QCT demonstrates excellent precision and reproducibility to changes and can be used for the monitoring of BMD in untreated and treated patients provided that there is routine calibration [22]. QCT is more sensitive to change than DXA because it detects mineralization in the cancellous bone, the portion of bone most sensitive to rapid changes, as well as at the cortex, such as newly formed bone in the cortical and subcortical compartments [61-63]. Femoral neck and total hip T-scores calculated from follow-up projectional QCT data are equivalent to corresponding DXA T-scores for monitoring of osteoporosis in accordance to the WHO criteria, and can be used longitudinally [22]. QUS There is insufficient evidence to the support the routine use of QUS for monitoring of untreated and treated patients. SXA There is insufficient evidence to the support the routine use of SXA for monitoring of untreated and treated patients. Osteoporosis and Bone Mineral Density TBS TBS is regarded as an adjunct tool to DXA. TBS may be useful in a small population where there is a need to look at marginal changes beyond BMD. TBS may be of benefit stratifying risk in individuals with relatively normal or osteopenic BMD values because most fractures occur in this subset of nonosteoporotic patients. Multiple studies have shown associations of TBS with fractures in postmenopausal women as well as a few fractures in men [64- 68]. DXA Follow-up DXA is supported for monitoring patients who have low BMD and VF risk factors [56]. DXA VFA In their 2019 guidelines, the ISCD recommended that densitometric spine imaging, or VFA, be considered for the listed indications in this variant [17]. VFA is a feature of DXA scanners in which a lateral thoracic and lumbar spine image from T5 to L5 is provided for the purpose of detecting vertebral body deformities; most VFs occur between the T7 and L4 levels [77].
Osteoporosis and Bone Mineral Density. QCT demonstrates excellent precision and reproducibility to changes and can be used for the monitoring of BMD in untreated and treated patients provided that there is routine calibration [22]. QCT is more sensitive to change than DXA because it detects mineralization in the cancellous bone, the portion of bone most sensitive to rapid changes, as well as at the cortex, such as newly formed bone in the cortical and subcortical compartments [61-63]. Femoral neck and total hip T-scores calculated from follow-up projectional QCT data are equivalent to corresponding DXA T-scores for monitoring of osteoporosis in accordance to the WHO criteria, and can be used longitudinally [22]. QUS There is insufficient evidence to the support the routine use of QUS for monitoring of untreated and treated patients. SXA There is insufficient evidence to the support the routine use of SXA for monitoring of untreated and treated patients. Osteoporosis and Bone Mineral Density TBS TBS is regarded as an adjunct tool to DXA. TBS may be useful in a small population where there is a need to look at marginal changes beyond BMD. TBS may be of benefit stratifying risk in individuals with relatively normal or osteopenic BMD values because most fractures occur in this subset of nonosteoporotic patients. Multiple studies have shown associations of TBS with fractures in postmenopausal women as well as a few fractures in men [64- 68]. DXA Follow-up DXA is supported for monitoring patients who have low BMD and VF risk factors [56]. DXA VFA In their 2019 guidelines, the ISCD recommended that densitometric spine imaging, or VFA, be considered for the listed indications in this variant [17]. VFA is a feature of DXA scanners in which a lateral thoracic and lumbar spine image from T5 to L5 is provided for the purpose of detecting vertebral body deformities; most VFs occur between the T7 and L4 levels [77].