Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry

Background Preterm infants are at risk of impaired bone health in later life. Dual-energy X-ray absorptiometry-scan (DXA) is the gold standard to determine bone mineralization. Phalangeal quantitative ultrasound (pQUS) is an alternative technique that is inexpensive, easy to use and radiation-free. The aim of this study was to investigate whether both techniques reveal equivalent results. Materials and methods Sixty former preterm infants (31 boys; 29 girls) received a DXA and pQUS at age 9 to 10 years. DXA measured bone mineral content (BMC) and bone mineral density (BMD) for total body and lumbar spine (L1-4), while pQUS measured the amplitude dependent speed of sound (AD-SoS) and bone transit time (BTT) at metacarpals II-IV providing continuous values and Z-scores based on age and sex. Four statistical methods evaluated the association between both techniques: Pearson's correlation coefficients, partial correlation coefficients adjusted for gestational age, height and BMI, Bland-Altman analysis and cross tabulation. Results Both techniques showed a statistically significant weak correlation for continuous values as well as Z-scores (0.291–0.462, p
Highlights • DXA is the golden standard to determine bone mineralization, while Quantitative ultrasound is a radiation-free alternative. • Four statistical tests were used to investigate the equivalence of both methods. • Comparison of results of 60 preterm born children at age 9 to 10 years found poor agreement between both methods. • There was a discrepancy in differentiating the same children with normal or reduced bone mineralization. • Quantitative ultrasound cannot replace the DXA scan for determination of bone mineralization in preterm born children.