array:24 [ "pii" => "S2173510712001188" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2011.09.005" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "522" "copyright" => "SERAM" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Radiologia. 2012;54:410-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 15880 "formatos" => array:2 [ "HTML" => 14190 "PDF" => 1690 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0033833811003729" "issn" => "00338338" "doi" => "10.1016/j.rx.2011.09.023" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "522" "copyright" => "SERAM" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Radiologia. 2012;54:410-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 36622 "formatos" => array:3 [ "EPUB" => 12 "HTML" => 34243 "PDF" => 2367 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Actualización</span>" "titulo" => "Absorciometría con rayos X de doble energía. Fundamentos, metodología y aplicaciones clínicas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "410" "paginaFinal" => "423" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Dual energy X-ray absorptimetry: fundamentals, methodology, and clinical applications" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figura 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 900 "Ancho" => 1400 "Tamanyo" => 121425 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Imagen de absorciometría con rayos X de doble energía en el antebrazo. La línea de referencia se sitúa en la estiloides cubital.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R.M. Lorente Ramos, J. Azpeitia Armán, N. Arévalo Galeano, A. Muñoz Hernández, J.M. García Gómez, J. Gredilla Molinero" "autores" => array:6 [ 0 => array:2 [ "nombre" => "R.M." "apellidos" => "Lorente Ramos" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Azpeitia Armán" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Arévalo Galeano" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Muñoz Hernández" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "García Gómez" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Gredilla Molinero" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510712001188" "doi" => "10.1016/j.rxeng.2011.09.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510712001188?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833811003729?idApp=UINPBA00004N" "url" => "/00338338/0000005400000005/v1_201305061511/S0033833811003729/v1_201305061511/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173510712001048" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2011.04.001" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "423" "copyright" => "SERAM" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Radiologia. 2012;54:424-31" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3421 "formatos" => array:2 [ "HTML" => 2956 "PDF" => 465 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Neuroimaging findings in the initial phase of development of high grade cortical astrocytomas" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "424" "paginaFinal" => "431" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hallazgos neurorradiológicos en la fase inicial del desarrollo de astrocitomas corticales de alto grado de malignidad" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1902 "Ancho" => 900 "Tamanyo" => 246521 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Patient No. 2. A 33-year-old male presents to the emergency room because of a partial seizure with secondary generalization. (A) The MRI sequences (FLAIR T2-weighted [left], perfusion MRI using arterial spin labeling [center] and contrast enhanced T1-weighted [right]) performed 48<span class="elsevierStyleHsp" style=""></span>h after the seizure show a focal lesion located in the cortex adjacent to the right superior frontal sulcum, with increased cerebral blood flow in the perfusion sequence and mild homogeneous enhancement after intravenous administration of contrast. (B) Proton MR spectroscopy (single-voxel technique with long echo time) reveals a marked increase in choline (Cho) associated with decreased N-acetyl-containing compounds (Nac) (Cr: creatine). (C) FLAIR T2-weighted (left) and contrast enhanced T1-weighted (right) MRI sequences of the brain performed 28 days later demonstrate marked tumor growth (TGR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.0<span class="elsevierStyleHsp" style=""></span>mm/week), but without the presence of necrosis or perilesional edema. The histologic diagnosis was anaplastic oligoastrocytoma.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Simonet Redondo, C. Auger Acosta, A. Rovira-Gols, M. Toledo Argany, S. Sarria Estrada, A. Rovira Cañellas" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Simonet Redondo" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Auger Acosta" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Rovira-Gols" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Toledo Argany" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Sarria Estrada" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Rovira Cañellas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833811002062" "doi" => "10.1016/j.rx.2011.04.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833811002062?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510712001048?idApp=UINPBA00004N" "url" => "/21735107/0000005400000005/v1_201305061506/S2173510712001048/v1_201305061506/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S217351071200105X" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2011.09.004" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "507" "copyright" => "SERAM" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Radiologia. 2012;54:401-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 9800 "formatos" => array:2 [ "HTML" => 8002 "PDF" => 1798 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Update in radiology</span>" "titulo" => "Cerebral cavernous malformations: Spectrum of neuroradiological findings" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "401" "paginaFinal" => "409" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Malformaciones cavernosas intracraneales: espectro de manifestaciones neurorradiológicas" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1058 "Ancho" => 1655 "Tamanyo" => 88249 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Theory suggested for cavernoma formation in the setting of a previous developmental anomaly.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.J. Cortés Vela, L. Concepción Aramendía, F. Ballenilla Marco, J.I. Gallego León, J. González-Spínola San Gil" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "Cortés Vela" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Concepción Aramendía" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Ballenilla Marco" ] 3 => array:2 [ "nombre" => "J.I." "apellidos" => "Gallego León" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "González-Spínola San Gil" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833811003547" "doi" => "10.1016/j.rx.2011.09.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833811003547?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351071200105X?idApp=UINPBA00004N" "url" => "/21735107/0000005400000005/v1_201305061506/S217351071200105X/v1_201305061506/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Update in Radiology</span>" "titulo" => "Dual energy X-ray absorptimetry: Fundamentals, methodology, and clinical applications" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "410" "paginaFinal" => "423" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R.M. Lorente Ramos, J. Azpeitia Armán, N. Arévalo Galeano, A. Muñoz Hernández, J.M. García Gómez, J. Gredilla Molinero" "autores" => array:6 [ 0 => array:4 [ "nombre" => "R.M." "apellidos" => "Lorente Ramos" "email" => array:1 [ 0 => "rosa.lorenteramos@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Azpeitia Armán" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Arévalo Galeano" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Muñoz Hernández" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "García Gómez" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Gredilla Molinero" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad Central de Radiodiagnóstico de la CAM, Hospital Infanta Leonor, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Absorciometría con rayos X de doble energía. Fundamentos, metodología y aplicaciones clínicas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 711 "Ancho" => 950 "Tamanyo" => 96905 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of the hip. Patient's positioning.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Dual X-ray absorptiometry (DXA), also known as densitometry or dual energy X-ray absorptiometry (DEXA), can distinguish different body structures. Axial bone densitometry of the lumbar spine and hip is the modality most commonly used in clinical practice. This technique is useful for measuring the bone mineral density (BMD), and from these data the risk of fracture can be estimated, therapeutic decisions can be taken and the response to treatment can be assessed.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">On the other hand, DXA, the least known method for whole body imaging, allows us to assess the total body composition. This is particularly useful in patients with weight disorders secondary to endocrine diseases and in pediatric patients with delayed growth.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Whole body DXA can also be useful to assess lipodystrophy associated with retroviral infections,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in the monitoring of arthroplasties<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> or to determine the cardiovascular risk.