How well does dual photon absorptiometry predict osteoporosis? A comparison between neutron activation analysis and DEXA

The accuracy of dual energy X-ray absorptiometry (DEXA) for measurement of bone mass carried out by quantitative digital radiography (Hologic Inc.) was compared to results with neutron activation analysis (NAA) on 106 subjects. The accuracy with DEXA was further investigated by measurements on aluminium samples of known composition. DEXA measured 4 lumbar vertebrae by spine scan. The central third of the skeleton also was measured by whole body scan to obtain data on the same large part of the skeleton as measured by NAA. Results suggested that DEXA spine scans were more reliable than whole body scans. In addition, the measurement of total mineral content (BMC) was more reliable than the normalization of BMC to bone surface area (BMC/Area) or bone mineral density (BDM). Since the proportion of bone below detection would increase with development of osteoporosis, with osteoporosis the BMC would be increasingly underestimated, but to only a small extent, while the BMD would be more significantly overestimated.