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      Body composition with dual energy X-ray absorptiometry: from basics to new tools

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          Abstract

          Dual-energy X-ray absorptiometry (DXA) in nowadays considered one of the most versatile imaging techniques for the evaluation of metabolic bone disorders such as osteoporosis, sarcopenia and obesity. The advantages of DXA over other imaging techniques are the very low radiation dose, its accuracy and simplicity of use. In addition, fat mass (FM) and lean mass (LM) values by DXA shows very good accuracy compared to that of computed tomography and magnetic resonance imaging. In this review we will explain the technical working principles of body composition with DXA, together with the possible limitations and pitfalls that should be avoided in daily routine to produce high-quality DXA examinations. We will also cover the current clinical practical application of whole body DXA values, with particular emphasis on the use of LM indices in the diagnostic workup of reduced muscle mass, sarcopenia and osteosarcopenic obesity according to the most recent guidelines. The possible use of adipose indices will be considered, such as the fat mass index (FMI) or the android/gynoid ratio, as well as lipodystrophy indices and the evaluation of visceral adipose tissue (VAT). Whenever available, we will provide possible cut-off diagnostic values for each of these LM and FM indices, according to current literature and guidelines.

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          Author and article information

          Journal
          Quant Imaging Med Surg
          Quant Imaging Med Surg
          QIMS
          Quantitative Imaging in Medicine and Surgery
          AME Publishing Company
          2223-4292
          2223-4306
          August 2020
          August 2020
          : 10
          : 8
          : 1687-1698
          Affiliations
          [1 ]IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy;
          [2 ]Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133, Milano, Italy;
          [3 ]Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo , 90127, Palermo, Italy;
          [4 ]Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy;
          [5 ]Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy;
          [6 ]Bone Metabolic Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico. Medicina Nucleare, Via Francesco Sforza 35, 20122, Milano, Italy;
          [7 ]Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy;
          [8 ]Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
          Author notes
          Correspondence to: Dr. Carmelo Messina, MD. Via Riccardo Galeazzi, 20161 Milan, Italy. Email: carmelo.messina@ 123456unimi.it .
          Article
          PMC7378094 PMC7378094 7378094 qims-10-08-1687
          10.21037/qims.2020.03.02
          7378094
          32742961
          ccf334d9-c371-429b-a075-19771eed8ac2
          2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.
          History
          : 03 May 2019
          : 03 February 2020
          Categories
          Review Article

          Dual-energy X-ray absorptiometry (DXA),sarcopenia,obesity,fat mass index

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