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">DXA is still little known among radiologists, who consider this technique to be more typical of other specialties. Moreover, DXA tends to be wrongly considered as a routine and automated technique, unlikely to be optimized and not requiring a radiological report. This is far from the truth. DXA, like any other diagnostic modality, requires an adequate indication, careful methodology and precise interpretation, which is only possible with appropriate training and interaction between technicians and radiologists.</p><p id="par0020" class="elsevierStylePara elsevierViewall">As a consequence, our aim is to examine the current status of DXA, particularly emphasizing its fundamentals, main modalities, methodology and clinical applications.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Fundamentals and modalities of dual energy X-ray absorptiometry</span><p id="par0025" class="elsevierStylePara elsevierViewall">DXA is based on the variable absorption of X-ray by the different body components and uses high and low energy X-ray photons. Depending on the equipment used, these photons can be obtained using two mechanisms.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In some cases, the generator emits alternating radiation of high (140<span class="elsevierStyleHsp" style=""></span>kVp) and low (70–100<span class="elsevierStyleHsp" style=""></span>kVp) kilovoltage while moving across the surface of the body to be examined. In others, the generator emits a constant beam while a rare-earth filter separates high energy (70<span class="elsevierStyleHsp" style=""></span>keV) from low energy (40<span class="elsevierStyleHsp" style=""></span>keV) photons.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The available DXA systems include different types of hardware (filters, collimators, detectors) and software (analysis algorithms).<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The X-ray source can emit a pencil-beam (pinhole collimator), which is registered by a single detector, or a fan beam (slit collimator), which is registered by a multiple detector.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> The latter system reduces the acquisition time and improves image quality.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> At the same time, the analysis algorithm discriminate bone from soft tissue in a variable way.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The main modalities of DXA in clinical practice are axial bone densitometry with stationary scan table, the modality of choice to measure the BMD, and whole body densitometry, used to assess body composition.</p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Bone densitometry with dual energy X-ray absorptiometry</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Historical perspective</span><p id="par0040" class="elsevierStylePara elsevierViewall">Axial DXA of the lumbar spine and hip is at present the technique of choice to study osteoporosis,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> although other imaging techniques are potentially useful to assess and measure the bone structure and study its quality<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,7,12</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Plain radiography is useful to assess bone structure, although it cannot measure BMD. Some authors have tried to apply digital radiography with dual energy to obtain an estimated measurement of the BMD.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Quantitative computed tomography (QCT) of the lumbar spine (central QCT) is performed using conventional computed tomography (CT) systems. QCT of radius or tibia (peripheral QCT) can be performed using less sophisticated equipment. QCT provides volumetric acquisitions from which BMD can be estimated. Central QCT has advantages over DXA, since it allows us to differentiate between cortical and trabecular bone, assess the geometry of the vertebrae, and estimate the BMD volumetrically, expressed in g/cm<span class="elsevierStyleSup">3</span>. The disadvantages of central QCT are the radiation dose and the lack of validated diagnostic criteria.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">High resolution magnetic resonance (MR) imaging may be used for assessment of the trabecular structure of peripheral bones (calcaneus, distal radius and phalanx).<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The bone architecture studied using CT or MR, quantified in terms of scale, shape, anisotropy and connectivity, allows for the assessment of bone strength without considering the BMD. Advanced MR techniques such as diffusion, perfusion and spectroscopy will most likely provide useful additional information in the future.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Quantitative ultrasound (QUS) is used for measuring BMD in the peripheral skeleton, generally at the calcaneus.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Photonic absorptiometry with iodine-125 (I-125) was initially used to study the peripheral skeleton (radius and calcaneus). It was subsequently replaced by dual photonic absorptiometry that uses gadolinium-153 and may be employed to study the axial skeleton (hip, spine and whole skeleton).<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">These modalities were later on substituted by X-ray based technology, initially by plain X-ray and subsequently by DXA, which allowed for the measurement of the axial skeleton.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Equipment</span><p id="par0075" class="elsevierStylePara elsevierViewall">Peripheral DXA performed with portable units (such as AccuDXA<span class="elsevierStyleSup">®</span>) focuses on the study of phalanxes. It is not very accurate, but its cost is also low.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> AccuDXA can be used to select patients likely to be assessed with central DXA<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> on stationary table or as a substitute where central DXA is not available.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Axial DXA of the lumbar spine and femur (central DXA) is the preferred technique to measure BMD because of its good resolution and reliability, rapid acquisition and little radiation. Several devices are commercially available (Lunar, Hologic, Norland) with different characteristics. This fact makes it advisable to perform the follow up of each patient always in the same unit. The accuracy of bone densitometry performed on a DXA system with stationary table is high, with a margin of error of 1–2%.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Indications</span><p id="par0085" class="elsevierStylePara elsevierViewall">The main use of DXA is the diagnosis of osteoporosis. It may also predict the risk of fractures, help determine the treatment, and monitor the response to treatment.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Its indications are set out in the official guidelines of the International Society for Clinical Densitometry, which are revised every two years (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19,20</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Osteoporosis is the “reduction in bone mass and increase of bone fragility which in turn increases the risk of fracture”.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Osteoporosis is a common, often silent disease that can lead to an increased risk of fractures, sometimes atraumatic. Osteoporosis poses a serious problem to public health because of its prevalence and the cost associated with its comorbidity. According to the National Osteoporosis Foundation (NOF), osteoporosis affects 10 million Americans, but another 34 million are at risk of developing the condition. It is estimated that approximately 50% of women over the age of 50 will suffer an osteoporic fracture during their lives.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> In Europe, the International Osteoporosis Foundation (IOF)<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> collects data and promotes initiatives in every country. In Spain, approximately two million women have osteoporosis (26.1% prevalence in women ≥50 years).<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">In 1994, the WHO introduced the measurement of BMD with DXA as the reference standard to quantify osteoporosis. Based on a study performed on postmenopausal white women that revealed a correlation between BMD and risk of fracture,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> osteoporosis was defined as a “<span class="elsevierStyleItalic">T</span>-score of −2.5”. Other values of reference for potentially useful parameters were also determined (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Thus, axial DXA became the reference standard for osteoporosis.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methodology</span><p id="par0100" class="elsevierStylePara elsevierViewall">The methodology of bone densitometry with axial DXA requires optimization and careful execution. The importance of each step to obtain good results must be highlighted.</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Preparation</span><p id="par0105" class="elsevierStylePara elsevierViewall">In order to properly plan the study, detailed patient information is required, and both the medical report provided by the referring physician as well as the preliminary questionnaire completed in the diagnostic center. The request form must include the indications for the study, so the areas to be examined can be determined. Bone diseases that might alter the shape or density of the bone, such as osteopetrosis or ankylosing spondylitis, need to be ruled out. Previous fractures or joint replacements that might alter the planning must also be ruled out. Contraindications to DXA include pregnancy, recent (<5 days) oral administration of a contrast agent, and a recent (<2 days) isotopic study.