• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.384-389
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• 2013

Objective : Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. Methods : A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. Results : The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. Conclusion : The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

• Journal of the Korean Society of Radiology
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• v.14 no.1
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• pp.31-37
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• 2020

This study was conducted to examine the kinds and the frequency of incorrect outcomes occurring depending examiners' skills, in testing osteoporosis by using Dual Energy X-ray Absorptiometry(DXA) and improve frequently occurring errors by educating them. The results of an analysis show that the outcomes from the test of hips in patients with wrong postures or some regions with pressure fracture and degenerative changes were often included, even though they should be excluded, and that surgical instruments were also included in the analysis, though they should be excluded from resulting values. Of them, the errors most often found were those about patients' postures (n=56, 6 cases for spines and 50 cases for hips), followed by those about analytical processes (n=37, 35 cases for spines and 2 cases for hips), and then those about regions of interest (n=33, 28 cases for spines and 5 cases for hips). There were, however, no errors caused by the defectiveness of quality control.

• Journal of radiological science and technology
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• v.23 no.2
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• pp.13-19
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• 2000

There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and Febuary in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry(DEXA). The result was compared using age matched paired T test. The results were as follows ; 1. The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. 2. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. 3. The bone density of neck, Ward's triangle, trochanter(P<0.05) and lumbar spine(P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. 4. The bone density of neck, Ward's triangle, trochanter(P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. 5. The bone density of neck, Ward's triangle, trochanter and lumbar spine(P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities(BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.1
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• pp.188-201
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• 2006

Purpose : This study was conducted to investigate the effect of pregnancy and parity on bone marrow density using Dual Energy X-ray Absorptiometry (DXA) after parturition Methods : The observation cases who was over 20 and under 35 years old just after childbirth were admitted twice to woosuk university hospital from Aug 2000 to July 2005. During the first admission period, we measured the bone marrow density(BMD) using DXA in 13th day, and when the patient came to the hospital just after childbirth again, we followed up the BMD in 13th day. The evaluation index of this report was comparison of the T-score which was about the lumbar spine(L1-L4) BMD and femur neck BMD. Results : The continuous parturition was increased the lumbar spine BMD(P<<0.05), and decreased the femur neck BMD but it had no meaning. In the cases of the parturition interval under 24 months regarded as siblings born within a year of each other, the analysis results of BMD showed increase in lumbar spine BMD. In the cases of the parturition interval over 24 months, there was increased in lumbar BMD, and decreased in femur neck BMD. To the analysis of the weight variation, the increased BMI group has a significant increase in lumbar spine BMD, and the decreased BMI group also increase in lumbar spine BMD but there was no meaning about that. Conclusion : The continuous parturition was increased the lumbar spine BMD.

• Nutrition Research and Practice
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• v.15 no.1
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• pp.95-105
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• 2021

BACKGROUND/OBJECTIVES: The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS: A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008-2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland-Altman plot and intraclass correlation coefficient (ICC). RESULTS: The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS: All equations had low bias, moderate agreement based on the Bland-Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.422-424
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• 2002

The accuracy of DXA(Dual Energy X-ray Absorptiometry) highly depends on the detection and separation capability of dual energy X-ray X-ray photons. In addition both of scan time and patient exposure are affected by detection efficiency. A CZT detector with a good energy resolution and high detection efficiency was evaluated for the application of bone densitometry. Its performance was compared to a photomultiplier tube with a NaI(T1) scintillator in terms of energy resolution, detection efficiency and the accuracy of bone mineral density measurement. The comparison study was performed with CZT detector and PM tube using DXA equipments(OSTEO Plus, OSTEO Prima, ISOL Technology). The energy spectrum was acquired using MCA(Multi-Channel Analyzer). The used X-ray energy ranged from 20keV to 86keV. The MCA result of the CZT detector showed a slightly sharper energy spectrum than that of NaI(T1). Detection efficiency of the CZT detector at 59.5keV was 1.4 times better. Remarkably the final results of bone mineral density measurements demonstrate only less than 1% difference. The CZT detector appears to have many benefits for the application of bone densitometry. Its excellent energy resolution can enhance the counting accuracy of dual energy X-ray spectrum. Furthermore its compactness in physical dimension and no cooling requirement will be additional benefits for a more compact and accurate bone densitometer.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.311-316
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• 2017

