Clinical Use of Quantitative Computed Tomography and Peripheral Quantitative Computed Tomography in the Management of Osteoporosis in Adults: The 2007 ISCD Official Positions

Engelke, Klaus; Adams, Judith E.; Armbrecht, Gabriele; Augat, Peter; Bogado, Cesar E.; Bouxsein, Mary L.; Felsenberg, Dieter; Ito, Masako; Prevrhal, Sven; Hans, Didier B.; Lewiecki, E. Michael

doi:10.1016/j.jocd.2007.12.010

« Previous Next »Journal of Clinical Densitometry
Volume 11, Issue 1 , Pages 123-162, January 2008

Clinical Use of Quantitative Computed Tomography and Peripheral Quantitative Computed Tomography in the Management of Osteoporosis in Adults: The 2007 ISCD Official Positions

Klaus Engelke
- Institute of Medical Physics, University of Erlangen, Germany
- Synarc, Hamburg, Germany
- Task Force Chair.
- Address correspondence to: Klaus Engelke, PhD, Institute of Medical Physics, University of Erlangen, Henkestr 91, D 91052 Erlangen, Germany.
Judith E. Adams
- Department of Clinical Radiology, Division of Imaging Science and Biomedical Engineering, University of Manchester, UK
- Task Force Member.
Gabriele Armbrecht
- Center of Muscle and Bone Research, Charite—University Medicine Berlin, Germany
- Task Force Member.
Peter Augat
- Biomechanics Research Laboratory, Trauma Center, Murnau, Germany
- Task Force Member.
Cesar E. Bogado
- Department of Clinical Research, Instituto de Investigaciones Metabolicas, Buenos Aires, Argentina
- Task Force Member.
Mary L. Bouxsein
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Task Force Member.
Dieter Felsenberg
- Department of Radiology, Charite—University Medicine Berlin, Germany
- Task Force Member.
Masako Ito
- Division of Radiology, Nagasaki University Hospital, Nagasaki, Japan
- Task Force Member.
Sven Prevrhal
- Department of Radiology, University of California, San Francisco, CA, USA
- Task Force Member.
Didier B. Hans
- Division of Nuclear Medicine, Geneva University Hospital, Switzerland
- Task Force Liaison.
E. Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
- Task Force Liaison.

Received 5 December 2007; accepted 5 December 2007.

Abstract

The International Society for Clinical Densitometry (ISCD) has developed Official Positions for the clinical use of dual-energy X-ray absorptiometry (DXA) and non-DXA technologies. While only DXA can be used for diagnostic classification according to criteria established by the World Health Organization, DXA and some other technologies may predict fracture risk and be used to monitor skeletal changes over time. ISCD task forces reviewed the evidence for clinical applications of non-DXA techniques and presented reports with recommendations at the 2007 ISCD Position Development Conference. Here we present the ISCD Official Positions for quantitative computed tomography (QCT) and peripheral QCT (pQCT), with supporting medical evidence, rationale, controversy, and suggestions for further study. QCT is available for bone mineral density measurements at the spine, hip, forearm, and tibia. The ISCD Official Positions presented here focus on QCT of the spine and pQCT of the forearm. Measurements at the hip may have clinical relevance, as this is an important fracture site; however, due to limited medical evidence, definitive advice on its use in clinical practice cannot be provided until more data emerge.

Key Words: Bone mineral density, diagnosis, fracture assessment, guideline, monitoring, osteoporosis, position, pQCT, QCT, standards