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> The patient does not require any specific preparation except for the removal of any metal items located on the body area to be imaged.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Areas of study</span><p id="par0110" class="elsevierStylePara elsevierViewall">For most adult patients, the DXA examination should include the lumbar spine and proximal femur; the forearm can also be included when hip or spine cannot be measured.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> In children and adolescents (younger than 20 years), the measurement is only performed in the lumbar spine.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27,28</span></a> The final result of the densitometry would be the lowest value of the two regions studied.</p><p id="par0115" class="elsevierStylePara elsevierViewall">The postero-anterior (PA) scan of the lumbar spine includes the vertebral bodies of L1–L4, from which a mean BMD of these four vertebrae is obtained. Vertebrae with changes due to fracture or focal lesions will be excluded. To assess the lumbar spine, at least two evaluable vertebrae are required.</p><p id="par0120" class="elsevierStylePara elsevierViewall">The study of the femur can indistinctly be performed on the right or left hip, although it is useful to become used to studying always the same side. Hips with changes due to fracture, focal lesions or replacements will be excluded. The total proximal femur or the femoral neck are used, whichever is lowest.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The study of the non-dominant forearm is performed when hip or spine cannot be measured (in order to have a second measurable region), to obese patients (to bypass technical difficulties), and to patients suffering from hyperparathyroidism (since forearm bones change before the axial skeleton).</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patient positioning</span><p id="par0130" class="elsevierStylePara elsevierViewall">Optimization of the patient's position on the DXA table is essential. Incorrect positioning is one of the main causes of errors in the estimation of BMD.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> In the PA study of the lumbar spine, the patient lies supine on the table with the legs flexed over a support pad that reduces the lumbar lordosis and approaches the spine to the table (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">For the study of the hip, the patient lies supine with legs slightly in abduction in order to maintain the femoral axis straight and in internal rotation (15–30°), in a way that the lesser trochanter is not visible on the image (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">In the study of the forearm, the patient is seated, side against the table with the arm resting on the tabletop with the palm of the hand downwards patients sit beside the table and with their forearm resting on it, with the hand in pronation and strapped (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">The field of view must include 1–2<span class="elsevierStyleHsp" style=""></span>cm above and below the area to be imaged. The bone must be straight and centered.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Acquisition</span><p id="par0150" class="elsevierStylePara elsevierViewall">For most patients, the DXA includes PA projections of the lumbar spine and proximal femur. The lateral spine is not used in a standard osteoporosis study, but it is used in vertebral morphometry. In those devices with mobile scanning arm, measurements can be done with the patient lying supine, whereas in systems with stationary arm measurements can only be done in lateral decubitus.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Regarding the scanning time, the first densitometers with pencil-beam scans took around 5<span class="elsevierStyleHsp" style=""></span>min per scan, but now the images can be obtained in less than one minute. According to the examination guidelines of the SERAM (<span class="elsevierStyleItalic">Spanish Society of Medical Radiology</span>),<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> the time of room occupancy for a spine or hip densitometry is 8<span class="elsevierStyleHsp" style=""></span>min, 10<span class="elsevierStyleHsp" style=""></span>min for the whole body, and the radiologist reporting time is 5<span class="elsevierStyleHsp" style=""></span>min.</p><p id="par0160" class="elsevierStylePara elsevierViewall">DXA uses low radiation doses and generally most of these devices do not require lead shielding of the room or special protection measures for the technicians. In the DXA units using pencil-beam scans, the equivalent surface dose for spine and hip examinations is approximately 20–100<span class="elsevierStyleHsp" style=""></span>μSv per examination, and the equivalent effective dose is 1–5<span class="elsevierStyleHsp" style=""></span>μSv per examination.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> For fan beam DXA, the dose is slightly higher, approximately 56<span class="elsevierStyleHsp" style=""></span>μSv for the hip, 59<span class="elsevierStyleHsp" style=""></span>μSv for the spine, and 75<span class="elsevierStyleHsp" style=""></span>μSv for whole body. The disperse radiation that the technician would receive being 1<span class="elsevierStyleHsp" style=""></span>m away from the table using a fan beam unit, performing 4 hip studies and 4 spine ones per hour would be of around 4<span class="elsevierStyleHsp" style=""></span>μSv.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Analysis</span><p id="par0165" class="elsevierStylePara elsevierViewall">Once the image is acquired, the assessment is carried out by selecting different regions of interest (ROI). Inadequate placement of the ROIs is another important source of errors.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> Although the equipment automatically proposes specific areas, both the technician and the radiologist must validate them and, given the case, rectify them.</p><p id="par0170" class="elsevierStylePara elsevierViewall">In the study of the lumbar spine, the ROIs are placed on the L1–L4 vertebral bodies (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). It must be remembered that D12 is usually the last vertebra connected to a rib (although this is not always the case), and that L3 usually has the longest transverse process.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">In the study of the hip, the ROI must be placed at the femoral neck, avoiding superimposition of the ischiopubic ramus and the greater trochanter (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>). The system measures automatically the inclination of the femoral axis and the rest of the ROIs.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0180" class="elsevierStylePara elsevierViewall">In the forearm, the area of analysis is set at the distal radius, with the line of reference at the urnal styloid process (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Screening of the causes of error</span><p id="par0185" class="elsevierStylePara elsevierViewall">The radiologist must try to detect all those artifacts that might be possible causes of error in the acquisition, analysis and interpretation of the study (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>). Once the possible sources of error are identified, they must be excluded when performing the analysis and subsequent interpretation.</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0190" class="elsevierStylePara elsevierViewall">First, the correct positioning of the patient and absence of movement during the scanning must be checked. Artifacts caused by superimposition of dense structures (including surgical material, calcifications or contrast agents) must be ruled out (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>).<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34,35</span></a> Bone lesions<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> may also alter the analysis and must be mentioned in the report.</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0195" class="elsevierStylePara elsevierViewall">The condition that most frequently distorts the analysis is spondyloarthrosis, which is associated with bone proliferation (osteophytes, endplate sclerosis) and morphologic changes (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>). Vertebral fractures (<a class="elsevierStyleCrossRef" href="#fig0045">Fig. 9</a>), lytic or sclerotic lesions (<a class="elsevierStyleCrossRef" href="#fig0050">Fig. 10</a>), metastases, lymphomas, bone islets, Paget's disease, or hemangiomas. In cases of unknown suspected bone lesion, complementary radiological studies are required. It must be remembered that in patients with severe osteoporosis, the DXA scan might simulate a lytic lesion (<a class="elsevierStyleCrossRef" href="#fig0055">Fig. 11</a>).</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia><elsevierMultimedia ident="fig0045"></elsevierMultimedia><elsevierMultimedia ident="fig0050"></elsevierMultimedia><elsevierMultimedia ident="fig0055"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Parameters evaluated in bone densitometry</span><p id="par0200" class="elsevierStylePara elsevierViewall">Following the acquisition and analysis of DXA, the system calculates various parameters<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). The BMC is the quantity of calcium estimated by the energy absorbed by it in a specific region. The BMD, much more relevant, is the mean quantity of mineral per unit area. It is calculated dividing the BMC by unit area (g/cm<span class="elsevierStyleSup">2</span>). The values used for diagnosis (<span class="elsevierStyleItalic">T</span>- and <span class="elsevierStyleItalic">Z</span>-score) are obtained by comparison with the reference database.