Short-term precision assessment of trabecular bone score and bone mineral density using dual-energy X-ray absorptiometry with different scan modes: an in vivo study

Objectives: We estimated the in vivo reproducibility of trabecular bone score (TBS) from dual-energy X-ray absorptiometry (DXA) using different imaging modes to be compared to that of bone mineral density (BMD).Methods: We enrolled 30 patients for each imaging mode: fast-array, array, high definition. Each patient underwent two DXA examinations with in-between repositioning. BMD and TBS were obtained according to the International Society for Clinical Densitometry guidelines. The coefficient of variation (CoV) was calculated as the ratio between root mean square standard deviation and mean, percent least significant change (LSC) as 2.77 × CoV, reproducibility as the complement to 100 % LSC.Results: Fast-array imaging mode resulted in 0.8 % CoV and 2.1 % LSC for BMD, 1.9 % and 5.3 % for TBS, respectively; array imaging mode resulted in 0.7 % and 2.0 % for BMD, 1.9 % and 5.2 %, for TBS; high-definition imaging mode resulted in 0.7 % and 2.0 %, for BMD; 2.0 % and 5.4 % for TBS, respectively. Reproducibility of TBS (95 %) was significantly lower than that of BMD (98 %) (p < 0.012). Difference in reproducibility among the imaging modes was not significant for either BMD or TBS (p = 0.942).Conclusion: While TBS reproducibility was significantly lower than that of BMD, differences among imaging modes were not significant for both TBS and BMD.Key Points: • TBS is an emerging tool for assessing BMD.• TBS reproducibility is lower than that of BMD.• Differences between imaging modes are not significant for either TBS or BMD.