Reporting Fewer Than Four Vertebrae: 2023 Official Positions of the International Society for Clinical Densitometry

Harold Rosen; Adrian Lau; Auryan Szalat; S Bobo Tanner; Diane Krueger; Tyler Prout; Alan Malabanan; Christopher Shuhart

doi:10.1016/j.jocd.2023.101436

Reporting Fewer Than Four Vertebrae: 2023 Official Positions of the International Society for Clinical Densitometry

J Clin Densitom. 2024 Jan-Mar;27(1):101436. doi: 10.1016/j.jocd.2023.101436. Epub 2023 Oct 31.

Authors

Harold Rosen¹, Adrian Lau², Auryan Szalat³, S Bobo Tanner⁴, Diane Krueger⁵, Tyler Prout⁶, Alan Malabanan⁷, Christopher Shuhart⁸

Affiliations

¹ Osteoporosis Prevention and Treatment Center, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, United States. Electronic address: hrosen@bidmc.harvard.edu.
² Division of Endocrinology and Metabolism, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
³ Osteoporosis Center, Internal Medicine Ward, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
⁴ Department of Medicine, Divisions of Rheumatology, Allergy & Immunology, Vanderbilt University Medical Center, Nashville, TN, United States.
⁵ School of Medicine and Public Health, Osteoporosis Clinical Research Program, University of Wisconsin-Madison, Madison, WI, United States.
⁶ Radiology Department, University of Wisconsin, Madison, WI, United States.
⁷ Bone Health Clinic, Boston Medical Center, Boston, MA, United States.
⁸ Bone Health and Osteoporosis Center, Swedish Medical Group, Seattle, WA, United States.

PMID: 37985274
DOI: 10.1016/j.jocd.2023.101436

Abstract

The precision for spine bone mineral density (BMD) worsens as vertebrae are excluded, so recommendations are needed for least significant change (LSC) for spine BMDs based on fewer than 4 vertebrae. The task force recommends re-analysis of each facility's L1-L4 in-house precision study to determine the precision in order to calculate the LSC for each combination of 2 or 3 reported vertebrae. The task force recommended not reporting spine BMDs based on single vertebral bodies for either the diagnosis or monitoring of osteoporosis. Specific data for studies assessing the precision of two non-contiguous vertebrae are mixed, but ultimately the task force recommended that spine BMD based on 2 non-contiguous vertebrae can be used for the diagnosis and monitoring of osteoporosis.

Keywords: Bone mineral density; DXA; Degenerative changes; Least significant changes; Official positions; Reporting; Vertebrae.

Publication types

Review

MeSH terms

Absorptiometry, Photon
Bone Density
Humans
Lumbar Vertebrae* / diagnostic imaging
Osteoporosis* / diagnostic imaging