Carmelo Messina¹², Stefano Fusco³, Silvia Gazzotti⁴, Domenico Albano⁵, Gloria Bonaccorsi⁶, Giuseppe Guglielmi⁷⁸⁹, Alberto Bazzocchi⁴
1-RCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy.
2-Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy.
3-Postgraduate School of Diagnostic and Interventional Radiology, University of Milan, 20122, Milan, Italy.
4-Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.
5-Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122, Milan, Italy.
6-Department of Translational Medicine, Menopause and Osteoporosis Center, University of Ferrara, Ferrara, Italy.
7-Radiology Unit, Department of Clinical and Experimental Medicine, Foggia University, School of Medicine, 71122, Foggia, Italy.
8-Radiology Unit "Mons. Dimiccoli" Teaching Hospital, Barletta (BT), Italy.
9-Radiology Unit, Scientific Institute "Casa Sollievo Della Sofferenza" Hospital, 71013, San Giovanni Rotondo, Italy.
Osteoporosis is the most prevalent skeletal disorder, a condition that is associated with significant social and healthcare burden. In the elderly, osteoporosis is commonly associated with sarcopenia, further increasing the risk of fracture. Several imaging techniques are available for a non-invasive evaluation of osteoporosis and sarcopenia. This review focuses on dual-energy X-ray absorptiometry (DXA), as this technique offers the possibility to evaluate bone mineral density and body composition parameters with good precision and accuracy. DXA is also able to evaluate the amount of aortic calcification for cardiovascular risk estimation. Additionally, new DXA-based parameters have been developed in recent years to further refine fracture risk estimation, such as the Trabecular Bone Score and the Bone Strain Index. Finally, we describe the recent advances of a newly developed ultrasound-based technology known as Radiofrequency Echographic Multi-Spectrometry, which represent the latest non-ionizing approach for osteoporosis evaluation at central sites.
Keywords: Bone Strain Index (BS); Bone mineral density (BMD); Dual-energy X-ray absorptiometry (DXA); Osteoporosis; Radiofrequency Echographic Multi-Spectrometry (REMS); Trabecular Bone Score (TBS)