimston, KC Fischer and R Pacifici
Division of Bone and Mineral Diseases, Washington University School of Medicine, St Louis, MO.

PURPOSE: To compare the diagnostic sensitivity of posteroanterior and lateral dual x-ray absorptiometry (PA-DXA, L-DXA, respectively) and quantitative computed tomography (CT). MATERIALS AND METHODS: Among 108 women undergoing lumbar spine bone mineral density assessment, 66 were healthy (mean age, 52.9 years +/- 1.2 [standard error of mean]) and 42 had osteoporosis (mean age, 66.9 years +/- 1.2). RESULTS: Although both L-DXA and PA-DXA correlated well with quantitative CT (r = .73 and .72, respectively; P < .0001), L-DXA correlated better than PA-DXA with age (r = -.69 and -.50, respectively; P < .0001). Women with osteoporosis showed higher bone loss with quantitative CT (1.33% per year) and L-DXA (0.3% per year) than with PA-DXA (0.07% per year). Logistic regression analysis indicated that quantitative CT and L-DXA but not PA-DXA are significant predictors of osteoporotic fractures. Receiver-operating- characteristic curve analyses showed L-DXA to have a sensitivity and specificity closer to those of quantitative CT than did PA-DXA. CONCLUSION: Performance of L-DXA helped discriminate better than PA-DXA between healthy subjects and those with osteoporosis.


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