Quantification of Scan Analysis Errors in GE Lunar DXA Visceral Adiposity in Adults |
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| Authors: | David Wing Job G. Godino Anh Vo Ryan Moran Sarah Graham Jeanne F. Nichols |
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| Affiliation: | 1. Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA;2. UCSD Bone Densitometry School, La Jolla, CA, USA;3. Department of Psychiatry, UCSD, La Jolla, CA, USA;4. Sam and Rose Stein Institute for Research on Aging, UCSD, La Jolla, CA, USA;1. Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece;2. Laboratory for the Research of Musculoskeletal System “Th. Garofalidis,” Medical School, National and Kapodistrian University of Athens, KAT Hospital, Greece;3. Department of Computed Tomography, Asklepeion Voulas Hospital, Athens, Greece;4. First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece;5. Department of Endocrinology and Diabetes and Department of Medical Research, 251 Hellenic Airforce and VA Hospital, Athens, Greece;1. Growth and Pediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India;2. School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India;1. Department of Internal Medicine, Military Hospital, Tunis, Tunisia;2. Department of Rheumatology, Rabta Hospital,Tunis, Tunisia;3. Department of Clinical Biochemistry, Pateur Institute,Tunis, Tunisia;4. Department of Immunology, Rabta Hospital, Tunis, Tunisia;5. Department of Nephrology, Rabta Hospital, Tunis, Tunisia;6. University of Tunis El Manar – Tunisia;1. Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Ireland;2. Department of Rheumatology, Galway University Hospitals, Ireland;3. School of Medicine, National University of Ireland, Galway, Ireland;4. Department of Radiology, Galway University Hospitals, Ireland;1. Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia;2. Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia;3. Diabetes Service, Royal Women''s Hospital, Melbourne, Australia;4. Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Australia;5. Centre for Women''s Infectious Diseases Research, Royal Women''s Hospital, Melbourne, Australia;6. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;7. Infection & Immunity, Murdoch Children''s Research Institute, Melbourne, Australia;8. Bone and Mineral Medicine, Royal Melbourne Hospital, Melbourne, Australia;1. Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland;2. Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland;3. Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland;4. Department of Psychology, Poznan University of Physical Education, Poland |
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| Abstract: | Utilization of dual-energy X-ray absorptiometry is increasing in clinical settings and the fitness industry as a viable tool to assess total and regional body composition, including visceral adiposity. Previous research using small samples (<50) has described several pitfalls in patient positioning, scan acquisition, and/or analysis that alter regional body composition values. Our aim was to quantify the largest probable error in measures of total, android, gynoid, and visceral fat caused by incorrect placement of the head cut-line, in a large sample of adults. Total body images (N = 436) from 196 women and 67 men (20–85 years) scanned on a GE Lunar Prodigy densitometer were analyzed using enCORE software in 2 ways: (1) placing the head cut-line just beneath the bony protuberance of the chin according to manufacturer recommendation (correct method); (2) placing the head cut-line at the lowest point below the chin and just above the soft tissue at the shoulders (incorrect method). All other cut-lines were fixed. Mean differences in adiposity were examined using Lin's concordance correlation coefficient; equality of means and variances were evaluated using Bradley-Blackwood F-tests. The limits of agreement were displayed as Bland-Altman plots and calculated as the mean difference ±1.96 times the standard deviation of the difference. Correlation coefficients for paired comparisons of adiposity for correct vs incorrect cut-line placement ranged from 0.983–0.999 for all variables (all p < 0.001). Significant mean differences were 172 ± 130, 201 ± 168, 65 ± 122, and ?143 ± 336 g for android, gynoid, visceral, and total fat mass, respectively (all p < 0.0001). These differences exceeded our site's least significant change in 66%, 37%, 29%, and 4% of participant scans for android, gynoid, visceral, and total fat mass, respectively. Our findings underscore the importance of careful review of the manufacturer's auto analysis and consistency in conducting serial scans to ensure accurate and precise measures of regional body fat. |
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