qCT vs. DXA for diagnosing osteoporosis



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The gold normal for diagnosing osteoporosis has lengthy been dual-energy X-ray absorptiometry (DXA scan). It's typically referred to as a bone density take a look at or bone mineral density (BMD) take a look at. A DXA measures the amount of bone in no less than two places on the physique, often the decrease backbone and one or each hips. The outcomes of a DXA scan are transformed to a T-score that compares a person’s bone density to that of a median 30-year-old lady. DXA is cheap, it gives worthwhile outcomes, and it delivers a really low dose of radiation.

Not too long ago, nevertheless, a rising variety of sufferers have been getting quantitative computed tomography (QCT) scans to check their bone mineral density (QCT is a way for testing bone; it's distinct from different varieties of computed tomography that you could be be accustomed to.) A current investigative report in MedPage Today (subscription required) reviewed Medicare claims for QCT research of bone density. It discovered there have been 32,694 such claims submitted by suppliers between 2015 and 2019. The quantity elevated every of these years. The article quoted medical doctors who're involved that QCT is much less correct, costlier, and delivers a a lot larger dose of radiation than DXA.

American Bone Well being shares these considerations. Let’s take a look at every of them in additional element.

Accuracy

DXA measures the bone mineral density of each the outer (cortical) shell and the interior (trabecular) construction of the bone. QCT, however, measures solely the interior half. Due to this distinction, QCT research of the backbone present a decrease T-score than a DXA would. Individuals could possibly be identified incorrectly with osteoporosis primarily based on the decrease T-score from a qCT scan. It overstates how a lot bone they've misplaced. They could possibly be prescribed therapies that they don’t want.

For scans of the hip, QCT outcomes are similar to DXA.

There may be one more reason that QCT is much less correct than DXA. For DXA, particular person bone scans are in comparison with a nationwide normal that displays modifications over time within the U.S. inhabitants. Which means there's extra information for evaluating a person’s outcomes with the common U.S. inhabitants. The accuracy of DXA is improved in case you are scanned on the identical machine as your prior scan.

Value

Citing the American Faculty of Radiology and Medicare doctor assets, Medpage At present reported that Medicare pays virtually 3 times extra for QCT in a doctor’s imaging heart than for a DXA. After Medicare reimbursement charges for DXA have been lower in 2007, many physicians stopped providing the service and eliminated the testing machines from their workplaces. This development might need contributed to a reversal of the decline in hip fracture charges, in accordance with a 2017 evaluation of Medicare information.

Radiation

DXA makes use of a low-dose X-ray to scan the bones. The process delivers solely about one-tenth the radiation of a typical chest X-ray. You is perhaps uncovered to extra radiation on a cross-country airline flight. QCT, however, “delivers radiation that is approximately 1,000 to 3,000 times greater than a radiation from a DXA,” MedPage At present reported, citing the American Faculty of Radiology.

What it's best to know

DXA stays the gold normal to check sufferers for osteoporosis. QCT is most frequently used to evaluate bone mineral density for analysis functions. In case your well being care supplier is recommending a QCT as an alternative of a DXA to guage you for osteoporosis, be sure you ask them why they're making that advice.

The U.S. Preventive Providers Process Pressure recommends DXA for all ladies 65 and older, and for girls youthful than 65 who've elevated threat elements for osteoporosis. These threat elements embody having sure medical circumstances, like diabetes, and taking sure medicines, like corticosteroids. The Endocrine Society recommends DXA for all ladies who're in danger for osteoporosis or who've damaged a bone resulting from a low affect. Some specialists really feel it is very important receive a DXA at a youthful age to ascertain your regular baseline bone density.

In case you are a lady youthful than 65, or a person, non-public insurance coverage will cowl a DXA when you have no less than one threat issue. Your well being care supplier would possibly use a device referred to as FRAX to evaluate your threat elements. The American Bone Well being Fracture Danger Calculator™ is designed for customers 45 and older to study their threat elements and their threat of breaking a bone within the subsequent 10 years. Focus on your Fracture Danger Calculator outcomes together with your healthcare supplier, and ask if a DXA is best for you.

Posted: 06/22/2022 
As a service to our readers, American Bone Well being gives entry to our library of archived content material. Please observe the date of the final assessment on all articles. No content material on this website, no matter date, ought to ever be used as an alternative to direct medical recommendation out of your physician or different certified clinician.

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