- 期刊
醫學影像部門建立放射師之雙能量X光骨質密度吸收測量儀的最小顯著變化值與精確度誤差值的評估
Establish Department of Imaging Medicine Least Significant Change and Precision Error Assessment in Dual-Energy X-ray Absorptiometry Technologists
摘要
根據WHO世界衛生組織（World Health Organization, WHO），檢測骨質疏鬆症標準工具是雙能量X光吸收儀（Dual-energy X-ray Absorptiometry, DXA），正確檢測有助於預防因跌倒造成的骨折風險。骨密檢測結果與操作人員技術有關，每位放射師必須依照標準方法，建立自己的最小顯著變化值（Least significant change, LSC），且此精確度需在可接受的範圍內。本研究目的在建立3位放射技術師在腰椎、全髖骨、股骨頸，骨質密度掃描上造成的平均最小顯著變化值。實驗對象為90位平均年齡為46.28±9.84歲（介於20－69歲）排除有心臟血管疾病、糖尿病、無懷孕、且無服用影響骨骼代謝藥物的自願受測者。90位受測者平均身高為160.07±6.11公分（mean ± SD），體重為59.15±11.51公斤，身體質量指數（body massindex; BMI）為23.04±3.83。實驗當天骨質密度吸收測量儀的每日校準變異係數百分比（percent coefficient ofvariation; % CV）為0.344%。選擇正面腰椎掃描（PA Lumbar spine）與髖骨包含全髖骨（Total hip）及股骨頸（Femur neck）掃描模式。代入腰椎掃描骨密度值經＂ISCD Precision Calculating Tool＂公式，為達到95%信賴度，將精密度誤差值乘上2.77倍，計算得到第一腰椎至第四腰椎（L1－L4）最小顯著變化值（LSC）為0.022 g/cm^2（= 0.008 g/cm^2× 2.77）全髖骨為0.014 g/cm^2，股骨頸為0.016 g/cm^2。腰椎的PE值應小於0.02 g/cm^2、全髖骨的PE值應小於0.018 g/cm^2、股骨頸的PE值應小於0.025 g/cm^2）。本次放射師的腰椎、全髖骨、股骨頸掃描的最小顯著變化值（LSC），完全符合國際臨床骨密學會的建議標準。
並列摘要
According to World Health Organization, (WHO), standard tool for detecting osteoporosis is Dual-energy X-ray Absorptiometry, DXA, Correct detection helps prevent fracture risk from falls. Bone density test results are dependent on Radiological technologists, and each radiologist technologists must establish his or her own Least Significant Change (LSC) with acceptable accuracy according to standard methods. The purpose of this study was to establish the least significant change on lumbar spine, total hip, femoral neck, and BMD scans by 3 radiologic technologists. A total of 90 healthy subjects who ranged from 20 to 69 years old (mean = 46.28±9.84) , no pregnancy and without taking any medicine which could influence bone metabolism. Their mean height was 160.07±6.11cm, mean weight was 59.15±11.51 kg and mean body mass index (BMI) was 23.04±3.83. Each patient was done on sameday. The percent coefficient of variation (%CV) of daily quality assurance was 0.344%. Choosing PA spine and hip scan mode. Substituting the bone density value of ＂ISCD Precision Calculating Tool＂, an average calculate LSC for the group at the 95% confidence interval was 0.022 g/cm^2(= 0.008 g/cm^2 × 2.77) for lumbar spine, than 0.014g/cm^2 for total hip , than 0.016g/cm^2 for femoral neck. Precision error (RMS SD) in BMD for lumbar spine (L1-L4) scans was less than 0.002 g/cm^2, total hip was less than 0.018 g/cm^2, femoral neck was less than 0.025 g/cm^2. This study was a very successful experience about establishing an average LSC value created by multiple technologists.