3 new abstracts with DXL Calscan from the ASBMR 26^th Annual Meeting.

Updated reference database for DXL Calscan - New study in the Journal of Clinical Densitometry.

A new study has been published in the international journal "Annals of Traumatology and Orthopedics" by a research team led by Prof. S.S. Rodionova, founder of the Russian Osteoporosis Society and Professor of Traumatology at the Central Institute of Traumatology & Orthopedics (CITO). Random bone mineral density testing was performed using the portable DXL Calscan device (Demetech, Sweden) on 2854 women who are now between the ages of 15 and 80 years. The device uses a patented technology of dual energy x-ray and laser (DXL) to better eliminate errors caused by lean soft tissue and fat in DXA devices. 

The Chernobyl accident of April 1986 caused radioactive contamination to the environment in many communities in the Brjansk region of western Russia, near the Ukraine and Belarus borders. While some specific communities within this region were spared from this contamination, other communities were greatly affected. The effects of the environmental damage caused in the affected communities continue to be seen in the form of health problems for their inhabitants. This study examines the increased risk of osteoporosis and future fragility fractures in affected areas compared to control groups.

The subjects from the city of Novozybkov, a well-documented area of radioactive contamination, were compared to subjects from the city Zhukovka (also in the Brjansk region, but unaffected by contamination) and subjects from the city of Tver (northwest of Moscow and far from the contaminated area). The second control group from Tver was added to assure that subjects from Zhukovka were actually representative of a non-contaminated population, due to Zhukovka's relative proximity to the contaminated area. A comparison of the results from these two control groups showed no significant differences in the age-adjusted BMD values for women from Zhukovka or Tver. The subjects from all three cities were also verified to be life-long residents of their respective cities. 

Results from the age-adjusted comparison of subjects from the non-contaminated areas to the subjects from the contaminated area were significantly different and these differences were confirmed statistically as reliable (p>0.001). Logistic regression analysis showed that in women >56 years of age from the contaminated area, the decrease in bone mineral density per year was almost double that of the decrease per year from the non-contaminated areas. It was also shown that the increased risk of future osteoporosis development was mainly due to the negative influence on subjects in attaining normal peak bone mass formation at young ages. In fact, the largest differences in age-adjusted bone density were found in individuals who were around the age of 10 years at the time of the accident, i.e. in whom the process of peak bone mass formation proceeded during very unfavorable conditions. It is important to note that these unfavorable conditions for bone development also include significant changes in diet for inhabitants in the contaminated area due to the lack of access to affordable fresh foods locally.

In conclusion the authors state that widespread use of the DXL Calscan scanner could permit control of rates of peak bone mass formation in the young, allowing the formation of osteoporosis risk groups for outpatient observation and treatment if necessary. The aim would be to reduce the number of patients who develop osteoporosis and osteoporotic fractures in the future, when these patients exceed the age of 50 years.

Regarding the use of the DXL Calscan device, Coe sites the example of The Centre for Metabolic Bone Disease, Royal Hull Hospitals NHS Trust, which evaluated the capabilities of the DXL Calscan (Thorpe and Steel, BJR 2006). This facility is the largest bone densitometry centre in the UK, and following the results of the study, the metabolic bone unit purchased a Calscan and now uses it effectively for triage diagnostics in the Hull area.

Traditional DXA machines are operator dependent, with the quality of the results varying between operators. In fact, the same patient scanned by different operators can produce different results.
With the Calscan, the scanning site is automatically defined by advanced edge detection software, which makes reproducibility independent from operators. The Calscan also permits comparison with previous scans, allowing for monitoring of the response to pharmaceutical and non-pharmaceutical therapy.

The new  Study collection is udated with the latest 21 studies about DXL Calscan.

Contact Demetech for more information or download, as a PDF-file, from: The scientific study collection.

Sweden-based Demetech has been selected as the recipient of the 2007 Frost & Sullivan Award Technology Innovation Award in the European bone densitometry systems market for its proprietary Dual X-Ray and Laser (DXL) technology. This innovative system is set to fulfill the need for a technology that accurately determines bone density in a cost-effective manner.

“Due to the method used by the current standard, Dual Energy X-Ray Absorptiometry (DEXA) technology, persons with very low or high fat content get distorted results, with fat error estimated to be anywhere between 10 and 40 per cent for individual patients,” notes Frost & Sullivan Research Analyst Divya B. “Demetech’s DXL Calscan solves this issue by innovatively combining a dualwavelength X-ray source with laser definition of the measurement area.” Demetech is the only company in the market with the patented DXL technology. Among the technology’s key benefits are high precision and accuracy, rapid scanning, user friendliness and affordability. “In a market characterized by the established DEXA technology, Demetech has carved a niche for itself by investing substantially in R&D activities,” observes Ms. Divya. “Through a well-established distribution network and focused marketing strategies, the company is poised to fulfill the need for affordable yet accurate technology alternatives in the bone densitometry market.”

