Common errors in dual-energy x-ray absorptiometry (DXA) examinations: insights from a cross-sectional study in Northeastern Brazil
Errores comunes en las exploraciones de absorciometría dual de rayos X (DXA): hallazgos de un estudio transversal en el noreste de Brasil
Luiz Henrique Rosendo, Lucas Silva, Cátia Gondim
Abstract
Introduction: Common technical errors in dual-energy X-ray absorptiometry (DXA) exams may compromise diagnostic accuracy. This study aims to analyze the frequency and types of those errors in DXA scans performed in a referral center.
Material and methods: This cross-sectional study evaluated 100 DXA exams performed at multiple radiology clinics and analyzed at the General Outpatient Clinic of the Medical Residency Program in Endocrinology and Metabolism at Alcides Carneiro University Hospital (HUAC), in Campina Grande. Exams were assessed for technical errors, including improper positioning, vertebral exclusion, and inaccurate region of interest (ROI) definition. Patient demographic data (age, sex, body mass index) were also collected. Descriptive statistics were used to summarize patient characteristics and the frequency of errors.
Results: The study population had a mean age of 65.6 years (± 10 years), with a predominance of female patients (95%). The mean BMI was 26.4 kg/m² (±4.8 kg/m²). Regarding ethnicity, 91% of the sample identified as white. A total of 76% of exams presented at least one technical error, with the most common being osteophyte presence (64%), inadequate femoral rotation (45%), and incorrect ROI (35%). Only 24% of the exams were free of errors.
Conclusions: These findings highlight the need for systematic training and strict adherence to imaging protocols to improve diagnostic accuracy and patient outcomes.
Keywords
Resumen
Introducción: Los errores técnicos frecuentes en las exploraciones de absorciometría dual de rayos X (DXA) pueden comprometer la precisión diagnóstica. Este estudio tiene como objetivo analizar dichos errores en una unidad de referencia.
Material y métodos: Se trata de un estudio transversal que evaluó 100 exploraciones de DXA realizadas en diversas clínicas de radiología y analizadas en el Ambulatorio General del Programa de Residencia Médica en Endocrinología y Metabolismo del Hospital Universitario Alcides Carneiro (HUAC), en Campina Grande. Se examinaron los errores técnicos, incluidos el posicionamiento inadecuado, la exclusión vertebral y la definición incorrecta de la región de interés (ROI). También se recopilaron datos demográficos de los pacientes (edad, sexo e índice de masa corporal). Se utilizaron estadísticas descriptivas para resumir las características de los pacientes y la frecuencia de errores.
Resultados: La población del estudio presentó una edad media de 65,6 años (±10 años), con predominio de mujeres (95%). El IMC medio fue de 26,4 kg/m² (±4,8 kg/m²). En cuanto a la etnicidad, el 91% de la muestra se identificó como blanca. El 76% de los exámenes presentó al menos un error técnico, siendo los más frecuentes la presencia de osteofitos (64%), la rotación femoral inadecuada (45%) y la delimitación incorrecta de la ROI (35%). Solo el 24% de las exploraciones estuvieron libres de errores.
Conclusiones: Estos hallazgos subrayan la necesidad de formación sistemática y del cumplimiento riguroso de los protocolos de imagen para mejorar la precisión diagnóstica y los resultados en los pacientes.
Palabras clave
References
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Submitted date:
08/25/2025
Reviewed date:
10/08/2025
Accepted date:
10/12/2025
Publication date:
10/12/2025
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