Principles of operation of DXA systems Dr Wil Evans Head of Medical Physics University Hospital of Wales, Cardiff What does DXA mean and why is it important? • DXA stand s for Dual e nergy X-ray Absorptiometry - the measurement of absorption of x-rays at two different energies • Some times t he long er abbr eviat ion DEXA is used • Widely accepted me thod of bo ne densitome try - measuring bone mineral density (BMD) • Bone de nsito metry i s import ant for ass essin g fracture risk, diagnosing osteoporosis, making decisions about patient management and monitoring change of BMD How can we measure bone mineral density? • Wha t age nts can we use ? – Radia tion (x and gamma) – Ultrasound • What properties can we measure ? – Vel oci ty – Attenuation (reduction of intensity) What is radiation? • X and ga mma ray s are typ es of elec troma gneti c radiation • Similar in nature to ordinary visible light • Light ( and oth er typ es of elec troma gneti c radiation) exist in two forms • For phenomen a such as inte rfere nce and polarisation, we need the wave picture of radiation • To descr ibe the in teract ion of rad iatio n with mat ter, we ne ed the photon picture Mobile phones What kinds of electromagnetic radiation are there? • X and g amma – ver y short wavel eng th (1 nm = 10 -9 m) and very high photon energy (1 keV = 10 3 eV)
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Head of Medical PhysicsUniversity Hospital of Wales, Cardiff
What does DXA mean
and why is it important?
• DXA stands for Dual energy X-rayAbsorptiometry - the measurement of absorptionof x-rays at two different energies
• Sometimes the longer abbreviation DEXA isused
• Widely accepted method of bone densitometry -measuring bone mineral density (BMD)
• Bone densitometry is important for assessingfracture risk, diagnosing osteoporosis, makingdecisions about patient management andmonitoring change of BMD
How can we measure bone mineral
density?
• What agents can we use?
– Radiation (x and gamma)
– Ultrasound
• What properties can we measure? – Velocity
– Attenuation (reduction of intensity)
What is radiation?
• X and gamma rays are types of electromagneticradiation
• Similar in nature to ordinary visible light
• Light (and other types of electromagneticradiation) exist in two forms
• For phenomena such as interference and polarisation, we needthe wave picture of radiation
• To describe the interaction of radiation with matter, we need thephoton picture
Mobilephones
What kinds of electromagnetic
radiation are there?
• X and gamma – very short wavelength (1 nm = 10-9 m) and very highphoton energy (1 keV = 103 eV)
• DXA is an excellent example of how theapplication of radiation physics has produced anindispensable clinical tool
• DXA is firmly established as a low radiation doseand relatively low cost technology
• Combined with imaging capability for fractureidentification DXA is likely to continue to be usedfor the diagnosis and management ofosteoporosis for some time