Prototype of dual energy x-ray tomodensimeter for lumbar spine bone mineral density measurement: choice of the reconstruction algorithm and first experimental results.

A dual-energy x-ray tomodensimeter adapted for the determination of bone mineral density (BMD) of the lumbar vertebrae has been directly developed from a typical dual-energy x-ray absorptiometer. This apparatus consists of two fundamental parts: a dual energy x-ray tube, and a multidetector made by an array of 24 NaI(T1) crystals. It provides both tomographic and non-tomographic (anteroposterior, lateral etc) measurement. The detection area is limited to 132 mm. In this condition, the choice of the best reconstruction algorithm in order to give a direct BDM is considered. Preliminary studies based on numerical simulated projections and hydroxyapatite phantoms demonstrated the superiority of algebraic reconstruction algorithms, such as conjugated gradient, in order to resolve the problems of (i) the impossibility of defining an internal calibration, and (ii) the potential for reconstruction errors due to the presence of bone structures located out of the detection area. The accuracy of BMD measurement is within 2%, with in vitro precision approximately 1%, and linearity characterized by a standard error of estimation (SEE) of 2 mg cm-3 in the range of lumbar BMD (less than 400 mg cm-3). Experimental data derived from two volunteers are presented.