</p><p id="par0205" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">T</span>-score is the value used to diagnose osteoporosis in postmenopausal women and in men aged 50 and over. <span class="elsevierStyleItalic">T</span>-score is the number of standard deviations the patient's BMD above or below the mean for the young adult reference population of the same sex. A <span class="elsevierStyleItalic">T</span>-score >−1.0 is considered normal, osteopenia when the <span class="elsevierStyleItalic">T</span>-score is between −1 and −2.5, and osteoporosis is a <span class="elsevierStyleItalic">T</span>-score <−2.5.</p><p id="par0210" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Z</span>-score is used in premenopausal women, in men younger than 50 years, and in children and adolescents (up to 20 years). <span class="elsevierStyleItalic">Z</span> score is the number of standard deviations the patient's BMD above or below the mean for the reference population of the same race, sex and age. A <span class="elsevierStyleItalic">Z</span>-score <−2 standard deviations is defined as “below the expected range for age”.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a></p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Reporting</span><p id="par0215" class="elsevierStylePara elsevierViewall">The report should be tailored to the particular characteristics of each center, but in general it must comply with some minimum requirements. In addition to the patient's personal details, the report must include the date of examination, the type of DXA system used, as well as the protocol followed. It must also specify if any region of analysis has been excluded and the reasons, and the possible presence of artifacts or suspected lesions.</p><p id="par0220" class="elsevierStylePara elsevierViewall">The report must also include the scans obtained for each region of study, with a graph showing the patient's data and then related back to the reference curve, the numerical values of the BMD, <span class="elsevierStyleItalic">T</span>- and <span class="elsevierStyleItalic">Z</span>-scores, and finally, a diagnostic category based on WHO criteria. The value considered most useful to diagnose a particular patient must be specified. In some cases, an estimation of the risk of fracture is also included. In general, the risk of fracture doubles for each standard deviation reduction in BMD. The study's conclusion should be global, taking into account the lowest value of the areas studied. In patients with previous studies, any possible changes should be reported.</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Estimation of the body composition using dual energy X-ray absorptiometry</span><p id="par0225" class="elsevierStylePara elsevierViewall">Several techniques have been used to assess the composition and quantification of the body fat, mostly anthropometric methods such as the waist circumference, the waist-to-hip ratio, and the skin fold thickness.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> Among the imaging studies, CT stands out to measure visceral fat, but with some drawbacks such as radiation, among others. Bioimpedance techniques and isotope dilution have also been used.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Whole body DXA allows for an easy and rapid measurement of body composition. It provides an estimate of body fat, and when needed, it may also estimate the BMD of the whole body. DXA is very accurate, with a margin of error of 2–6% for body composition.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Unlike anthropometric methods, DXA has advantage of providing regional and whole-body measurements. DXA is increasingly being used; for many clinicians it is a common tool and for some authors it is the reference standard.</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Indications</span><p id="par0235" class="elsevierStylePara elsevierViewall">Whole body DXA is used in eating disorders, especially those where there might be a hormonal disorder or cardiovascular risk factors. It is also used in gastrointestinal diseases, hepatobiliary disorders, advanced renal failure, in endocrinal diseases, bone disorders such as Paget's disease or osteopetrosis, lung diseases and various chronic treatments.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> DXA may also help design the diet in patients with malnutrition and in the follow-up of patients with eating disorders.</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methodology</span><p id="par1230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Patient's positioning</span>. The patient lies supine, centered on the table with the arms along sides of the body, hands facing the legs without touching them and the thumbs up (<a class="elsevierStyleCrossRef" href="#fig0060">Fig. 12</a>). If the patient is wider than the width of the DXA table, a half-body scanning is performed (including the neck and head, one whole side with their corresponding arm and leg). In this case, the patient lies supine but is positioned off the center line of the table to ensure that one side is completely included in the scan field.</p><elsevierMultimedia ident="fig0060"></elsevierMultimedia><p id="par2230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Analysis</span>. As in BMD studies, the correct positioning and absence of motion artifacts must be verified. Following the acquisition, two images of the whole body are obtained, one of bones and other of soft tissues (<a class="elsevierStyleCrossRefs" href="#fig0065">Figs. 13 and 14</a>). The system places the ROIs automatically. The technician revises the ROIs and, if necessary, modifies them, although it is advisable to manipulate them as little as possible. The changes performed on an image are automatically introduced on the other. The ROIs correspond to anatomic regions: the head up under the chin; arms separated from the body with the cut lines passing through the armpits; forearms separated from the body, legs separated from the arms and the medial cut lines located between both legs; the limits of the spine are adjacent to it, on both sides; pelvis: the upper cut line located immediately above the pelvis and cut lines through the femoral neck without touching the pelvis. In patients wider than the width of the scan field where only a half-body is scanned, the ROI is placed as explained and the system provides a total estimation (<a class="elsevierStyleCrossRef" href="#fig0075">Fig. 15</a>).</p><elsevierMultimedia ident="fig0065"></elsevierMultimedia><elsevierMultimedia ident="fig0070"></elsevierMultimedia><elsevierMultimedia ident="fig0075"></elsevierMultimedia><p id="par3230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Interpretation</span>. The system provides various parameters (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>) such as the body mass index (BMI), quantification of body fat, distribution of the abdominal fat, or values obtained from these data such as the android/gynoid ratio (A/G ratio) in the abdominal fat.</p><p id="par0345" class="elsevierStylePara elsevierViewall">The BMI is an anthropometric indicator designed for adult males and non-pregnant females, but it does not distinguish between fat and muscle and therefore cannot be assessed in athletes. The BMI is a number calculated from a person's weight and height and is measured in kg/m<span class="elsevierStyleSup">2</span>. The distribution of body tissues is expressed as percentages for the whole body and per regions: percentage of fat (fat mass), of soft parts and muscle (lean mass) and of body (BMD). Several studies have calculated curves that can be used as a reference for different populations.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">41–44</span></a></p><p id="par0255" class="elsevierStylePara elsevierViewall">In addition to the composition by anatomic regions, it calculates the distribution of fat in predefined regions in the pelvic area: android (central, the lower limit is the pelvis and the lateral limit is the arms) and gynoid (hip and thighs, the lateral limits are the outer part of the legs) (<a class="elsevierStyleCrossRef" href="#fig0080">Fig. 16</a>).</p><elsevierMultimedia ident="fig0080"></elsevierMultimedia><p id="par0260" class="elsevierStylePara elsevierViewall">The android/gynoid (A/G) ratio of the fat is the relation between the fat percentage of the android and the gynoid region. The excess of abdominal fat (android) is associated with a number of cardiovascular risk factors.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">The determination of the A/G ratio using DXA is an easy and useful tool to assess the distribution of pelvic fat. This ratio may have a role in evaluating the cardiovascular risk in overweight or underweight patients.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0270" class="elsevierStylePara elsevierViewall">BMD values of the whole body are useful to estimate mineralization, but not to diagnose osteoporosis (it is necessary to study the spine and hip in order to compare the results with the reference curves to reach a diagnosis).