QCT versus DXA in 320 survivors of childhood cancer

Association of BMD with fracture history

Sue C. Kaste, Xin Tong, Jennifer M. Hendrick, Evguenia J. Karimova, Deo Kumar Srivastava, Frances A. Tylavsky, Terry L. Snider, Laura D Carbone

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Purpose. To assess agreement on diagnosis of diminished bone mineral density (BMD) and correlation between BMD values obtained by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in childhood cancer survivors. Patients and Methods. We retrospectively reviewed lumbar spine QCT and DXA studies for BMD in patients who underwent both imaging studies within a 24-hr period. We determined correlation between BMD values and agreement on diagnosis of diminished BMD obtained by both modalities. Diminished BMD was defined as two or more SDs below mean for age- and gender-matched reference values. We evaluated the relationship of BMD values determined by each modality to self-reported fracture history in the 160 (50%) patients with available reports. Results. Of 320 patients, 56% (178) were male; 87% (277) were white. Median age was 16.4 (range, 5.1-36.0) years. Median BMD Z-score was -1.43 (range, -5.96 to 3.20) by QCT and -1.30 (range, -5.50 to 2.80) by DXA. Correlation between QCT- and DXA-determined BMD values was significant but low, and agreement on diminished BMD was fair (κ = 0.32). There was no association between BMD measured by either QCT or DXA and self-reported traumatic fracture history. Male gender was associated with doubling the traumatic fracture risk (P = 0.0499). Conclusions. Quantitative computed tomography and DXA may give discrepant results when used to assess bone health in childhood cancer survivors, especially in those of non-white race. This inconsistency in indicators of BMD deficiency may complicate clinical decision-making. Consecutive use of a single modality is recommended to provide reliable longitudinal information.

Original languageEnglish (US)
Pages (from-to)936-943
Number of pages8
JournalPediatric Blood and Cancer
Volume47
Issue number7
DOIs
StatePublished - Dec 1 2006
Externally publishedYes

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Bone Neoplasms
Photon Absorptiometry
Bone Density
Survivors
Tomography
Neoplasms
Reference Values
Spine

Keywords

  • Bone density
  • Childhood cancer
  • DXA
  • Quantitative computed tomography (QCT)

ASJC Scopus subject areas

  • Cancer Research
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Kaste, S. C., Tong, X., Hendrick, J. M., Karimova, E. J., Srivastava, D. K., Tylavsky, F. A., ... Carbone, L. D. (2006). QCT versus DXA in 320 survivors of childhood cancer: Association of BMD with fracture history. Pediatric Blood and Cancer, 47(7), 936-943. https://doi.org/10.1002/pbc.20854

QCT versus DXA in 320 survivors of childhood cancer : Association of BMD with fracture history. / Kaste, Sue C.; Tong, Xin; Hendrick, Jennifer M.; Karimova, Evguenia J.; Srivastava, Deo Kumar; Tylavsky, Frances A.; Snider, Terry L.; Carbone, Laura D.

In: Pediatric Blood and Cancer, Vol. 47, No. 7, 01.12.2006, p. 936-943.

Research output: Contribution to journalReview article

Kaste, SC, Tong, X, Hendrick, JM, Karimova, EJ, Srivastava, DK, Tylavsky, FA, Snider, TL & Carbone, LD 2006, 'QCT versus DXA in 320 survivors of childhood cancer: Association of BMD with fracture history', Pediatric Blood and Cancer, vol. 47, no. 7, pp. 936-943. https://doi.org/10.1002/pbc.20854
Kaste SC, Tong X, Hendrick JM, Karimova EJ, Srivastava DK, Tylavsky FA et al. QCT versus DXA in 320 survivors of childhood cancer: Association of BMD with fracture history. Pediatric Blood and Cancer. 2006 Dec 1;47(7):936-943. https://doi.org/10.1002/pbc.20854
Kaste, Sue C. ; Tong, Xin ; Hendrick, Jennifer M. ; Karimova, Evguenia J. ; Srivastava, Deo Kumar ; Tylavsky, Frances A. ; Snider, Terry L. ; Carbone, Laura D. / QCT versus DXA in 320 survivors of childhood cancer : Association of BMD with fracture history. In: Pediatric Blood and Cancer. 2006 ; Vol. 47, No. 7. pp. 936-943.
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abstract = "Purpose. To assess agreement on diagnosis of diminished bone mineral density (BMD) and correlation between BMD values obtained by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in childhood cancer survivors. Patients and Methods. We retrospectively reviewed lumbar spine QCT and DXA studies for BMD in patients who underwent both imaging studies within a 24-hr period. We determined correlation between BMD values and agreement on diagnosis of diminished BMD obtained by both modalities. Diminished BMD was defined as two or more SDs below mean for age- and gender-matched reference values. We evaluated the relationship of BMD values determined by each modality to self-reported fracture history in the 160 (50{\%}) patients with available reports. Results. Of 320 patients, 56{\%} (178) were male; 87{\%} (277) were white. Median age was 16.4 (range, 5.1-36.0) years. Median BMD Z-score was -1.43 (range, -5.96 to 3.20) by QCT and -1.30 (range, -5.50 to 2.80) by DXA. Correlation between QCT- and DXA-determined BMD values was significant but low, and agreement on diminished BMD was fair (κ = 0.32). There was no association between BMD measured by either QCT or DXA and self-reported traumatic fracture history. Male gender was associated with doubling the traumatic fracture risk (P = 0.0499). Conclusions. Quantitative computed tomography and DXA may give discrepant results when used to assess bone health in childhood cancer survivors, especially in those of non-white race. This inconsistency in indicators of BMD deficiency may complicate clinical decision-making. Consecutive use of a single modality is recommended to provide reliable longitudinal information.",
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author = "Kaste, {Sue C.} and Xin Tong and Hendrick, {Jennifer M.} and Karimova, {Evguenia J.} and Srivastava, {Deo Kumar} and Tylavsky, {Frances A.} and Snider, {Terry L.} and Carbone, {Laura D}",
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TY - JOUR

