“Which skeletal imaging modality is best for assessing bone health in children and young adults compared to DXA? A systematic review and meta-analysis”

Skeletal imaging techniques have become clinically valuable methods for measuring and assessing bone mineral density in children young people. Dual-energy X-ray absorptiometry (DXA) is the current reference standard evaluating density, as recommended by International Society Clinical Densitometry (ISCD). Various modalities, such quantitative ultrasound (QUS), peripheral computed tomography (pQCT), high-resolution (HR-pQCT), magnetic resonance (MRI), digital radiogrammetry (DXR) been developed to further quantify health adults. The purpose of this review, with meta-analysis, was systematically research literature compare various identify best modality status healthy papulations people chronic disease (up 18 years). A systematic computerized search Medline, PubMed, Web Science databases conducted English-only studies published between 1st January 1990 December 2019. In clinical comparing modalities DXA were chosen according inclusion criteria. risk bias quality articles assessed using Quality Assessment Tool Diagnostic Accuracy Studies (QUADAS-2). meta-analysis estimate overall correlation performed a Fisher Z transformation coefficient. Additionally, diagnostic accuracy measures different compared calculated. initial strategy identified 13,412 papers, 29 which matched exclusion Of these, twenty-two papers included meta-analysis. QUS 17 DXR 7 pQCT 4 papers. single paper DXA, DXR, pQCT. demonstrated that strongest coefficient 0.71 [95%CI: 0.43; 1.00, p-value < 0.001], while coefficients 0.57 0.25; 0.90, 0.001] 0.46; 0.67, respectively. sensitivity specificity statistically significant 0.80, No provides full evaluation adults, each method having some limitations. Compared pQCT, achieved positive relationship DXA. should be evaluated reliable predictor fractures