</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Other applications of dual energy X-ray absorptiometry</span><p id="par0275" class="elsevierStylePara elsevierViewall">Over the time, other potential clinical applications using DXA are being proposed. DXA systems now offer the possibility of creating personalized analysis areas to perform composition measurements. There are also studies in the field of orthopedics that investigate implant integration by assessing the regional mineralization.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Moreover, its use in lipodystrophy and lipoatrophy is being studied, especially in HIV patients.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusion</span><p id="par0280" class="elsevierStylePara elsevierViewall">DXA is a fast and reliable technique with little radiation exposure. It is the technique of choice in the diagnosis and monitoring of osteoporosis since it objectively measures the most relevant parameters. Moreover, it is useful to measure the whole body composition and its distribution by regions. There are other less common applications in potential expansion. Knowledge of the technique, its indications, methodology and applications are key issues to optimize its results and streamline its use.</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Authorship</span><p id="par0285" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0290" class="elsevierStylePara elsevierViewall">Responsible for the integrity of the study: RMLR.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0295" class="elsevierStylePara elsevierViewall">Conception of the study: RMLR.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0300" class="elsevierStylePara elsevierViewall">Design of the study: RMLR and JAA.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4</span><p id="par0305" class="elsevierStylePara elsevierViewall">Acquisition of data: RMLR, JAA and NAG.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5</span><p id="par0310" class="elsevierStylePara elsevierViewall">Analysis and interpretation of data: RMLR, AMH, JMGG and JGM.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6</span><p id="par0315" class="elsevierStylePara elsevierViewall">Statistical analysis: RMLR</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7</span><p id="par0320" class="elsevierStylePara elsevierViewall">Bibliographic search: RMLR and JAA.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8</span><p id="par0325" class="elsevierStylePara elsevierViewall">Drafting of the paper: RMLR.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9</span><p id="par0330" class="elsevierStylePara elsevierViewall">Critical review with intellectually relevant contributions: RMLR, JAA, NAG, AMH, JMGG and JGM.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10</span><p id="par0335" class="elsevierStylePara elsevierViewall">Approval of the final version: RMLR, JAA, NAG, AMH, JMGG and JGM.</p></li></ul></p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0340" class="elsevierStylePara elsevierViewall">The authors declare not having any conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres122081" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec109368" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres122080" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec109369" "titulo" => "Palabras clave" ] 4 => array:3 [ "identificador" => "sec0005" "titulo" => "Introduction" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Fundamentals and modalities of dual energy X-ray absorptiometry" ] ] ] 5 => array:3 [ "identificador" => "sec0015" "titulo" => "Bone densitometry with dual energy X-ray absorptiometry" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Historical perspective" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Equipment" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Indications" ] 3 => array:3 [ "identificador" => "sec0035" "titulo" => "Methodology" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Preparation" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Areas of study" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Patient positioning" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "Acquisition" ] 4 => array:2 [ "identificador" => "sec0060" "titulo" => "Analysis" ] 5 => array:2 [ "identificador" => "sec0065" "titulo" => "Screening of the causes of error" ] 6 => array:2 [ "identificador" => "sec0070" "titulo" => "Parameters evaluated in bone densitometry" ] 7 => array:2 [ "identificador" => "sec0075" "titulo" => "Reporting" ] ] ] 4 => array:2 [ "identificador" => "sec0080" "titulo" => "Estimation of the body composition using dual energy X-ray absorptiometry" ] 5 => array:2 [ "identificador" => "sec0085" "titulo" => "Indications" ] 6 => array:2 [ "identificador" => "sec0090" "titulo" => "Methodology" ] 7 => array:2 [ "identificador" => "sec0110" "titulo" => "Other applications of dual energy X-ray absorptiometry" ] ] ] 6 => array:2 [ "identificador" => "sec0115" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0120" "titulo" => "Authorship" ] 8 => array:2 [ "identificador" => "sec0125" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-03-15" "fechaAceptado" => "2011-09-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec109368" "palabras" => array:7 [ 0 => "Dual-energy X-ray absorptiometry" 1 => "Densitometry" 2 => "DXA" 3 => "DEXA" 4 => "Osteoporosis" 5 => "Bone mineral density" 6 => "Body composition" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec109369" "palabras" => array:7 [ 0 => "Absorciometría con rayos X de doble energía" 1 => "Densitometría" 2 => "DXA" 3 => "DEXA" 4 => "Osteoporosis" 5 => "Densidad mineral ósea" 6 => "Composición corporal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dual-energy X-ray absorptiometry (DXA; DEXA) is the technique of choice to diagnose osteoporosis and to monitor the response to treatment. It is also useful for measuring body composition. In recent years, new applications have been developed, including vertebral morphometry through the study of the lateral spine, prosthesis integration in orthopedics, and lipodystrophy in HIV+ patients, although its use in these cases is not well established. DXA densitometry is accurate and precise. It is essential to optimize each step of the diagnostic process, taking care to ensure the best acquisition, image analysis, and interpretation of the results. Thus, to obtain the greatest utility from DXA, radiologists need to know the technique, its indications, and its pitfalls. This article reviews the fundamentals, modalities, methods, and clinical applications of DXA.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La absorciometría con rayos X de doble energía (DXA o DEXA) es la técnica de elección para diagnosticar la osteoporosis y monitorizar la respuesta al tratamiento. Además, es útil para estudiar la composición corporal. En los últimos años han surgido nuevas aplicaciones como la morfometría vertebral, estudiando la columna en visión lateral, la integración de prótesis en ortopedia, o la lipodistrofia en los pacientes con infección por VIH, aunque su utilización en estos casos no está bien consolidada. En el estudio de la osteoporosis, densitometría es precisa y exacta. Para ello, es imprescindible optimizar cada etapa del proceso diagnóstico, cuidando la adquisición, el análisis de imágenes y la interpretación de los resultados. Por ello, para obtener la máxima utilidad para el clínico y el paciente, el radiólogo debe conocer la técnica, sus indicaciones y las dificultades. El objetivo de este artículo es revisar la DXA, haciendo hincapié en sus fundamentos, modalidades, metodología y aplicaciones clínicas.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Lorente Ramos RM, et al. Absorciometría con rayos X de doble energía. Fundamentos, metodología y aplicaciones clínicas. Radiología. 2012;54:410–23.</p>" ] ] "multimedia" => array:20 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 726 "Ancho" => 951 "Tamanyo" => 107171 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry. PA study of the lumbar spine. Patient's positioning.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 711 "Ancho" => 950 "Tamanyo" => 96905 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of the hip. Patient's positioning.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1422 "Ancho" => 951 "Tamanyo" => 181373 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of the forearm. Patient's positioning.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1304 "Ancho" => 2310 "Tamanyo" => 228630 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry image of a PA lumbar spine. The study includes the L1–L4 vertebral bodies.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1188 "Ancho" => 2305 "Tamanyo" => 231228 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of the left hip. The lesser trochanter must not be visualized. The area of analysis (ROI) is placed on the femoral neck.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1500 "Ancho" => 2332 "Tamanyo" => 227774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of the forearm. The line of reference is placed at the urnal styloid.</p>" ] ] 6 => array:7 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 968 "Ancho" => 1404 "Tamanyo" => 165179 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">On the left, dual energy X-ray absorptiometry of the spine. Dense image superimposed on the L3 vertebral body (arrow). On the right, the plain abdominal radiograph shows a calcified mesenteric lymph node (arrow).</p>" ] ] 7 => array:7 [ "identificador" => "fig0040" "etiqueta" => "Figure 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1486 "Ancho" => 2292 "Tamanyo" => 281015 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry image of spine. The increase of density in the radiography (arrow) corresponds to an L3 and L4 sclerosis. In the analysis, the bone mineral density (BMD) in L3 and L4 is higher than in L1 and L2. Exclusion of both vertebrae shows a <span class="elsevierStyleItalic">T</span>-score L1–L2<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−1.9 (L1–L4<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.5).