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  • 1.
    Kälvesten, Johan
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Sectra Imtec AB, Linköping, Sweden.
    Brismar, Torkel B.
    Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Persson, Anders
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping.
    Potential sources of quantification error when retrospectively assessing metacarpal bone loss from historical radiographs by using digital X-ray radiogrammetry: an experimental study2014In: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 17, no 1, p. 104-108Article in journal (Refereed)
    Abstract [en]

    During the past 15 yr, digital X-ray radiogrammetry (DXR) has been used to measure metacarpal bone mineral density (BMD). BMD is often measured in existing cohorts where X-ray images were not acquired in accordance with the DXR imaging protocol (DIP). The purpose of the present study was to analyze how deviations from DIP in historical radiographs may affect the reproducibility of DXR-BMD measurements. Cadaver hand phantoms were used to conduct repeat measurements of deviations from DIP with respect to voltage, exposure, lateral displacement, supination, combination of lateral displacement and supination or rotation, extension of the wrist, and edge enhancement. Direct digital radiography (Aristos; Siemens Healthcare, Erlangen, Germany) was used for image acquisition and dxr-online (Sectra, Linkoping, Sweden) for DXR-BMD measurements. The influence of the tested deviations from DIP ranged from 0 to 32.5 mg/cm(2) (0-6.8%). On repetition with the same specimen, none of the deviations resulted in a within-specimen reproducibility error greater than 2 mg/cm(2) (0.4%, equivalent to a T-score of 0.042). Among the tested deviations, all except tube voltage had a magnitude greater than the normal measurement noise for the technique and must therefore be considered when planning a study based on historical images.

  • 2.
    Löfman, Owe
    et al.
    Linköping University, Faculty of Health Sciences.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences.
    Toss, Göran
    Linköping University, Faculty of Health Sciences.
    Bone mineral density instead of T-score?2001In: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 4, no 1, p. 75-77Article in journal (Refereed)
    Abstract [en]

    No abstract available.

  • 3.
    Löfman, Owe
    et al.
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences. Linköping University, Faculty of Health Sciences.
    Toss, Göran
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Larsson, Lasse
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Bone Mineral Density in Diagnosis of Osteoporosis: Reference Population, Definition of Peak Bone Mass, and Measured Site Determine Prevalence2000In: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 3, no 2, p. 177-186Article in journal (Refereed)
    Abstract [en]

    A population-based study was performed in order to compare different definitions of peak bone mass, and to apply the corresponding T-scores for different skeletal sites to a cohort of 70-yr-old women for studying the prevalence of osteoporosis. Bone mineral density (BMD) of the hip, lumbar spine, and forearm was measured by dual X-ray absorptiometry (Hologic 4500) in 296 women ages 16–31 yr and 210 women age 70 yr. Peak bone mass occurred in women in their early 20s at the proximal femur and at 28 and 31 yr at the spine and forearm, respectively. BMD cutoff levels were compared to machine-specific cutoff values for the different sites. When applied to our cohort of 70-yr-old women, the prevalence of osteoporosis at the total hip was 9–25%, depending on which peak bone mass the T-score of – 2.5 was based. The prevalence in the spine was 28–33% and in the forearm 45–67%. Osteoporosis in at least one of the three measured sites was documented in 49–72% of the population sample. Our results show that the use of T-score to define osteoporosis results in a highly different prevalence rate in a given population depending on the reference population and the skeletal sites chosen for measurement.

  • 4.
    Wilczek, Michael L.
    et al.
    Karolinska University Hospital, Sweden.
    Nielsen, Christel
    Skåne University Hospital, Sweden.
    Kälvesten, Johan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Sectra AB, Linkoping, Sweden.
    Algulin, Jakob
    Sectra AB, Linkoping, Sweden.
    Brismar, Torkel B.
    Karolinska University Hospital, Sweden.
    Mammography and Osteoporosis Screening-Clinical Risk Factors and Their Association With Digital X-Ray Radiogrammetry Bone Mineral Density2015In: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 18, no 1, p. 22-29Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to study the association between digital X-ray radiogrammetry (DXR) T-score and clinical risk factors for osteoporosis. Women were recruited 2 d per wk at a single mammography screening center between year 2010 and 2012. Included women answered a questionnaire about risk factors for osteoporosis, and a radiograph of the nondominant hand was obtained for DXR analysis. Univariate associations between DXR T-score and risk factors were examined. A generalized linear regression model was fitted to independent variables with univariate associations at p less than 0.05. The multivariable model was reduced through manual backward elimination, with p greater than 0.1 as the exclusion criterion. Seventy-six percent of the women chose to participate in the study (n = 8810). The difference in number of daily mammograms performed on study vs nonstudy days was not significant. All univariate associations between DXR T-score and potential risk factors were highly significant. The multivariable model included height, weight, age, right-handedness, menopause before age 45, alcohol consumption, cortisone treatment, rheumatic disease, and age x smoking status. The coefficient of determination of the model was 0.37. The association between risk factors for osteoporosis and DXR T-score is similar to previously reported associations with dual-energy X-ray absorptiometry.

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