Bone Age in Children as Assessed by Dual-Energy X-Ray and Radiography

First Report from Clinical Osteoporosis 2017:
A Joint Conference of the NOF & ISCD

Use of dual-energy X-ray absorptiometry (DXA) for bone age assessment shows similar results when tested against traditional radiology, according to a study presented at Clinical Osteoporosis 2017: A Joint ISCD/NOF Symposium from April 20 to 22 in Orlando, Florida.

The investigators analyzed radiographic assessments with Norland bone age assessment to compare studies and sensitivities to change in children.

In 1 study, 18 males (aged 12-19 years) and 20 females (aged 12-16 years) underwent radiographic bone age assessment with the GE Discovery XR656 Digital Radiography System and DXA with the Norland XR-800. Regression analysis was used to determine results in the bone age assessment study.

In the sensitivity-to-change study based on the DXA assessment, 34 males aged 6 to 19 years and 37 females aged 6 to 16 years underwent 2 DXA bone assessments with 3 months between studies to account for a possible increase in bone mineral. Participant follow-up results were used to show an increase greater than the least significant change limit: 4.2% for studies with 1.2% precision.

The results showed that the 2 studies had a similar gross response to bone age. The X-ray and DXA assessed bone ages were found to be highly correlated in males (14.5777+0.9287x; r=0.9897; P <.001) and in females (41.2652+0.7619x; r=0.9250; P <.001).

Overall, 17 of the 34 male participants showed increases >4.2%, and 17 male participants showed differences <4.2% in the 2 studies. For the 34 female participants, 15 participants had increases >4.2% and 19 participants showed differences <4.2% in the 2 studies.

“We conclude that Bone Age Assessment Software can be a useful for bone age assessment and can complement traditional radiographic studies when assessment of short-term change in bone age is desired,” the researchers wrote. 

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Sun Y, Wang J, Sanchez T. Bone age assessment by dual energy x-ray absorptiometry. Presented at: Clinical Osteoporosis 2017: A Joint ISCD/NOF Symposium. April 20-22, 2017; Orlando, FL.