The role of quantitative ultrasound in predicting osteoporosis defined by dual-energy X-ray absorptiometry in pre- and postmenopausal women

Abstract

Objectives The aims of the study were, first, to compare correlations between calcaneal quantitative ultrasound parameters and femoral and spine bone mineral density measured with dual-energy X-ray absorptiometry (DXA) and, second, to analyze the predictive values of quantitative ultrasound (QUS) determinations for the diagnosis of osteoporosis in pre- and postmenopausal women.

Methods A total of 351 pre- and postmenopausal women were included in the study. The correlation between QUS and DXA was assessed and the optimal cut-off point in QUS was sought for the diagnosis of osteoporosis from sensitivity and specificity calculations and receiver operator characteristic (ROC) curves.

Results The QUS parameters of the postmenopausal group were significantly lower than those of premenopausal women. Significantly lower correlation coefficients between broadband ultrasound attenuation and DXA at the femoral neck and spine were found in premenopausal women (r = 0.44 and 0.38, respectively) compared to postmenopausal women (r = 0.60 and 0.48). The areas under the ROC curves ranged from 0.54 to 0.62 and QUS parameters were shown to be poor at predicting osteoporosis as defined by DXA.

Conclusions We concluded that, although DXA and QUS parameters were significantly correlated, QUS parameters cannot predict osteoporosis defined by DXA. Sensitivities and specificities of QUS parameters were not sufficiently high for QUS to be used as an alternative to DXA.

Key words:

• OSTEOPOROSIS
• QUANTITATIVE ULTRASOUND
• BONE MINERAL DENSITY
• DXA
• STIFFNESS INDEX
• BROADBAND ULTRASOUND ATTENUATION
• SPEED OF SOUND