Bone Mineral Density through DEXA and CBCT: A Systematic Review with Meta-Analysis

Dual-energy X-ray absorptiometry is used to determine bone density in several pathologies, namely osteoporosis and fracture risk in post-menopausal women. The aim of this study was to identify, appraise and synthesize all available evidence about the correlation between Dual Energy X-ray Absorptiometry (DEXA) and Cone Beam Computed Tomography (CBCT) techniques through a systematic review. A systematic literature search was conducted in the following databases: PubMed via MEDLINE, Cochrane Library, EMBASE and Web of Science Core Collection, along with several sources of grey literature. The Cochrane Risk of Bias Tools were used to perform the qualitative assessment of the selected studies. A total of 913 articles were initially scrutinized and 11 were included for qualitative analysis, of which 3 were included in a meta-analysis. Most of the included studies revealed a low risk of bias (7 out of 11). A strong correlation (min r = 0.46 max r = 0.62) between DEXA and CBCT values were found. Thus, opportunistic CBCT scans may be used to assess the bone mineral density and fracture risk, improving the ability to track disease progression and providing better care.