Vol 5, No 2 (2019)
Review paper
Published online: 2019-06-26
Bone densitometry by radiofrequency echographic multi-spectrometry (REMS) in the diagnosis of osteoporosis
1
, 21
, 21
DOI: 10.5603/FR.2019.0011
Forum Reumatol 2019;5(2):81-88.
Abstract
The paper summarises the present knowledge of the new bone densitometry method called radiofrequency echographic multi-spectrometry (REMS). This ultrasound-based approach enables the evaluation of bone mineral density (BMD) in the hip and the lumbar spine. During REMS densitometry, a fully automatic algorithm performs a series of spectral and statistical analyses involving both echographic images and corresponding “raw” (unfiltered) radiofrequency signals. This provides the identification of the region of interest (ROI) and the calculation of standard densitometric parameters: BMD, T-score and Z-score. Nondiagnostic scans and artifacts are automatically excluded by the algorithm, reducing the risk of false results. A recently published multi-center study has demonstrated high diagnostic sensitivity, specificity and accuracy of this innovative method in the diagnosis of osteoporosis. To the authors’ best knowledge, this is the first Polish paper on REMS densitometry.
Forum Reumatol. 2019, tom 5, nr 2: 81–88
Keywords: osteoporosisbone densityultrasonography
References
- Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. The American Journal of Medicine. 1993; 94(6): 646–650.
- Svedbom A, Ivergård M, Hernlund E, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013; 8: 136.
- Kanis JA, Cooper C, Rizzoli R, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2019; 30(1): 3–44.
- Ensrud KE, Lui LY, Taylor BC, et al. Study of Osteoporotic Fractures Research Group. A comparison of prediction models for fractures in older women: is more better? Arch Intern Med. 2009; 169(22): 2087–2094.
- Hillier TA, Cauley JA, Rizzo JH, et al. WHO absolute fracture risk models (FRAX): do clinical risk factors improve fracture prediction in older women without osteoporosis? J Bone Miner Res. 2011; 26(8): 1774–1782.
- Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996; 312(7041): 1254–1259.
- Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994; 843(6): 1–129.
- Faulkner KG. The tale of the T-score: review and perspective. Osteoporos Int. 2005; 16(4): 347–352.
- Leszczyński P, Mariusz K, Pawlak-Buś K, et al. Diagnostyka i leczenie osteoporozy — zalecenia Polskiego Towarzystwa Reumatologicznego 2015. Forum Reumatol. 2015; 1(1): 12–24.
- Schousboe JT, Shepherd JA, Bilezikian JP, et al. Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom. 2013; 16(4): 455–466.
- Lorente Ramos RM, Azpeitia Armán J, Arévalo Galeano N, et al. Dual energy X-ray absorptimetry: fundamentals, methodology, and clinical applications. Radiologia. 2012; 54(5): 410–423.
- Tatoń G, Rokita E, Korkosz M, et al. The ratio of anterior and posterior vertebral heights reinforces the utility of DXA in assessment of vertebrae strength. Calcif Tissue Int. 2014; 95(2): 112–121.
- Kyriakos G, Vidal-Casariego A, Fernández-Martínez MN, et al. Is vitamin D deficiency being considered in the differential diagnosis of osteoporosis in routine practice? Endocrinol Nutr. 2016; 63(1): 49–50.
- Szafrański T, Kostyk T, Leszczyński P. Interpretation of DXA densitometric and morphometric examinations. Menopausal Review. 2012; 5: 392–395.
- Pisani P, Renna MD, Conversano F, et al. Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques. World J Radiol. 2013; 5(11): 398–410.
- Conversano F, Franchini R, Greco A, et al. A novel ultrasound methodology for estimating spine mineral density. Ultrasound Med Biol. 2015; 41(1): 281–300.
- Casciaro S, Conversano F, Pisani P, et al. New perspectives in echographic diagnosis of osteoporosis on hip and spine. Clin Cases Miner Bone Metab. 2015; 12(2): 142–150.
- https://www.echolightmedical.com (17.05.2019).
- Casciaro S, Peccarisi M, Pisani P, et al. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry. Ultrasound Med Biol. 2016; 42(6): 1337–1356.
- Peccarisi M, Bottai V, Greco A, et al. In-vitro study of human proximal femur microstructure: analysis of the relationship between micro-computed tomography data and quantitative ultrasound parameters. IET Science, Measurement & Technology. 2016; 10(3): 193–199.
- U.S. Food & Drug Administration (2018): Echolight S.p.a. EchoS 510(K) Premarket Notification. https://www.accessdata.fda.gov/cdrh_docs/pdf18/K180516.pdf (17.05.2019).
- Skoog DA, Holler FJ, Crouch SR. An Introduction to Spectrometric Methods. Principles of Instrumental Analysis. Wydanie siódme. Cengage Learning, Boston 2018: 120.
- Di Paola M, Gatti D, Viapiana O, et al. Radiofrequency echographic multispectrometry compared with dual X-ray absorptiometry for osteoporosis diagnosis on lumbar spine and femoral neck. Osteoporos Int. 2019; 30(2): 391–402.
- Muratore M, Conversano F, Pisani P, et al. Accurate assessment of femoral echosound approach performance through DXA error analysis. Ann Rheum Dis. 2017; 76(Suppl2): 1353.
- Casciaro S, Pisani P, Quarta E, et al. Innovative ultrasound approach to estimate spinal mineral density: diagnostic assessment on overweight and obese women. IET Science, Measurement & Technology. 2016; 10(1): 1–9.