"To be honoured 2007 Frost & Sullivan Technology Innovation Award is a proof that we have selected the best technology platform in our commitment to bring accurate and user friendly bone densitometry products to the market. The award was given to Demetech in competition with all the world's other top medical imaging companies. This shows that our strategies work well in today's very competitive markets", says Mr. Lars J.A. Johnson, Chairman and CEO of Demetech AB. "We hope our technology will contribute to an increased assessment of the bone density in the global fight against osteoporosis and that more women and men can benefit from accurate bone density measurements to prevent future fractures", adds Mr. Johnson.

The new  Study collection is udated with the latest 19 studies about DXL Calscan.

Contact Demetech for more information or download, as a PDF-file, from: The scientific study collection.

Alf Svensson, the popular former party leader of kd, has submitted a motion to the Swedish Parliament calling for a national campaign to prevent fractures and suffering. With an estimated 450,000 Swedish citizens suffering from osteoporosis, Svensson calls for a mandatory investigation of all fractures and falls by the elderly, as is now required in Great Britain. Svensson notes that no region in Sweden offers routine bone density testing to persons in high-risk groups. Many elderly patients come to primary care facilities with forearm fractures. After being fitted with a cast, they are sent home without even having a bone density scan, which is very easy with today’s technology. Svensson proposes that a bone density scan should also be included in the general heathcare plan for all women who have gone through menopaus.    

Prof. Olle Svensson states that the lack of preventive care for fragility fracture patients has reached scandalous proportions in Sweden. His clinical study team from the University of Umeå has uncovered that 40% of all osteoporosis related fractures are repeat fractures for the same patients who have already experienced a fragility fracture. This means that 28,000 of the total 70,000 fragility fractures per year could be prevented if patients had access to early diagnosis and preventive care for those at risk.  According to Prof. Svensson, "If this was coronary care and repeat heart attacks were occurring, there would be a revolt!" Fragility fractures cost the Swedish state €500 million annually according to the study. Svenssons team presented these study results at a large international conference in the USA. The study also found that 20% of the patients accounted for almost 40% of the fractures. The most likely fracture site for any patient’s 2nd fracture was the hip – the site associated with the most suffering, mortality and cost to society. Preventing these repeat fractures should be the highest priority and the fact that almost nothing is being done is a scandal, according to Svensson. Svenssons own team in Umeå scans all patients over 50 years with suspected fragility fractures with DXL Calscan. By only keeping the patients with previous falls and fractures under preventive care we could reduce the number of fractures by 20% with untold savings in both patient suffering and the healthcare budget.

The scientific study collection is updated with the latest 16 studies about DXL Calscan.

Contact Demetech for more information or download, as a PDF-file, from: The scientific study collection.

This study was performed at the Metabolic Bone unit of Royal Hull Hospitals in the United Kingdom.  This facility is the largest bone densitometry center in the United Kingdom. After evaluating the capabilities of DXL Calscan, the Metabolic Bone unit decided to purchase DXL Calscan for their own use in managing osteoporosis in the Hull area.  Some of highlights of the article follow:

• “The DXL Calscan is well suited for use in the management of post-menopausal osteoporosis.”

• Use of the derived lower threshold provides a 90% confidence that the patient would be found osteoporotic by spine and hip, with almost all the remainder severely osteopenic by spine or hip.

• By placing the DXL Calscan in a clinical triage setting and using the diagnostic thresholds arrived at in this study, the DXL Calscan would itself be able to diagnose over 63% of all scanned patients and would refer only 37% for axial DXA scans, according to the best estimate of this study.

• Use of the DXL Calscan in a triage role as an adjunct to an established DXA service could bring substantial benefits to both patient and healthcare providers.

• “The DXL Calscan proved convenient, easy to use and was stable over time and within a range of operating temperatures.”

•  Long term in vitro precision was CV_RMS  0.73% while precision in vivo on 67 duplicate patient scans was CV_RMS 1.19%.

• The effective radiation dose to the patient was <0.1 µSv per scan.

• The DXL Calscan measures bone density at the heel, where there is a higher proportion (95%) of the more metabolically active trabecular bone. This suggests that this site is more sensitive to mechanisms affecting bone metabolism. Together with the advantage of the Calcaneus being a weight bearing bone, DXL Calscan scans of the Calcaneus should better reflect the changes occurring at the spine and the hip than at other peripheral sites.

The study named "The DXL Calscan heel densitometer: evaluation and diagnostic thresholds" of J A Thorpe MSc, BSc¹⁾ and S A Steel MSc, BSc¹⁾ is published and available online at The British Journal of Radiology, 79 (2006), 336-341.

Physicians in Varmland County Sweden created an effective and comprehensive osteoporosis management system using only limited economic resources and 5 units of a heel pDXA device called DXL Calscan.  By assembling a multi-disciplinary team of primary care physicians, orthopaedic surgeons, nurses, internists and physiotherapists, this system is so effective that some health officials believe they will save money over time. The system is not a screening approach as all patients had risk factors for osteoporosis before they were suggesting for bone density testing. Several studies have suggested that risk factors and the selective addition of bone mineral density testing (BMD) is effective in finding patients for assessment of osteoporosis and that efficient use of this method could prevent up to 25% of all fractures.