</p>" ] ] 8 => array:7 [ "identificador" => "fig0045" "etiqueta" => "Figure 9" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr9.jpeg" "Alto" => 2670 "Ancho" => 2020 "Tamanyo" => 459662 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Above, dual energy X-ray absorptiometry of spine. Increased density of the L2 vertebral body (arrow) that corresponds to a fracture (arrow) on the radiograph below. Both images show a calcification (arrowheads) that is not superimposed to the spine (not affecting the analysis).</p>" ] ] 9 => array:7 [ "identificador" => "fig0050" "etiqueta" => "Figure 10" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr10.jpeg" "Alto" => 1125 "Ancho" => 2361 "Tamanyo" => 266133 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry and AP radiograph of spine (right). Increased density in the pedicle of right L1 (arrow) corresponding in the radiography to a dense pedicle. The vertebra must be excluded from the analysis.</p>" ] ] 10 => array:7 [ "identificador" => "fig0055" "etiqueta" => "Figure 11" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr11.jpeg" "Alto" => 1548 "Ancho" => 953 "Tamanyo" => 170215 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Dual energy X-ray absorptiometry of spine in a patient with severe osteoporosis. The image simulates a defect of L3 and L4 (arrows), not confirmed by the radiographies.</p>" ] ] 11 => array:7 [ "identificador" => "fig0060" "etiqueta" => "Figure 12" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr12.jpeg" "Alto" => 770 "Ancho" => 954 "Tamanyo" => 123212 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Whole body dual energy X-ray absorptiometry. Patient's positioning.</p>" ] ] 12 => array:7 [ "identificador" => "fig0065" "etiqueta" => "Figure 13" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr13.jpeg" "Alto" => 1515 "Ancho" => 2342 "Tamanyo" => 349923 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Whole body dual energy X-ray absorptiometry. Underweight patient.</p>" ] ] 13 => array:7 [ "identificador" => "fig0070" "etiqueta" => "Figure 14" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr14.jpeg" "Alto" => 2569 "Ancho" => 929 "Tamanyo" => 138022 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Whole body dual energy X-ray absorptiometry. Obese patient.</p>" ] ] 14 => array:7 [ "identificador" => "fig0075" "etiqueta" => "Figure 15" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr15.jpeg" "Alto" => 3424 "Ancho" => 2341 "Tamanyo" => 496311 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Whole body dual energy X-ray absorptiometry. The patient is wider than the width of the table so the system performs half-body scanning (left). The left side is completely included in the scan field, and a contralateral estimation is performed.</p>" ] ] 15 => array:7 [ "identificador" => "fig0080" "etiqueta" => "Figure 16" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr16.jpeg" "Alto" => 2565 "Ancho" => 938 "Tamanyo" => 142170 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Android (continuous line) and gynoid (dotted line) areas of fat.</p>" ] ] 16 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X-ray \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Plain X-ray \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X-ray \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">QCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Quantitative computed tomography \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X-ray (CT) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Magnetic resonance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">QUS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Quantitative ultrasound \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ultrasound \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single photon absorptiometry \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Radioisotope 125-I \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dual photon absorptiometry \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Radioisotope Gd-153 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SXA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single X-ray absorptiometry \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X-ray \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DXA/DEXA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dual X-ray absorptiometry/Dual energy X-ray absorptiometry \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X-ray \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab209482.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Densitometry modalities.</p>" ] ] 17 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Females \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Older than 65 years \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Younger than 65 years (postmenopausal or perimenopausal) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Males \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Older than 70 years \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Younger than 70 years with risk factors of fracture \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Both sexes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unexplained fracture \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diseases or chronic treatments \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Any patient to whom possible treatment is considered and to monitor the response to treatment \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab209485.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Indications for bone densitometry.</p>" ] ] 18 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone mineral content \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone mineral density \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Standard deviation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T</span>-score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Difference in number of standard deviations between the mean BMD value of the patient and the mean of a young adult reference population of the same sex \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Z</span>-score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Difference in number of standard deviations between the mean BMD value of the patient and the mean of a reference population of the same race, sex and age \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Osteopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T</span>-score between −1 and −2.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Osteoporosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T</span>-score ≤−2.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body mass index \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A/G ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ratio of android and gynoid A/G pelvic fat \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab209483.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Parameters evaluated in dual energy X-ray absorptiometry.</p>" ] ] 19 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Technique \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient's positioning \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Movement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Region of interest (ROI) placement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Artifacts \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Foreign bodies</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgical material \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcifications \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Contrast media \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone diseases</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spondyloarthrosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fractures \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lytic or sclerotic lesions \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab209484.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Sources of error in densitometry.