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Comparison of Imaging-Guided and Non–Imaging-Guided Quantitative Sonography of the Calcaneus with Dual X-Ray Absorptiometry of the Spine and Femur

¹ Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
² Department of Internal Medicine, Krankenhaus der Barmherzigen Schwestern, A-1060 Vienna, Austria.

OBJECTIVE. The purpose of our study was to evaluate the diagnostic agreement between imaging-guided and non–imaging-guided quantitative sonography of the calcaneus and dual X-ray absorptiometry of the spine and femur to show osteoporosis.

SUBJECTS AND METHODS. In 113 patients (73 women, 59 ± 14 years old; 40 men, 48 ± 16 years old), dual X-ray absorptiometry of the lumbar spine and the proximal femur, imaging-guided quantitative sonography, and non–imaging-guided quantitative sonography of the calcaneus were performed. The percentage of patients having a T-score equal to or less than a threshold of –2.5 SDs (prevalence of osteoporosis) was calculated for each imaging technique. The diagnostic agreement of the three techniques in identifying individuals with osteoporosis was assessed.

RESULTS. Eleven percent of the women and 8% of the men were classified as osteoporotic by imaging-guided quantitative sonography, and 38% of the women and 25% of the men were so classified by non–imaging-guided quantitative sonography. At dual X-ray absorptiometry of the spine, 44% of the women and 38% of the men were classified as osteoporotic, and, at different femoral regions, 19–60% of the women and 8–38% of the men were so classified. Kappa analysis for both quantitative sonography techniques was not significant. Kappa analysis for both quantitative sonography techniques and dual X-ray absorptiometry showed diagnostic agreement to be generally poor.

CONCLUSION. No advantage in diagnostic accuracy could be found for imaging-guided quantitative sonography. The considerable diagnostic disagreement between both quantitative sonography techniques and dual X-ray absorptiometry could be confusing in daily clinical practice.

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				C. R. Krestan, S. Grampp, C. Henk, P. Peloschek, and H. Imhof Limited Diagnostic Agreement of Quantitative Sonography of the Radius and Phalanges with Dual-Energy X-Ray Absorptiometry of the Spine, Femur, and Radius for Diagnosis of Osteoporosis Am. J. Roentgenol., September 1, 2004; 183(3): 639 - 644. [Abstract] [Full Text] [PDF]