Accuracy of densitometric XXXX assessment when performed by DXA technicians-a cross-sectional, multiobserver study.

@entity1 @entity85 @entity170 @entity174
UNASSIGNED: Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 @entity1 referred for @entity170 assessment. The outcome was compared to findings on spinal radiographs assessed by two radiologists. Three DXA technicians performed acceptable or better in identifying @entity1 with fractured vertebrae. INTRODUCTION: This is the first study to evaluate the accuracy of @entity174 assessment (VFA) when used by DXA technicians as a triage test to select @entity1 with deformed vertebrae for spinal radiographs. METHODS: Lateral single-energy scans and radiographs of the thoracolumbar spine (T4-L4) were acquired in 235 @entity1 aged 65  years or more referred for @entity170 assessment. Six DXA technicians evaluated lateral scans using dedicated software. The DXA technicians were trained to identify deformed vertebrae, but they did not assess the aetiology of deformity. Two radiologists evaluated the radiographs and their consensus evaluation served as the reference test for @entity174 . The main outcome was sensitivity and specificity of the DXA technicians' identification of @entity1 with one or more @entity85 according to Genant's classification. RESULTS: The proportion of @entity1 with one or more @entity174 was 0.35. Sensitivity ranged from 0.61 to 0.83 and specificity ranged from 0.78 to 0.95 across the DXA technicians. In @entity1 with @entity85 on VFA, the mean probability of one or more @entity174 was 0.74 (range 0.66-0.86). Conversely, in @entity1 without such deformities, the mean probability of @entity174 was 0.14 (range 0.10-0.18). Accuracy was lower for grade I-III deformities for all the DXA technicians. CONCLUSION: Three of six DXA technicians achieved acceptable or better accuracy when using VFA to triage @entity1 with @entity85 for spinal radiographs. Heterogeneity between DXA technicians appears to be due to differences in subjective thresholds. VFA triage by DXA technicians to identify @entity1 with @entity174 is feasible.
