Diagnostic capabilities and monitoring the effectiveness of osteoporosis therapy using radiofrequency echographic multispectrometry in comparison with dual-energy x-ray absorptiometry

Abstract

This study assessed the potential of the radiofrequency echographic multispectrometry (REMS) for diagnosing and monitoring of osteoporosis over a 12-month period in comparison to the most commonly used diagnostic standard – dual-energy x-ray absorptiometry (DXA) in the Russian population. 25 women aged from 49 to 88 years were observed with both imaging methods. Outcomes included lumbar spine and femoral neck bone mineral density (BMD) for each method during two visits. REMS showed moderate diagnostic performance in the present sample. The diagnostic agreement for osteoporosis between DXA and REMS for the two sites was 64% (k = 0.28). Sensitivity and specificity of REMS were 0.63 (0.33 - 0.94 in 0.95 CI) and 0.64 (0.3895 - 0.8894 in 0.95 CI) respectively. However, the comparability of BMD data varied depending on the bone region. Correlation of T-scores for two bone regions between REMS and DXA based on the first visit were 0.65 (P<0.001) and 0.35 (P = 0.089) for lumbar spine and femoral neck respectively. Moreover, Bland–Altman analysis showed poor agreement, with wide agreement limits. Also, collected data revealed a weak correlation for measurements of the second visit within the study, which became statistically insignificant after initiation of antiresorptive therapy. Correlations were 0.47 (P = 0.022) and 0.22 (P = 0.307) for the same two bone regions. REMS demonstrated statistically significant diagnostic value in the diagnosis of osteoporosis, but the comparability and agreement of BMD data with DXA in the sample was near low and varied widely depending on the assessed bone region and decreased even more during active antiresorptive therapy, which may be due to both the limitations of this study and the characteristics of the method. The present results are not sufficiently precise or statistically robust to validate the method for BMD monitoring unequivocally in Russia, but they provide a basis for further research. A follow-up study in a larger sample is required and is already underway to better substantiate these findings in the Russian population.