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Advancing Bone Health Assessment: A New Era in Density Testing

Advancing Bone Health Assessment: A New Era in Density Testing

Osteoporosis affects over 200 million people worldwide, yet it remains largely undetected until fractures occur. [1] This "silent disease" presents a critical challenge: how do we identify at-risk individuals before irreversible bone loss leads to life-changing injuries?
Current bone density testing, while effective, faces significant barriers that limit widespread screening and monitoring. These limitations have sparked the development of new approaches that could transform how we assess and manage bone health.

The Challenge with Current Testing Methods

Today′s bone density assessment relies primarily on three established technologies, each with distinct advantages but also significant limitations that restrict their broader application.

DXA Scanning: The Gold Standard with Limitations

Dual-energy X-ray Absorptiometry (DXA) serves as the foundation for WHO diagnostic criteria [2], using T-scores to classify bone health. The T-score compares an individual′s bone density to the average peak bone density of healthy adults aged 20-29, with results expressed in standard deviations from this baseline:

  • Normal: T-score ≥ -1.0
  • Low bone mass (osteopenia): -2.5 < T-score < -1.0
  • Osteoporosis: T-score ≤ -2.5
  • Severe (established) osteoporosis: T-score ≤ -2.5 in the presence of one or more fragility fractures

DXA uses two X-ray beams of different energies to measure how bone and soft tissue absorb radiation, achieving excellent precision with coefficients of variation typically ≤1%. [3]

Key limitations

  • Dedicated equipment and controlled environment requirements
  • Higher costs limiting accessibility
  • Specialized technician training requirements
  • Fixed location testing constraints

QUS: Portable but Limited

Quantitative Ultrasound (QUS) measures how ultrasound waves travel through bone tissue, calculating parameters like Broadband Ultrasound Attenuation (BUA) and Speed of Sound (SOS) to assess bone stiffness. [4]

Key limitations

  • Treatment monitoring limitations: The International Society for Clinical Densitometry (ISCD) explicitly states QUS cannot monitor osteoporosis treatment effectiveness [5]
  • Diagnostic limitations: The National Osteoporosis Guideline Group (NOGG) does not recommend QUS for osteoporosis diagnosis [6]
  • Correlation variability: Significant correlation variability with DXA results (r=0.29-0.44) [7]
  • Measurement scope: Assessment of bone quality parameters rather than direct bone mineral density measurement

QCT: Comprehensive but Complex

Quantitative Computed Tomography (QCT) uses conventional CT scanners with calibration phantoms to provide volumetric bone mineral density measurements, offering separate analysis of cortical and trabecular bone. [8]

Key limitations

  • Higher radiation exposure than DXA
  • Incompatibility with standard WHO T-score classifications
  • Significantly higher costs
  • Extensive personnel training requirements

A New Approach: BIA-Based Bone Density Assessment

The limitations of current methods have created a clear need for more accessible, cost-effective bone density testing. This need has led to an unexpected discovery: Bioelectrical Impedance Analysis (BIA), traditionally used for body composition measurement, shows significant correlations with bone density.

Research has demonstrated that bioimpedance parameters, particularly phase angles from BIA and Bioelectrical Impedance Vector Analysis (BIVA), show significant correlations with bone density measurements. [9,10] As electrical current travels through the body, different tissues exhibit distinct resistance characteristics, and changes in bone density create unique signatures within these bioimpedance parameters.

This breakthrough works because bone tissue′s electrical properties change as density varies, creating measurable differences in impedance patterns that can be detected and analyzed to provide clinically meaningful bone density assessments.

Clinical Validation

To establish the technology′s clinical reliability, we conducted comprehensive validation studies:

  • Initial study (74 postmenopausal women) [11]: correlation coefficient r = 0.609 with DXA
  • Large-scale validation (318 adults) [12]: r = 0.737 with DXA
  • Both studies achieved statistical significance (p < 0.001)

These results demonstrate clinically significant measurement consistency and have been published in peer-reviewed journals including the International Journal of Gerontology and Scientific Reports.

