Oral and Poster Presentation 45th Annual ARA NSW-ACT Branch Meeting 2023

Radiofrequency Echographic Multi Spectrometry (REMS) for the measurement of bone density at the lumbar spine and hip – a “real-life” Australian validation study (#14)

Patrick J Baquir 1 , Peter Wong 1 2 , Christian Girgis 2 3 , David Farlow 2
  1. Rheumatology, Western Sydney Local Health District, Westmead, NSW, Australia
  2. Faculty of Medicine and Health Sciences, Westmead Clinical School, University of Sydney, WESTMEAD, NSW, Australia
  3. Endocrinology, Westmead Hospital, WESTMEAD, NSW, AUSTRALIA

Introduction

Osteoporosis is a major public health issue and is characterised by low bone mineral density (BMD). The current gold standard for measuring BMD is dual energy X-ray absorptiometry (DEXA) which uses ionising radiation. An alternative imaging modality – radiofrequency echographic multi-spectrometry (REMS) – uses ultrasound to measure BMD at the lumbar spine and femoral neck and calculates a T-score based on the National Health and Nutrition Examination Survey (NHANES) database. The benefit of REMS includes no ionising radiation and greater portability, providing the potential for a ‘point-of-care’ tool. Most studies assessing the use of REMS have enrolled relatively thin females. There have been no studies assessing the use of REMS in the Australian population, nor in males.

Aim

This study will assess the use of REMS compared to DEXA to assess BMD in a “real life” Australian population of males and female.

Methods

This single centre study will recruit participants from patients who have had a DEXA scan at Westmead Hospital in the previous three months from obtaining project approval from the WSLHD Human Research Ethics Committee (approval pending). We will then prospectively recruit over the next 2-years, aiming for a total of 200 patients. REMS scans of the lumbar vertebrae (L1-4) and femoral neck will be performed using an EchoStation Ultrasound Device (Echolight Spa, Lecce, Italy). Longitudinal images of the lumbar vertebrae and femoral neck will be captured and BMD calculated using EchoLight software. Anteroposterior DEXA scans will be performed according to standard clinical procedures as per International Society for Clinical Densitometry (ISCD) Guidelines.

Statistical analysis

Patient characteristics will be summarised as mean standard deviation (SD), or median and interquartile range (IQR), as appropriate. A scatterplot of BMD values calculated using REMS versus those based on DXA will be produced with a line of equality and markers varying by sex and BMI group. Pearson’s coefficient (r) between REMS and DXA measurements will be calculated for all subjects and separately by sex and BMI group. Estimates of the mean within subject difference (bias) between REMS and DXA together with 95% limits of agreement will be calculated and Bland-Altman plots used to illustrate the extent of agreement.

Results

Pending.

Discussion/Conclusion

Pending

Funding

REMS machine provided by EchoLight.