Dataset Information

Does a spinal implant alter dual energy X-ray absorptiometry body composition measurements?

ABSTRACT:

Background

Most manufacturer manuals do not verify the use of dual energy X-ray absorptiometry for body composition analysis in subjects with a metal implant. This study aimed to quantify the effects of a spinal implant on body composition, and to determine whether unadjusted lean mass estimates are valid for patients with a spinal implant.

Methods

A total of 30 healthy subjects were recruited. Three consecutive scans were performed for each participant, one with and two without extraneous spinal implant, without repositioning between scans. Lean, fat and bone estimates in the total body, trunk and limb were measured.

Results

Precision errors for all total and regional body compositions were within the recommended ranges. Bone masses in the trunk and total body were significantly increased with spinal implant, and the increases exceeded the least significant change. For total and regional lean and fat estimates, the measurements between subjects with and without metal implants were in substantial to almost perfect agreement and the differences were not significant and did not exceed the least significant change.

Conclusions

Spinal metal artifacts significantly increased the total body and trunk bone mass but the differences in lean- and fat-related estimates at total and regional body levels and all estimates in the extremity remained within the clinical acceptable range. Thus, a spinal implant may not compromise screening of patients for fat and lean masses using dual energy X-ray absorptiometry. Application of image reconstruction or a filtering algorithm may help reduce the effect of metallic artifacts and further study is needed.

SUBMITTER: Hsiao PL

PROVIDER: S-EPMC6752773 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Does a spinal implant alter dual energy X-ray absorptiometry body composition measurements?

Hsiao Pei-Lin PL Hsu Shu-Feng SF Chen Po-Han PH Tsai Hsiao-Wei HW Lu Hsin-Ying HY Wang Yue-Sheng YS Lee Li-Wen LW

PloS one 20190919 9

<h4>Background</h4>Most manufacturer manuals do not verify the use of dual energy X-ray absorptiometry for body composition analysis in subjects with a metal implant. This study aimed to quantify the effects of a spinal implant on body composition, and to determine whether unadjusted lean mass estimates are valid for patients with a spinal implant.<h4>Methods</h4>A total of 30 healthy subjects were recruited. Three consecutive scans were performed for each participant, one with and two without e ...[more]

PMID: 31536597

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Project description:BackgroundReference ranges for lean mass (LM) and fat mass (FM) are essential in identifying soft tissue disorders; however, no such reference ranges exist for the most commonly used Hologic dual-energy X-ray absorptiometry (DXA) machine in Australia.MethodsCross-sectional study of community-dwelling adults (aged 18-88 years) who underwent a Hologic DXA scan at one of three commercialized densitometry centres in Australia. Age-specific and sex-specific percentile curves were generated for LM [LM, appendicular lean mass (ALM), ALM adjusted for height squared (ALM/h2 ), and ALM adjusted for body mass index (ALM/BMI)] and FM [FM, FM adjusted for height squared (FM/h2 ), appendicular fat mass, and android and gynoid fat] parameters using the LMS statistical method. Cutpoints equivalent to T-scores of -1, -2, and -2.5 standard deviations below the young mean reference group (20-29 years) were also generated for LM parameters.ResultsA total of 15 479 community-dwelling adults (54% men) with a median age of 33 years (interquartile range: 28, 42) were included. LM, ALM, and ALM/h2 remained stable until age 50, after which these parameters started to decline in both sexes. Compared with age 50, median percentiles of LM, ALM, and ALM/h2 declined by -5.9 kg, -3.7 kg, and -0.86 kg/m2 in men and by -2.5 kg, -1.8 kg, and -0.10 kg/m2 in women at age 70, respectively. Adjusting ALM for BMI (rather than height squared) resulted in different trends, with ALM/BMI decreasing from as early as age 20. Compared with age 20, median percentiles of ALM/BMI at age 40 declined by -0.10 kg/kg/m2 in men and by -0.06 kg/kg/m2 in women; and at age 70, ALM/BMI declined by -0.25 kg/kg/m2 in men and by -0.20 kg/kg/m2 in women. Cutpoints equivalent to T-scores of -1, -2, and -2.5 standard deviations for ALM/BMI were 1.01, 0.86, and 0.77 kg/kg/m2 in men and 0.70, 0.59, and 0.53 kg/kg/m2 in women, respectively. All FM parameters progressively increased from age 20 and continued up until age 70.ConclusionsWe developed reference ranges for LM and FM parameters from Hologic DXA machines in a large cohort of Australian adults, which will assist researchers and clinicians in identifying soft tissue disorders such as obesity, sarcopenia, and cachexia.

Project description:Background:The 4-component (4C) model is a criterion method for human body composition that separates the body into fat, water, mineral, and protein, but requires 4 measurements with significant cost and time requirements that preclude wide clinical use. A simplified model integrating only 2 measurements-dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA)-and 10 min of patient time has been proposed. Objective:We aimed to validate a rapid, simplified 4C DXA + BIA body composition model in a clinical population. Design:This was a cross-sectional observational study of 31 healthy adults. Participants underwent whole-body DXA, segmental BIA, air displacement plethysmography (ADP), and total body water (TBW) measurement by deuterium (D2O) dilution. 4C composition was calculated through the use of the Lohman model [DXA mineral mass, D2O TBW, ADP body volume (BV), scale weight] and the simplified model (DXA mineral mass and BV, BIA TBW, scale weight). Accuracy of percentage of fat (%Fat) and protein measurements was assessed via linear regression. Test-retest precision was calculated with the use of duplicate DXA and BIA measurements. Results:Of 31 participants, 23 were included in the analysis. TBWBIA showed good test-retest precision (%CV = 5.2 raw; 1.1 after outlier removal) and high accuracy to TBWD2O [TBWD2O = 0.956*TBWBIA, R2= 0.92, root mean squared error (RMSE) = 2.2 kg]. %Fat estimates from DXA, ADP, D2O, and BIA all showed high correlation with the Lohman model. However, only the 4C simplified model provides high accuracy for both %Fat (R2 = 0.96, RMSE = 2.33) and protein mass (R2= 0.76, RMSE = 1.8 kg). %Fat precision from 4C DXA + BIA was comparable with DXA (root mean square-SD = 0.8 and 0.6 percentage units, respectively). Conclusions:This work validates a simplified 4C method that measures fat, water, mineral, and protein in a 10-min clinic visit. This model has broad clinical application to monitor many conditions including over/dehydration, malnutrition, obesity, sarcopenia, and cachexia.

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Dataset Information

Does a spinal implant alter dual energy X-ray absorptiometry body composition measurements?

Background

Methods

Results

Conclusions

Publications

Does a spinal implant alter dual energy X-ray absorptiometry body composition measurements?

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