Transforming Bone Health Assessment

BIA bone density testing addresses the fundamental barriers that have limited widespread screening. Unlike traditional methods that require specialized facilities, extensive operator training, and ongoing operational costs, BIA technology delivers clinical-grade accuracy through a fundamentally different approach.

Key advantages include:

  • Portable, radiation-free technology
  • Real-time results with minimal training requirements
  • Cost-effective equipment and operation
  • Integration capability with existing healthcare workflows

This transforms how we approach bone health management, allowing healthcare providers to integrate bone density screening into routine primary care visits and enabling testing in previously inaccessible settings.


Expanding Access to Critical Populations

BIA technology particularly benefits key at-risk groups who need regular monitoring:

  • Postmenopausal women experiencing rapid bone loss due to declining estrogen
  • Men over 65 with age-related bone density decline
  • High-risk individuals with family history or medication-related risk factors

From long-term care facilities monitoring residents regularly to corporate wellness programs providing preventive screening, BIA technology removes the practical barriers that have historically limited access to bone health assessment.


The Future of Bone Health Screening

As we continue refining this technology, BIA-based bone density testing offers a practical path toward more accessible bone health screening and earlier fracture prevention. By addressing the core accessibility challenges of traditional testing methods, this innovation opens new possibilities for proactive bone health management across diverse healthcare settings.


Our BIA bone density testing technology is protected by comprehensive patents and continues to undergo validation studies to expand its clinical applications and improve measurement accuracy.

Transform bone health assessment in your practice. Contact us to learn how this breakthrough technology can enhance your patient care capabilities while reducing operational complexity and costs.

References

[1] NIH Consensus Development Panel. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-795.
[2] WHO Technical Report Series 843. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Geneva: World Health Organization; 1994.
[3] Blake GM, Fogelman I. The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J. 2007;83(982):509-517.
[4] Hans D, Métrailler A, Rodriguez EG, Lamy O, Shevroja E. Quantitative ultrasound (QUS) in the management of osteoporosis and assessment of fracture risk: an update. Adv Exp Med Biol. 2022;1364:7-34. doi: 10.1007/978-3-030-91979-5_2.
[5] International Society for Clinical Densitometry. Adult official positions. ISCD; 2019. Available from: https://iscd.org/learn/official-positions/adult-positions/. Accessed June 6, 2025.
[6] Gregson CL, Armstrong DJ, Bowden J, et al. UK clinical guideline for the prevention and treatment of osteoporosis [published correction appears in Arch Osteoporos. 2022 May 19;17(1):80. doi: 10.1007/s11657-022-01115-8]. Arch Osteoporos. 2022;17(1):58. doi: 10.1007/s11657-022-01061-5.
[7] Swinton PA, Elliott-Sale KJ, Sale C. Comparative analysis of bone outcomes between quantitative ultrasound and dual-energy x-ray absorptiometry from the UK Biobank cohort. Arch Osteoporos. 2023;18:77. doi: 10.1007/s11657-023-01287-x.
[8] Adams JE. Quantitative computed tomography. Eur J Radiol. 2009;71(3):415-424.
[9] Tanaka S, Ando K, Kobayashi K, Hida T, Ito K, Tsushima M, et al. A low phase angle measured with bioelectrical impedance analysis is associated with osteoporosis and is a risk factor for osteoporosis in community-dwelling people: the Yakumo study. Arch Osteoporos. 2018;13(1):39.
[10] Lu HK, Lai CL, Lee LW, Chu LP, Hsieh KC. Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population. Sci Rep. 2021;11(1):21161.
[11] Chu LP, Chen KT, Hsieh KC. Novel Bioelectrical Impedance Analysis for Bone Mineral Density Measurement in Postmenopausal Women. Int J Gerontol. 2024;18(3):179-183.
[12] Chuang CL, Lai CL, Huang AC, Su PH, Chu LP, Hsieh KC, et al. Comparison of whole body bone mineral density measurements between dual energy X-ray absorptiometry and novel bioelectrical impedance analysis. Sci Rep. 2024;14:29127.