The DXL Calscan unit was selected according to the authors because, “Prospective studies have shown that bone mineral density measurements of the heel bone have a high predictive value for identifying patients who are at risk of sustaining fragility fractures.  This high predictive value is valid for both hip fractures and fractures at other sites (Marshall et al. 1996) Several studies show that the Calcaneus is the most effective site for predicting spine fractures (Vogel et al 1988; Black et al 1992).”

The study named “Comprehensive osteoporosis management with easy access to bone mineral density measurements)” written by Ragnar Kullenberg PhD (1), Bengt Hansson MD (2), Rolf Sandberg MD (3) and Hans Dahlberg MD (4) is published in the scientific journal “Journal of Evaluation in Clinical Practice” available online at Blackwell Publishing Ltd.

www.scanflex.se
www.swemac.se
www.demetech.se

DXL Calscan – New study in the Journal of Clinical Densitometry

DXL Calscan showed very good results in a new study named “Dual X-ray and Laser Absorptiomentry of the Calcaneus” published in the scientific Journal of Clinical Densitometry, vol. 7, no. 3, 349-354, 2004. The study performed at the University of Siena, Italy, included 20 osteoporotic women (age 65.7 +/-8) and 20 nonosteoporotic women (age 61.5 +/- 9). The WHO guidelines where used to classify osteoporotic and nonosteoporotic women. The WHO classification was based on T-scores from DXA measurements of lumbar spine (L1-L4). The study also included a total body measurement for each patient. The DXL Calscan was highly correlated to total body BMD (r=0.88, p<0.01) and lumbar spine BMD (r=0.77, p<0.01). The sensitivity and specificity for DXL Calscan, compared to measurements from L1-L4, were 70 respectively 80%. The data showed that DXL Calscan provides a convenient method of measuring skeletal BMD with some advantages over axial BMD; indeed, it is easy to use, transportable and performs fast scanning with a minimal dose of radiation.

Contact Demetech for more information or visit: Journal of Clinical Densitometry

Three new abstracts were presented at the ASBMR 26th Annual Meeting in Seattle, USA. 

Calcaneal BMD with DXL Technique Discriminates Between Postmenopausal Females With and Without a History of Fracture – The CALCOS Study (Calcaneal Osteoporosis Study)

Reference data for BMD in the calcaneus for healthy children 4-years of age by dual energy X-ray absorptiometry and laser (DXL)

T. B. Brismar*1, C. Nyberg*2, H. Salminen*3. 1Centre of Surgical Sciences, Division of Radiology, Karolinska Institutet, Stockholm, Sweden, 2Läkarhuset Hötorget, Stockholm, Sweden, 3Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden.

Presentation Number: SA105

L. I. M. Toft1, T. B. Brismar*2. 1Merck, Sollentuna, Sweden, 2Center for Surgical Sciences, Division of Radiology, Karolinska Institutet, Stockholm, Sweden.

Presentation Number: SA101

The aim of this cross-sectional study was to investigate: if the device was tolerated by young children, if BMD could be measured by good precision and related to height weight and body mass index and to create reference data. The DXL Calscan was modified for children with a lower absorbed dose (<0.12µSv). 110 strictly healthy Swedish children (49% boys, 51% girls, mean age 4.3 years) were included. The intra-individual CV measured by 2 repeated measurements on 26 subjects was 6.53% for BMD. The mean BMD was 0.22 g/cm2. No significant difference was found between girls and boys. BMD was significantly correlated to weight, weight SDS and height. BMD was not correlated to BMI or foot length. In conclusion, the measurements were easily performed and well tolerated by these young children. This is the first study to present normative data for BMD and BMC in the calcaneus in 4year old children by DXL Calscan.

A new study named “Reference Database for Dual X-Ray and Laser Calscan Bone Densitometer” is published in the Journal of Clinical Densitometry vol. 6, no. 4, 367–371, 2003. The database was obtained from 993 healthy women and 459 healthy men in a population from Sweden. Inclusion criteria were: healthy Swedish Caucasians, 15 to 85 years of age for women and 19 to 85 years of age for men, no history of osteoporosis treatment, no use of corticosteroids for more than 3 months, and no extended bed rest. The young adult reference mean BMD for women was found to be 0.483 ± 0.062 g/cm2 and for men 0.556 ± 0.074 g/cm2. The age-adjusted odds ratio was 3.7 for a history of fracture among women aged 50 years and over, comparing subjects with a 1-SD reduction in bone density to subjects with a bone density above this value. The DXL Calscan device used for the study was compared weekly against a heel bone phantom. The precision of these measurements was 0.5%. The in vivo precision was 1.2%, as assessed by duplicate measurements on 35 healthy individuals (mean age 52 years, range 25–72 years).

The scientific collection is updated with newly published studies about DXL Calscan.

Contact Demetech for more information or download, as a PDF-file, from: The scientific collection.