Radiographic measurement of bone mineral: reviewing dual energy x-ray absorptiometry.

Features of the three major brands of DEXA equipment available in Australasia have been summarised. Radiation hazard is small with patient effective doses of the order of a few microSieverts. In vivo measurement precision of the order of 1% is achievable for PA scans of the lumbar spine. Lateral scans can achieve measurement precision of the order of 4%. Recent technological developments using X-ray fan beams and multi element detector arrays on C-arm devices have resulted in faster scan times, higher resolution images, and an ability to perform PA and lateral scanning without the need to reposition the patient. Accuracy of DEXA is dependent upon specific instrumentation and data reduction algorithms, but results generally correlate well with ashed bone measurements. Major sources of inaccuracy include inhomogeneous distributions of fat, and machine specific factors such as edge detection algorithms. Lack of absolute inter unit comparability may cause difficulties in clinical practice.