Concordance between radiofrequency echographic multispectrometryand dual X-ray absorptiometry in diagnosing osteoporosis among postmenopausal women: a real-world study.

CONTEXT: DXA densitometry is the current gold standard for the diagnosis of osteoporosis, but alternatives have been proposed.

MAIN RESULT: REMS densitometry shows high correlation with DXA in the identification of osteoporosis, especially in the lumbar spine.

RELEVANCE: REMS can be a useful tool for the identification of osteoporosis.

INTRODUCTION

Osteoporosis is characterized by reduced bone mineral density (BMD). The gold standard for diagnosis is bone densitometry using dual-energy X-ray absorptiometry (DXA). However, a non-ionizing technique based on quantitative ultrasound-radiofrequency echographic multispectrometry (REMS)-has recently emerged as a potential alternative.

OBJECTIVE

To evaluate the diagnostic concordance between REMS and DXA in identifying osteoporosis among postmenopausal women attending the endocrinology clinic at Hospital de San José in Bogotá, Colombia, between June and December 2024.

MATERIALS AND

METHODS

This descriptive cross-sectional study included 50 women with clinical indications for densitometry, for whom BMD was assessed using both DXA and REMS. Diagnostic agreement was evaluated based on the proportion of patients classified into the same diagnostic category by both methods and the corresponding concordance correlation coefficient (CCC).

RESULTS

The mean age of participants was 67 ± 12.4 years. According to DXA, 56% were diagnosed with osteoporosis and 38% with osteopenia. Among those diagnosed with osteoporosis by DXA, 92.9% were similarly classified by REMS. The CCC between methods was 0.53 (95% CI 0.32-0.68; p < 0.01) for the lumbar spine and 0.38 (95% CI 0.13-0.58; p < 0.01) for the femoral neck.

CONCLUSIONS

REMS demonstrates substantial concordance with DXA in diagnosing osteoporosis, particularly in the lumbar spine. However, agreement varies by anatomical site, and influencing factors should be considered. This is the first study in Colombia to assess diagnostic agreement between these two techniques, and further research is recommended to validate and expand upon these findings.