T1 - QCT versus DXA in 320 survivors of childhood cancer

T2 - Association of BMD with fracture history

AU - Kaste, Sue C.

AU - Tong, Xin

AU - Hendrick, Jennifer M.

AU - Karimova, Evguenia J.

AU - Srivastava, Deo Kumar

AU - Tylavsky, Frances A.

AU - Snider, Terry L.

AU - Carbone, Laura D

PY - 2006/12/1

Y1 - 2006/12/1

N2 - Purpose. To assess agreement on diagnosis of diminished bone mineral density (BMD) and correlation between BMD values obtained by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in childhood cancer survivors. Patients and Methods. We retrospectively reviewed lumbar spine QCT and DXA studies for BMD in patients who underwent both imaging studies within a 24-hr period. We determined correlation between BMD values and agreement on diagnosis of diminished BMD obtained by both modalities. Diminished BMD was defined as two or more SDs below mean for age- and gender-matched reference values. We evaluated the relationship of BMD values determined by each modality to self-reported fracture history in the 160 (50%) patients with available reports. Results. Of 320 patients, 56% (178) were male; 87% (277) were white. Median age was 16.4 (range, 5.1-36.0) years. Median BMD Z-score was -1.43 (range, -5.96 to 3.20) by QCT and -1.30 (range, -5.50 to 2.80) by DXA. Correlation between QCT- and DXA-determined BMD values was significant but low, and agreement on diminished BMD was fair (κ = 0.32). There was no association between BMD measured by either QCT or DXA and self-reported traumatic fracture history. Male gender was associated with doubling the traumatic fracture risk (P = 0.0499). Conclusions. Quantitative computed tomography and DXA may give discrepant results when used to assess bone health in childhood cancer survivors, especially in those of non-white race. This inconsistency in indicators of BMD deficiency may complicate clinical decision-making. Consecutive use of a single modality is recommended to provide reliable longitudinal information.

AB - Purpose. To assess agreement on diagnosis of diminished bone mineral density (BMD) and correlation between BMD values obtained by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in childhood cancer survivors. Patients and Methods. We retrospectively reviewed lumbar spine QCT and DXA studies for BMD in patients who underwent both imaging studies within a 24-hr period. We determined correlation between BMD values and agreement on diagnosis of diminished BMD obtained by both modalities. Diminished BMD was defined as two or more SDs below mean for age- and gender-matched reference values. We evaluated the relationship of BMD values determined by each modality to self-reported fracture history in the 160 (50%) patients with available reports. Results. Of 320 patients, 56% (178) were male; 87% (277) were white. Median age was 16.4 (range, 5.1-36.0) years. Median BMD Z-score was -1.43 (range, -5.96 to 3.20) by QCT and -1.30 (range, -5.50 to 2.80) by DXA. Correlation between QCT- and DXA-determined BMD values was significant but low, and agreement on diminished BMD was fair (κ = 0.32). There was no association between BMD measured by either QCT or DXA and self-reported traumatic fracture history. Male gender was associated with doubling the traumatic fracture risk (P = 0.0499). Conclusions. Quantitative computed tomography and DXA may give discrepant results when used to assess bone health in childhood cancer survivors, especially in those of non-white race. This inconsistency in indicators of BMD deficiency may complicate clinical decision-making. Consecutive use of a single modality is recommended to provide reliable longitudinal information.

KW - Bone density

KW - Childhood cancer

KW - DXA

KW - Quantitative computed tomography (QCT)

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U2 - 10.1002/pbc.20854

DO - 10.1002/pbc.20854

M3 - Review article

VL - 47

SP - 936

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JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

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