16/04/2022
QCT or DXA for osteoporosis screening?
Recent Medicare claims for quantitative computed tomography (QCT) is on the rise, but DXA remains the gold standard for bone mineral density testing.
QCT focuses on density changes in the inner, trabecular bone in the spine. It does not include the cortical shell on the outside of the vertebrae.
The DXA includes both, and is a better way to measure bone density because cortical bone plays an important role in bone density measurement.
The chair of the American College of Radiology's practice parameters committee for imaging, stated that:
QCT's ability to measure bone loss in the trabecular region of the spine is important because that's where bone loss first appears, so the QCT may be more sensitive to detecting early change….if appropriately interpreted using specific established ranges for QCT.
But for clinical purposes, he said, "DXA should be the first line." "We just feel that the higher costs and higher radiation is usually not needed."
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