Prospective comparative study of quantitative X-ray (QXR) versus dual energy X-ray absorptiometry to determine the performance of QXR as a predictor of bone health for adult patients in secondary care.

Autor:	Rangan A; Trauma and Orthopaedics, The James Cook University Hospital, Middlesbrough, UK amar.rangan@york.ac.uk.; Department of Health Sciences, University of York, York, UK., Tuck SP; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK., Scott PD; IBEX Innovations, Sedgefield, UK., Kottam L; Department of Orthopaedics, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK., Jafari M; Radiology, South Tees Hospitals NHS Foundation Trust, Middlesbrough, Middlesbrough, UK., Watson T; Nuclear Medicine and Bone Mineral Assessment, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Newcastle upon Tyne, UK., Lopez B; IBEX Innovations, Sedgefield, UK., Crone B; IBEX Innovations, Sedgefield, UK., Whitbread T; IBEX Innovations, Sedgefield, UK., Ratcliffe A; IBEX Innovations, Sedgefield, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Dec 24; Vol. 11 (12), pp. e051021. Date of Electronic Publication: 2021 Dec 24.
DOI:	10.1136/bmjopen-2021-051021
Abstrakt:	Objectives: To evaluate a method of quantitative X-ray (QXR) for obtaining bone health information from standard radiographs aimed at identifying early signs of osteoporosis to enable improved referral and treatment. This QXR measurement is performed by postexposure analysis of standard radiographs, meaning bone health data can be acquired opportunistically, alongside routine imaging. Design: The relationship between QXR and dual energy X-ray absorptiometry (DEXA) was demonstrated with a phantom study. A prospective clinical study was conducted to establish areal bone mineral density (aBMD) prediction model and a risk prediction model of a non-normal DEXA outcome. This was then extrapolated to a larger patient group with DEXA referral data. Setting: Secondary care National Health Service Hospital. Participants: 126 consenting adult patients from a DEXA clinic. Interventions: All participants underwent a DEXA scan to determine BMD at the lumbar spine (L2-L4) and both hips. An additional Antero-Posterior pelvis X-ray on a Siemens Ysio, fixed digital radiograph system was performed for the study. Outcome: Performance of QXR as a risk predictor for non-normal (osteoporotic) BMD. Results: Interim clinical study data from 78 patients confirmed a receiver operator curve (area under the ROC curve) of 0.893 (95% CI 0.843 to 0.942) for a risk prediction model of non-normal DEXA outcome. Extrapolation of these results to a larger patient group of 11 029 patients indicated a positive predictive value of 0.98 (sensitivity of 0.8) for a population of patients referred to DEXA under current clinical referral criteria. Conclusions: This study confirms that the novel QXR method provides accurate prediction of a DEXA outcome. Trial Registration Number: ISRCTN98160454; Pre-results. Competing Interests: Competing interests: The coauthors on this paper from IBEX Innovations hold the intellectual property rights over the QXR technology and have a vested interest in the adoption of this technology into clinical practice. The lead author (AR) holds grants from NIHR, ORUK and DePuy J&J Ltd unrelated to this study. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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