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Dual-energy X-ray absorptiometry (DXA) has long been the gold standard for assessing bone mineral density. However, recent advancements in technology have led to the development of alternative techniques that offer additional insights into bone health.

Quantitative Computed Tomography (QCT)

Quantitative computed tomography (QCT) is a method that utilizes CT scans to measure bone density. Unlike DXA, which provides a two-dimensional image, QCT generates a three-dimensional image of the bone, allowing for a more precise assessment of bone density and geometry. QCT is particularly useful in assessing bone density in the bone mineral densitometry spine and can differentiate between cortical and trabecular bone.

Peripheral Quantitative Computed Tomography (pQCT)

Peripheral quantitative computed tomography (pQCT) is a variation of QCT that focuses on measuring bone density in peripheral sites such as the forearm and lower leg. This technique provides information about both cortical and trabecular bone density and can assess bone geometry and muscle density, offering a more comprehensive evaluation of bone health.

High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT)

High-resolution peripheral quantitative computed tomography (HR-pQCT) is a state-of-the-art imaging technique that provides detailed three-dimensional images of bone microarchitecture at peripheral sites such as the wrist and ankle. HR-pQCT can assess not only bone density but also bone structure, including trabecular thickness, spacing, and connectivity, providing valuable insights into bone quality and fracture risk.

While DXA remains an important tool in the assessment of bone health, alternative techniques such as QCT, pQCT, and HR-pQCT offer additional benefits, particularly in the evaluation of bone microarchitecture and geometry. These advancements allow for a more comprehensive understanding of bone health and fracture risk, paving the way for personalized interventions to optimize bone strength and reduce the burden of osteoporosis and related fractures.

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