Whole body dual X-ray absorptiometry for bone mineral density and body composition using a flat panel detector

Whole-body dual-energy X-ray absorptiometry (DXA) systems are used for the determination of bone mineral density (BMD) but also for body composition estimates (lean mass and fat mass). The calculation is based on the difference in attenuation of body tissues for a low-energy of about 50 KeV and a high-energy of about 80-100 KeV. The measurement of dual-energy projections allows first to compute to the body composition in the non-bone area, and then to extrapolate the fat / lean ratio of soft tissue into the bone area in order to compute the BMD. Since detectors have limited area, a whole body examination requires a scan of the patient and a reconstruction process in order to build up a large field image from smaller radiographs. This reconstruction process must keep the quantitative value of the radiographs, and avoid any distortion which could be a consequence of the conic acquisition geometry. The cone angle is low (6 at maximum) and the large overlap between radiographs helps to reconstruct an image equivalent with a parallel-beam geometry. Scatter is corrected from the radiographs before reconstruction, as described in a previous paper ('Dual-energy X-rays absorptiometry using a 2D digital radiography detector. Application to bone densitometry', SPIE Medical Imaging 2001, Medical Physics). We have developed an original reconstruction method dedicated to whole-body examinations which will be described. Thanks to the quasi-radiologic quality of the detector, reconstructed images are of very good quality and this makes the measurement of BMD and fat / lean masses easier. (author)