CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE QUALITY OF DXA SCANS AND REPORTS
CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE QUALITY OF DXA SCANS AND REPORTS
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DOI：
10.4158/cs-2017-0081
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发表时间：
2018-02-01
影响因子：
4.2
通讯作者：
Camacho, Pauline M.
中科院分区：
文献类型：
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作者：
Licata, Angelo A.;Binkley, Neil;Camacho, Pauline M.
目的：高质量的双能X线骨密度仪（DXA）扫描对于骨质疏松症的准确诊断和治疗监测是必要的;然而，DXA扫描报告可能包含错误，导致诊断和治疗混淆。本美国临床内分泌学家协会/美国内分泌学会共识声明旨在引起人们对影响DXA报告结论的许多常见技术问题的注意，并就如何解决这些问题提供指导，以确保患者接受适当的骨质疏松症护理。方法：DXA编写委员会根据对现有骨质疏松症和骨密度测定相关文献的讨论和评价，达成共识。结果：技术错误可能包括扫描采集和/或分析中的错误，导致错误的诊断和随时间变化的报告。尽管国际临床密度测定学会提倡培训技术人员和医疗口译员，以帮助消除这些问题，但许多人缺乏这项技术的技能。当临床病史与扫描解释不一致时，怀疑报告是错误的（例如，在短时间内急剧增加/减少;在多年治疗后以前稳定的骨密度下降），当使用不同的扫描仪时，或当不一致的解剖部位用于监测对治疗的反应时。了解的概念，最不显着的变化将减少错误的结论骨density. Conclusion的变化：临床医生必须发展的技能，区分技术问题，混淆报告，从真实的生物变化。我们建议临床医生审查实际扫描图像和数据，而不是仅仅依赖于报告的印象，以查明错误并准确解释DXA扫描图像。
Objective: High-quality dual-energy X-ray absorptiometry (DXA) scans are necessary for accurate diagnosis of osteoporosis and monitoring of therapy; however, DXA scan reports may contain errors that cause confusion about diagnosis and treatment. This American Association of Clinical Endocrinologists/American College of Endocrinology consensus statement was generated to draw attention to many common technical problems affecting DXA report conclusions and provide guidance on how to address them to ensure that patients receive appropriate osteoporosis care.Methods: The DXA Writing Committee developed a consensus based on discussion and evaluation of available literature related to osteoporosis and osteodensitometry.Results: Technical errors may include errors in scan acquisition and/or analysis, leading to incorrect diagnosis and reporting of change over time. Although the International Society for Clinical Densitometry advocates training for technologists and medical interpreters to help eliminate these problems, many lack skill in this technology. Suspicion that reports are wrong arises when clinical history is not compatible with scan interpretation (e.g., dramatic increase/decrease in a short period of time; declines in previously stable bone density after years of treatment), when different scanners are used, or when inconsistent anatomic sites are used for monitoring the response to therapy. Understanding the concept of least significant change will minimize erroneous conclusions about changes in bone density.Conclusion: Clinicians must develop the skills to differentiate technical problems, which confound reports, from real biological changes. We recommend that clinicians review actual scan images and data, instead of relying solely on the impression of the report, to pinpoint errors and accurately interpret DXA scan images.