POS1111 DIAGNOSIS OF OSTEOPOROSIS USING RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS) AT THE LUMBAR SPINE IN PATIENTS WITH DIFFERENT BODY MASS INDEX

Abstract

Background: In recent years, the technology based on the analysis of raw ultrasound signals, Radiofrequency Echographic Multi Spectrometry (REMS), has been validated against Dual-energy X-ray Absorptiometry (DXA) for the diagnosis of osteoporosis and risk fracture prediction. Objectives: The aim of this multicenter observational study was to evaluate the diagnostic performance of REMS with respect to DXA in patients with different body mass index (BMI) categories. Methods: The inclusion criteria were: Caucasian women; age between 30 and 90 years; referral by their clinician for spinal DXA assessment; absence of significant walking impairment; signed informed consent. Patients underwent DXA and REMS scans at the lumbar spine, according to the procedures described in Di Paola et al. [1], including an a-posteriori quality check of the examinations in order to guarantee the maximum reliability of the diagnostic outputs. Three groups of patients were considered according to BMI:: underweight (BMI<18.5 kg/m2), normal weight (BMI≥18.5 kg/m2 and <25 kg/m2), and overweight/obese (BMI≥25 kg/m2). DXA and REMS BMD values were also stratified in 3 diagnostic categories: osteoporotic, osteopenic, or healthy. The degree of correlation between DXA and REMS BMD values was quantified by calculating Pearson’s correlation coefficient ( r ). The diagnostic concordance between REMS and DXA was assessed by Cohen’s K considering the 3 diagnostic categories. REMS´s sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for discriminating patients with and without osteoporosis were also calculated using DXA outcomes as reference. The same statistics were calculated accepting a 0.3 T-score tolerance on T-score values of borderline cases [1]. Results: Overall, 4282 patients were enrolled and, after the quality check, 3501 couples of scans were included in the analyses. Of these patients, 122 (3.5%) were underweight, 1964 (56.1%) were normal weight, and 1415 (40.4%) were overweight. The results of the diagnostic performance in patients after BMI stratification are reported in [Table 1][1]. Conclusion: We observed an excellent correlation between REMS-based diagnosis with respect to the osteoporosis diagnosis performed by DXA in patients from each BMI category. These results indicate that lumbar spine REMS analysis is a suitable and accurate diagnostic tool for patients with different BMI. References: [1]Di Paola M et al. Osteoporos Int. 2019 Feb;30(2):391-402. View this table: Table 1. Diagnostic performance of REMS with respect to DXA considered as reference for patients of different body size. Disclosure of Interests: None declared. [1]: #T1