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:45 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical use of bone densitometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.R. Cummings" 1 => "D. Bates" 2 => "D.M. Black" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2002" "volumen" => "288" "paginaInicial" => "1889" "paginaFinal" => "1897" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12377088" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual energy X-ray absorptiometry (DEXA) measurements of bone density and body composition: promise and pitfalls" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.K. Bachrach" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Endocrinol Metab" "fecha" => "2000" "volumen" => "13" "paginaInicial" => "983" "paginaFinal" => "988" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11086651" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of dual-energy X-ray absorptiometry machines for measuring fat distribution changes of HIV-associated lipodystrophy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Yang" 1 => "W.D. Zhu" 2 => "N.I. Paton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Antiviral Therapy" "fecha" => "2004" "volumen" => "9" "paginaInicial" => "771" "paginaFinal" => "778" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15535415" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone loss around 2 different types of hip prostheses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J. Spittlehouse" 1 => "T.W. Smith" 2 => "R. Eastell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "1998" "volumen" => "13" "paginaInicial" => "422" "paginaFinal" => "427" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9645523" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal and gynoid fat mass are associated with cardiovascular risk factors in men and women" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Wiklund" 1 => "F. Toss" 2 => "L. Weinehall" 3 => "G. Hallmans" 4 => "P.W. Franks" 5 => "A. Nordström" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2008-0804" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2008" "volumen" => "93" "paginaInicial" => "4360" "paginaFinal" => "4366" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18728169" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Single and dual energy X-ray absorptiometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.E. Adams" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Eur Radiol" "fecha" => "1997" "volumen" => "7" "paginaInicial" => "S20" "paginaFinal" => "S31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9126456" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0009739X10000023" "estado" => "S300" "issn" => "0009739X" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current state of bone densitometry for osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.K. Genant" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiographics.18.4.9672976" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "1998" "volumen" => "18" "paginaInicial" => "913" "paginaFinal" => "918" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9672976" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La densitometría ósea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.J. Alcaraz Mexía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Radiología ortopédica y radiología dental. Una guía práctica" "paginaInicial" => "91" "paginaFinal" => "98" "serieFecha" => "2004" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical principles of dual energy X-ray absorptiometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.M. Blake" 1 => "I. Fogelman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Semin Nucl Med" "fecha" => "1997" "volumen" => "27" "paginaInicial" => "210" "paginaFinal" => "228" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9224663" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Universal Standardization for dual-X-ray absorptiometry: patient and phantom cross-calibration results" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.K. Genant" 1 => "S. Grampp" 2 => "C.C. Glüer" 3 => "K.G. Faulkner" 4 => "M. Jergas" 5 => "K. Enkelge" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Mineral Res" "fecha" => "1994" "volumen" => "9" "paginaInicial" => "1503" "paginaFinal" => "1514" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual X-ray absorptiometry in today's clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.G. Dasher" 1 => "C.D. Newton" 2 => "L. Lenchik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rcl.2010.02.019" "Revista" => array:6 [ "tituloSerie" => "Radiol Clin North Am" "fecha" => "2010" "volumen" => "48" "paginaInicial" => "541" "paginaFinal" => "560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20609891" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advances in osteoporotic imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.S. Bauer" 1 => "T.M. Link" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2008.04.064" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2009" "volumen" => "71" "paginaInicial" => "440" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19651482" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.E. Adams" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2009.04.074" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2009" "volumen" => "71" "paginaInicial" => "415" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19682815" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive assessment of bone density and structure using computed tomography and magnetic resonance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Lang" 1 => "P. Augat" 2 => "S. Majumdar" 3 => "X. Ouyang" 4 => "H.K. Genant" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "1998" "volumen" => "22" "numero" => "Suppl" "paginaInicial" => "S149" "paginaFinal" => "S153" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone densitometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.J. Chun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.semnuclmed.2010.12.002" "Revista" => array:6 [ "tituloSerie" => "Semin Nucl Med" "fecha" => "2011" "volumen" => "41" "paginaInicial" => "220" "paginaFinal" => "228" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21440697" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A list of device-specific thresholds for the clinical interpretation of peripheral X-ray absorptiometry examinations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.M. Blake" 1 => "D.J. Chinn" 2 => "S.A. Steel" 3 => "R. Patel" 4 => "E. Panayiotou" 5 => "J. Thorpe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Osteoporosis Int" "fecha" => "2005" "volumen" => "16" "paginaInicial" => "2149" "paginaFinal" => "2156" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ability of peripheral DXA measurement to diagnose osteoporosis as assessed by central DXA measurement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Picard" 1 => "J.P. Brown" 2 => "L. Rosenthall" 3 => "M. Couturier" 4 => "J. Lévesque" 5 => "M. Dumont" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2004" "volumen" => "7" "paginaInicial" => "111" "paginaFinal" => "118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14742895" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical applications of body composition measurements using DXA" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.V. Albanese" 1 => "E. Diessel" 2 => "H.K. Genant" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2003" "volumen" => "6" "paginaInicial" => "75" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12794229" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204507702450" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Official position of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD position development conference" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Baim" 1 => "N. Binkley" 2 => "J.P. Bilezikian" 3 => "D.L. Kendler" 4 => "D.B. Hans" 5 => "E.M. Lewiecki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2007.12.007" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2008" "volumen" => "11" "paginaInicial" => "75" "paginaFinal" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18442754" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Official positions of the International Society for Clinical Densitometry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.M. Lewiecki" 1 => "N.B. Watts" 2 => "M.R. McClung" 3 => "S.M. Petak" 4 => "L.K. Bachrach" 5 => "J.A. Shepherd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2004-0124" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2004" "volumen" => "89" "paginaInicial" => "3651" "paginaFinal" => "3655" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15292281" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis, prophylaxis and treatment of osteoporosis" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Consensus Development Conference" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "1993" "volumen" => "94" "paginaInicial" => "646" "paginaFinal" => "650" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8506892" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "National Osteoporosis Foundation. Available from: <a class="elsevierStyleInterRef" href="http://www.nof.org/">http://www.nof.org/</a> [accessed 06.05.11]" ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis in the European Community: a call to action. An audit of policy development since 1998" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Internacional Osteoporosis Fundation (IOF)" ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2001" "editorial" => "IOF" "editorialLocalizacion" => "Brussels" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://www.iofbonehealth.org" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de osteoporosis determinada por densitometría en la población femenina española" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Álvarez Sanz" 1 => "A. Rapado" 2 => "M. Díaz Curiel" 3 => "J.J. García" 4 => "J.L. Carrasco" 5 => "J. Honorato" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "2001" "volumen" => "116" "paginaInicial" => "86" "paginaFinal" => "88" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "World Health Organ Tech Rep Ser" "fecha" => "1994" "volumen" => "843" "paginaInicial" => "1" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7941614" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimized interpretation and reporting of dual X-ray absorptiometry (DXA) scans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Lenchik" 1 => "P. Rochmis" 2 => "D.J. Sartoris" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "1998" "volumen" => "171" "paginaInicial" => "1509" "paginaFinal" => "1520" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Official positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD pediatric position development conference" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Baim" 1 => "M.B. Leonard" 2 => "M.L. Bianchi" 3 => "D.B. Hans" 4 => "H.J. Kalkwarf" 5 => "C.B. Langman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2007.12.002" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2008" "volumen" => "11" "paginaInicial" => "6" "paginaFinal" => "21" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18442749" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fracture prediction and the definition of osteoporosis in children and adolescents: the ISCD 2007 pediatric official positions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Rauch" 1 => "H. Plotkin" 2 => "L. DiMeglio" 3 => "R.H. Engelbert" 4 => "R.C. Henderson" 5 => "C. Munns" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2007.12.003" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2008" "volumen" => "11" "paginaInicial" => "22" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18442750" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis: what a clinician expects to learn from a patient's bone densitometry examination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.C. Lentle" 1 => "J.C. Prior" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2283020093" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2003" "volumen" => "228" "paginaInicial" => "620" "paginaFinal" => "628" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12954887" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Catálogo de exploraciones de la Sociedad Española de Radiología Médica (SERAM). <a class="elsevierStyleInterRef" href="http://www.seram.es/">http://www.SERAM.es</a>; 2009 [accessed online 29.04.11]." ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective dose values in bone mineral measurements by photon absorptiometry and computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.A. Kalender" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Osteoporosis Int" "fecha" => "1992" "volumen" => "2" "paginaInicial" => "82" "paginaFinal" => "87" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An assessment of the radiation dose to patients and staff from a Lunar Expert-XL fan beam densitometer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.A. Steel" 1 => "A.J. Baker" 2 => "J.R. Saunderson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Physiol Meas" "fecha" => "1998" "volumen" => "19" "paginaInicial" => "17" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9522384" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Computerized bone densitometric analysis: operator-dependent errors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.B. Staron" 1 => "R. Greenspan" 2 => "T.T. Millar" 3 => "J.P. Bilezikian" 4 => "E. Shane" 5 => "N. Haramati" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiology.211.2.r99ma55467" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "1999" "volumen" => "211" "paginaInicial" => "467" "paginaFinal" => "470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10228530" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual X-ray absorptiometry. Recognizing image artifacts and pathology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Jacobson" 1 => "D.A. Jamadar" 2 => "C.W. Hayes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "2000" "volumen" => "174" "paginaInicial" => "1699" "paginaFinal" => "1705" ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual-energy X-ray absorptiometry in the diagnosis of osteoporosis. A practical how-to guide" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Lorente-Ramos" 1 => "J. Azpeitia-Armán" 2 => "A. Muñoz-Hernández" 3 => "J.M. García-Gómez" 4 => "P. Díez-Martínez" 5 => "M. Grande-Bárez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "2011" "volumen" => "196" "paginaInicial" => "897" "paginaFinal" => "904" ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual-energy X-ray absorptiometry in clinical practice: application and interpretation of scans beyond the numbers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.J. Theodorou" 1 => "S.J. Theodorou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Imaging" "fecha" => "2002" "volumen" => "26" "paginaInicial" => "43" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11814753" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical aspects and clinical interpretation of bone mineral measurements" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Wahner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Public Health Rep" "fecha" => "1989" "volumen" => "104" "numero" => "Suppl" "paginaInicial" => "S27" "paginaFinal" => "S30" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0190" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dual energy X-ray absorptiometry interpretation and reporting in children and adolescents: the 2007 ISCD pediatric official positions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. Gordon" 1 => "L.K. Bachrach" 2 => "T.O. Carpenter" 3 => "N. Crabtree" 4 => "G.E. Fuleihan" 5 => "S. Kutilek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2007.12.005" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2008" "volumen" => "11" "paginaInicial" => "43" "paginaFinal" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18442752" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0195" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body composition analysis in obesity: radionuclide and non radionuclide methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Tzotzas" 1 => "G.E. Krassas" 2 => "A. Doumas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hell J Nucl Med" "fecha" => "2008" "volumen" => "11" "paginaInicial" => "63" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18392235" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0200" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of body composition methods: a literature analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Fogelholm" 1 => "W. van Marken Lichtenbelt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Nutr" "fecha" => "1997" "volumen" => "51" "paginaInicial" => "495" "paginaFinal" => "503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11248873" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0205" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total-body and regional bone mineral content and areal bone mineral density in children aged 8–18: the Fels longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.M. Maynard" 1 => "W.C. Chumlea" 2 => "A.F. Roche" 3 => "W.A. Wisemandle" 4 => "C.M. Zeller" 5 => "B. Towne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "1998" "volumen" => "68" "paginaInicial" => "1111" "paginaFinal" => "1117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9808230" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fat-free mass and fat mass referente values by dual-energy X-ray absorptiometry (DEXA) in a 20–80 year-old italian population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Coin" 1 => "G. Sergi" 2 => "N. Minicuci" 3 => "S. Gianni" 4 => "E. Barbiero" 5 => "E. Manzato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2007.10.008" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2008" "volumen" => "27" "paginaInicial" => "87" "paginaFinal" => "94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18206273" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-linear relationships between visceral fat area and percent regional fat mass in the trunk and the lower limbs in Japanese adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Demura" 1 => "S. Sato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.ejcn.1602887" "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Nutr" "fecha" => "2008" "volumen" => "62" "paginaInicial" => "1395" "paginaFinal" => "1404" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17805228" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0220" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The validity of the World Health Organisation's obesity body-mass index criteria in a Turkish population: a hospital-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Bozkirli" 1 => "M.E. Ertorer" 2 => "O. Bakiner" 3 => "N.B. Tutuncu" 4 => "N.G. Demirag" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Asia Pac J Clin Nutr" "fecha" => "2007" "volumen" => "16" "paginaInicial" => "443" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17704025" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0225" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measures of adiposity and body fat distribution in relation to serum folate levels in postmenopauseal women in a feeding study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Mahabir" 1 => "S. Ettinger" 2 => "L. Johnson" 3 => "D.J. Baer" 4 => "B.A. Clevidence" 5 => "T.J. Hartman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.ejcn.1602771" "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Nutr" "fecha" => "2008" "volumen" => "62" "paginaInicial" => "644" "paginaFinal" => "650" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17457338" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735107/0000005400000005/v1_201305061506/S2173510712001188/v1_201305061506/en/main.assets" "Apartado" => array:4 [ "identificador" => "8097" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Updates in radiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735107/0000005400000005/v1_201305061506/S2173510712001188/v1_201305061506/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510712001188?idApp=UINPBA00004N" ]
Journal Information
Share
Download PDF
More article options
Update in Radiology
Dual energy X-ray absorptimetry: Fundamentals, methodology, and clinical applications
Absorciometría con rayos X de doble energía. Fundamentos, metodología y aplicaciones clínicas
R.M. Lorente Ramos
, J. Azpeitia Armán, N. Arévalo Galeano, A. Muñoz Hernández, J.M. García Gómez, J. Gredilla Molinero
Corresponding author
Unidad Central de Radiodiagnóstico de la CAM, Hospital Infanta Leonor, Madrid, Spain