|
|
OMNISENSE 7000S/8000S
Bone Assessment at
Multiple Skeletal Sites
The Multi-Site Advantage
Sunlight
OmnisenseTM 7000S is the only multi-site bone sonometer available
worldwide. This unique advantage is crucial in the diagnosis of osteoporosis, a
systemic disease that involves the deterioration of bone in the entire skeleton.
Osteoporosis strikes different bones at different rates. It is therefore
important for the physician to test bone strength at various skeletal sites in
order to increase confidence in the prediction of fracture risk for osteoporotic
patients.
Combining Measurement Sites –
A Proven Benefit
Diagnosis
of osteoporosis at multiple sites is a well-established procedure in X-ray-based
technologies.[i],[ii],[iii],[iv]Omnisense
is the only bone sonometer that is capable of assessing bone strength at a
number of proven skeletal sites, an innovation that brings multi-site
measurement to primary care facilities with safe, user-friendly equipment.[v]
Testing
at multiple sites reveals additional important skeletal information to the
physician. It enables the testing of bones with different combinations of
cortical and cancellous bone and weight-bearing and non-weight-bearing bone, and
thus provides a more comprehensive analysis of the skeleton. Information from
several sites is also useful in the monitoring of treatment for osteoporosis[vi],
because different
bones reflect changes after treatment at different rates.2,4,[vii]
The
use of multi-site
measurement also provides better measurement sensitivity than single site,
increasing the likelihood of osteoporosis detection in the individual patient.5,7,[viii],[ix]As
in X-ray-based assessment, the accepted clinical measurement method uses the
lower T-score between the results at the two sites as the diagnostic score. In
the study recording the collection of the Omnisense reference database[x],[xi],
multi-site measurement
found a significantly higher prevalence of women with an osteoporotic T-score
(T-score <-2.5) than measurement at any single site.
Improved Measurement Flexibility
Multi-site
measurement is essential for patients who cannot be measured at a particular
measurement site. Obesity, edema at a particular site, a previous fracture, or
an IV line can all cause difficulties in measuring a patient’s SOS at a
specific site. While measurement problems at one measurement site are revealed
in five percent of patients, 99 percent of patients can be measured in at least
one of the Sunlight OmnisenseTM measurement sites.4
Three Informative Skeletal Sites
Radius
The
third distal radius (wrist) is a measurement site that boasts a wealth of
clinical data showing its efficacy in predicting fracture risk. In addition, a
number of cross-sectional studies5,[xii] found that measurements at this site significantly
discriminate between fractured and non-fractured subjects. These findings
clearly demonstrate Omnisense’s capability to detect osteoporosis.
Phalanx
The
3rd proximal phalanx (finger) is a site clinically proven to predict fracture
risk.10,11,[xiii]
Measurement at the
phalanx is particularly useful when combined with measurement from the radius,
since differences in cortical thickness at the two sites provide more
information, creating a more comprehensive picture of bone health.
Metatarsus
Measurements
at the 5th metatarsus (foot), a weight-bearing bone, have been shown to be
useful in the assessment of fracture risk.11
Measurement at this site is particularly important because weight-bearing bone
may lose strength at a different rate than non-weight-bearing bone.
References:
[i]
Cummings, S.R., D.M. Black, M.C. Nevitt, et. al., “Bone Mineral Density at
various Sites for Prediction of Hip Fractures,” Lancet 1993,
341:72-75
[ii]
Davis, J.W., R.D. Ross, R.D. Wasnich, “Evidence for Both Generalized and
Regional Low Bone Mass among Elderly Women, Journal of Bone Mineral
Research, 1994, 9:305-309
[iii]
Ross, P.D., H.K. Genant, J.W. Davis, P.D. Miller, R.D. Wasnich,
“Predicting Vertebral Fracture Incidence from Prevalent Fractures and Bone
Density among Non-black, Osteoporotic Women,” Osteoporosis
International, 1993, 3:120-126
[iv]
Njeh, C.F., I. Saeed, M. Grigorian, D.L. Kendler, B. Fan, J. Shepherd, M.
McClung, W. Drake, and H.K. Genant, “Assessment of Bone Status Using Speed
of Sound at Multiple Sites,” Bone, December 2000
[v]
Barkmann, R.,
E. Kantrovich, C. Singal, D. Hans, H.K. Genant, M. Heller, and C.C. Glüer,
“A New Method for Quantitative Ultrasound Measurements at Multiple
Skeletal Sites,” Journal of Clinical Densitometry, Volume 3, No. 1,
1-7, Spring 2000
[vi]
Weiss, M., A. Ben Shlomo, P. Hagag, M. Rapoport, and S. Ish-Shalom,
“Effect of Estrogen Replacement Therapy on Speed of Sound at Multiple
Skeletal Sites,” Maturitas 35 (2000), 237-243
[vii]
Hans, D., S.K. Srikastav, C. Singal, R. Barkmann, C.F. Njeh, E. Kantrovich,
C.C. Glüer,
H.K. Genant, “Does Combining the Results from Multiple Bone Sites Measured
by a New Quantitative Ultrasound Device Improve Discrimination of Hip
Fracture?”, Journal of Bone and Mineral Research, Volume 14, No. 4,
1999
[viii]
Abrahamson, B., T.B. Hansen, B. Bjørn Jensen, A.P. Hermann, P. Eiken, “Site of Osteodensitometry in
Perimenopausal Women: Correlation and Limits of Agreement between Anatomic
Regions,” Journal of Bone Mineral Research, 1997, 12:1471-1479
[ix]
Melton, L.J., III, “How Many Women Have Osteoporosis Now?” Journal of
Bone Mineral Research, 1994, 9:305-309
[x]
Knapp, K., G.M. Blake, T.D. Spector, and I. Fogelman, “Multi-Site
Quantitative Ultrasound: Precision, Age, and Menopause Related Changes,
Fracture Discrimination, and T-Score Equivalence with DXA,” Osteoporosis
International 12 (2001), 6:456-464
[xi]
Weiss, M., A.B. Ben-Shlomo, P. Hagag, and M. Rapoport, “Reference Database
for Bone Speed of Sound Measurement by a Novel Quantitative Multi-Site
Ultrasound Device,” Osteoporosis International 11 (2000), 8:
688-696
[xiii]
Njeh, C.F., C. Wu, B. Fan, D. Hans, T. Fuerst, Y. He, J. Richards, P. Augat,
and H.K. Genant, “Estimation of Wrist Fracture Load Using Phalangeal Speed
of Sound: An In-Vitro Study,” In Press
|