Generally assessing bone mineral density (BMD) were performed on dual energy X-ray absorptiometry (DEXA) the same as dual energy CT (DECT) with a rapid-kVp switching. The purpose of this study is to compare the different of BMD value between DEXA and DECT method, and evaluate usefulness of DECT method. Using scanner for BMD measurements were GE, Healthcare Discovery 750 HD for DECT and Hologic QDR 4500W for DEXA. For compare BMD value in each method, scanned lumbar spine phantom and subjects visiting Korean National Cancer Center from April 2015 to December 2015, records of 50 patients. This study was approved by the Institutional Review Board. The mean BMD value measures for spine phantom and for subjects in each scanners presented strong correlation (r=0.948 with p<0.05 for phantom; r=0.635 with p<0.05 and Kendall's tau $({\tau})=0.46$ with p<0.05 for subjects) and linear relationship between DECT and conventional DEXA. DECT technique for BMD measurement will provide a very useful methodology without additional radiation dose.

• Korean Journal of Community Nutrition
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• v.23 no.5
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• pp.424-430
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• 2018

Objectives: The purpose of this study was to compare predictions and measurements of the resting energy expenditure (REE) of overweight and obese adult women in Korea. Methods: The subjects included 65 overweight or obese adult women ranging in age from 20~60 with a recorded body mass index (BMI) of 23 or higher. Their height, weight, waist-hip ratio, and blood pressure were measured. The investigator also measured their body fat, body fat percentage, and body composition of total weight without fat using Dual energy X-ray absorptiometry (DXA) and measured resting energy expenditure by indirect calorimetry. Measured resting energy expenditures were compared with predictions from six methods: Harris-Benedict, Mifflin, Owen, WHO-WH, Henry-WH, and KDRI. Results: Harris-Benedict predictions showed the smallest differences from measured resting energy expenditure at an accurate prediction rate of 70%. The study analyzed regression between measured resting energy expenditure and body measurements including height, weight and age. The formula proposed by this research is as follows: Proposed REE equation for overweight and obese Korean women = $721-(1.5{\times}age)+(0.4{\times}height)+(9.9{\times}weight)$. Conclusions: These findings suggest that age is a significant variable when predicting resting energy expenditure in overweight and obese women. Therefore, prediction of resting energy expenditure should consider age when determining energy requirements in overweight and obese women.

• Journal of Korea Multimedia Society
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• v.12 no.9
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• pp.1233-1241
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• 2009

Over the 50 percents of women who are older than 45 years have osteoporosis. Because people hardly recognize this disease by themselves, the researches that measure bone mineral density have been doing widely to detect osteoporosis in the early stage. The most widely used methods for bone mineral density measurement are based on the X-ray imaging. Among them, DEXA(Dual-energy X-ray Absorptiometry) imaging is one of the important methods in bone mineral density measurement. DEXA images are useful methods to increase diagnosis efficiency by reducing anatomic noise as two images obtained from two different energy levels. However, it has some problems to a calibration parameter determined by the heuristic method for bone extraction. In this paper, we propose the method to extract bone in DEXA image using calibration parameter based on anatomic attenuation coefficient. The experimental results reveal that the proposed method is effective.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.53-60
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• 2022

Purpose: The aim of this study was to compare the fractal dimension (FD) measured at 2 bone sites (second cervical vertebra and mandible) on cone-beam computed tomography (CBCT). The research question was whether FD could serve as an accessory tool to refer postmenopausal women for densitometric analysis. Therefore, the reliability and accuracy of FD were evaluated. Materials and Methods: In total, 103 postmenopausal women were evaluated, of whom 52 had normal bone mineral density and 51 had osteoporosis, according to dual X-ray absorptiometry of the lumbar spine and hip. On the CBCT scans, 2 regions of interest were selected for FD analysis: 1 at the second cervical vertebra and 1 located at the mandible. The correlations between both measurements, intra- and inter-observer agreement, and the accuracy of the measurements were calculated. A P value less than 0.05 was considered to indicate statistical significance for all tests. Results: The mean FD values were significantly lower at the mandibular region of interest in osteoporotic patients than in individuals with normal bone mineral density. The areas under the curve were 0.644 (P=0.008) and 0.531 (P=0.720) for the mandibular and vertebral sites, respectively. Conclusion: FD at the vertebral site could not be used as an adjuvant tool to refer women for osteoporosis investigation. Although FD differed between women with normal BMD and osteoporosis at the mandibular site, it demonstrated low accuracy and reliability.