ICCBH2013 Poster Presentations (1) (201 abstracts)
Reflection analysis of infant scans results may improve infant DXA bone density and body composition result that contain motion
John Shepherd 1 , Bo Fan 1 , Cassidy Powers 1 , Lynda Stranix-Chibanda 2 , Mary Fowler 3 , Linda DiMeglio 4 , Kathy George 5 & George Siberry 6
1University of California, San Francisco, California, USA; 2University of Zimbabwe, Harare, Zambia; 3Makerere University, Kampala, Uganda; 4Indiana University, Indianapolis, Indiana, USA; 5Family Health International, Durham, North Carolina, USA; 6National Institutes of Child Health and Human Development, NIH, Bethesda, Maryland, USA.
Objectives: Special dual-energy X-ray absorptiometry (DXA) protocols permit quantification of bone mineralization, fat mass, and fat distribution in infants. Our objective was to evaluate the accuracy and precision of a multiscan acquisition protocol designed to allow for reflection and imputation analysis for regions with movement.
Methods: The IMPAACT P1084s Study assesses bone and kidney safety of antiretrovirals used for PMTCT. Newborns received a spine and whole body DXA scan with up to three attempts to acquire a motion free scan. A novel six-region whole body analysis was used to isolate movement artifacts. Precision was estimated as a root mean square error (RMSE) or percent coefficient of variation (%CV) for scans with multiple valid results. Results from whole body scans without movement were compared to estimated whole body results from either single-scan reflection of arms and legs, or from multiscan imputation using the Student’s t-test.
Results: Of 229 sequentially recruited infants (100 males), 41 and 132 infants had repeat scans for spine and whole body respectively. Spine precision for duplicate scans was 5.0% (BMD) and 4.4% BMC (n=38). Whole body bone precision was 9.9% for BMC and 6.7% for BMD (n=3), and 0.9, 4.9, 4.0, and 1.1% for lean, fat, % fat, and total mass respectively. Omitting one of the four vertebrae did not significantly impact the total BMD no matter which vertebrae was left out. One-vertebra imputation resulted in less than a 1.5% difference in total BMD. The standard error of total body measures using reflected appendages was in all cases less than the precision for any single region, and smaller than for imputed values in most cases.
Conclusion: Motion artifacts can be effectively removed from infant DXA scans using either omission, reflection, or imputation techniques. The reflection method provides the best agreement to whole body results without movement.
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Bone Abstracts
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