Radiofrequency Echographic Multi-Spectrometry in the Diagnosis of Metabolic Bone Disease

Abstract

Dual-energy X-ray absorptiometry (DXA) and bone mineral density (BMD) pose several limitations in some patient categories, such as pregnant women and young people. This review article explores whether the innovative radiofrequency echographic multi-spectrometry (REMS) technology is beneficial for assessing the bone condition of various patient groups. Common consequences in patients with acromegalia, prostate cancer undergoing hormone therapy, osteogenesis imperfecta, anorexia nervosa, and in a peritoneal dialysis setting include decreased BMD and an increased risk of fragility fracture.

DXA is currently regarded as the gold standard for BMD assessment. However, using the DXA technique has several drawbacks in a young patient who requires repeated BMD tests because it uses ionizing radiation. Because of its precision and consistency, the REMS technique may be a valuable tool to assess changes in bone condition in patients of all ages, particularly in female patients who are fertile or who are pregnant or nursing.

Keywords

bone mineral density - osteoporosis - radiofrequency echographic multi-spectrometry - bone health status

Publikationsverlauf

Artikel online veröffentlicht:
15. Oktober 2024

• References

• 1 Rolla M, Halupczok-Żyła J, Jawiarczyk-Przybyłowska A, Bolanowski M. Bone densitometry by radiofrequency echographic multi-spectrometry (REMS) in acromegaly patients. Endokrynol Pol 2020; 71 (06) 524-531
• 2 Messina C, Gitto S, Colombo R. et al. Short-term precision and repeatability of radiofrequency echographic multi spectrometry (REMS) on lumbar spine and proximal femur: an in vivo study. J Imaging 2023; 9 (06) 118
• 3 Shevroja E, Lamy O, Kohlmeier L, Koromani F, Rivadeneira F, Hans D. Use of Trabecular Bone Score (TBS) as a complementary approach to dual-energy X-ray absorptiometry (DXA) for fracture risk assessment in clinical practice. J Clin Densitom 2017; 20 (03) 334-345
• 4 Vladeva S, Bischoff E, Kirilov N, Bischoff F, Batalov Z, Batalov A. An observational study of the radiofrequency echographic multi-spectrometry (REMS)-based fragility score of the lumbar spine and total fracture risk at 5 years in women. Rheumatol Int 2023; 43 (11) 2107-2114
• 5 Kirilov N, Vladeva S, Bischoff F, Batalov Z, Batalov A, Bischoff E. Effect of the body mass index, basal metabolic rate, and body fat on the radiofrequency echographic multi-spectrometry (REMS)-based bone mineral density and fracture risk: a cross-sectional study. Rheumatol Int 2023; 43 (12) 2271-2279
• 6 Singh S, Bray TJP, Hall-Craggs MA. Quantifying bone structure, micro-architecture, and pathophysiology with MRI. Clin Radiol 2018; 73 (03) 221-230
• 7 Clarke B. Normal bone anatomy and physiology. Clin J Am Soc Nephrol 2008; 3 (Suppl. 03) S131-S139
• 8 Giovanni A, Luisa BM, Carla C. et al. Bone health status evaluation in men by means of REMS technology. Aging Clin Exp Res 2024; 36 (01) 74
• 9 Amorim DMR, Sakane EN, Maeda SS, Lazaretti Castro M. New technology REMS for bone evaluation compared to DXA in adult women for the osteoporosis diagnosis: a real-life experience. Arch Osteoporos 2021; 16 (01) 175
• 10 Ishizu H, Shimizu T, Sakamoto Y. et al. Radiofrequency echographic multispectrometry (REMS) can overcome the effects of structural internal artifacts and evaluate bone fragility accurately. Calcif Tissue Int 2024; 114 (03) 246-254
• 11 Lalli P, Mautino C, Busso C. et al. Reproducibility and accuracy of the radiofrequency echographic multi-spectrometry for femoral mineral density estimation and discriminative power of the femoral fragility score in patients with primary and disuse-related osteoporosis. J Clin Med 2022; 11 (13) 3761
• 12 Nowakowska-Płaza A, Wroński J, Płaza M, Sudoł-Szopińska I, Głuszko P. Diagnostic agreement between radiofrequency echographic multispectrometry and dual-energy X-ray absorptiometry in the assessment of osteoporosis in a Polish group of patients. Pol Arch Intern Med 2021; 131 (09) 840-847
• 13 Sergio RO, Nayelli RGE. Evaluation of the bone mineral density in the Mexican female population using the radiofrequency echographic multi spectrometry (REMS) technology. Arch Osteoporos 2022; 17 (01) 43
• 14 Caffarelli C, Tomai Pitinca MD, Al Refaie A, De Vita M, Catapano S, Gonnelli S. Could radiofrequency echographic multispectrometry (REMS) overcome the overestimation in BMD by dual-energy X-ray absorptiometry (DXA) at the lumbar spine?. BMC Musculoskelet Disord 2022; 23 (01) 469
• 15 Kirilov N, Bischoff F, Vladeva S, Bischoff E. A case showing a new diagnostic aspect of the application of radiofrequency echographic multi-spectrometry (REMS). Diagnostics (Basel) 2023; 13 (20) 3224
• 16 Caffarelli C, Al Refaie A, Mondillo C. et al. The advantages of radiofrequency echographic multispectrometry in the evaluation of bone mineral density in a population with osteoarthritis at the lumbar spine. Diagnostics (Basel) 2024; 14 (05) 523
• 17 Pisani P, Conversano F, Muratore M. et al. Fragility score: a REMS-based indicator for the prediction of incident fragility fractures at 5 years. Aging Clin Exp Res 2023; 35 (04) 763-773
• 18 Di Paola M, Gatti D, Viapiana O. et al. Radiofrequency echographic multispectrometry compared with dual X-ray absorptiometry for osteoporosis diagnosis on lumbar spine and femoral neck. Osteoporos Int 2019; 30 (02) 391-402
• 19 Adami G, Arioli G, Bianchi G. et al. Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: a 5-year follow-up study. Bone 2020; 134: 115297
• 20 Hans D, Baim S. Quantitative ultrasound (QUS) in the management of osteoporosis and assessment of fracture risk. J Clin Densitom 2017; 20 (03) 322-333
• 21 Tomai Pitinca MD, Fortini P, Gonnelli S, Caffarelli C. Could radiofrequency echographic multi-spectrometry (REMS) overcome the limitations of BMD by DXA related to artifacts? A series of 3 cases. J Ultrasound Med 2021; 40 (12) 2773-2777
• 22 Shevroja E, Reginster JY, Lamy O. et al. Update on the clinical use of Trabecular Bone Score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging. Osteoporos Int 2023; 34 (09) 1501-1529
• 23 Kanis JA, Harvey NC, Johansson H. et al. A decade of FRAX: how has it changed the management of osteoporosis?. Aging Clin Exp Res 2020; 32 (02) 187-196
• 24 NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285 (06) 785-795
• 25 Fan Y, Wei F, Lang Y, Liu Y. Diabetes mellitus and risk of hip fractures: a meta-analysis. Osteoporos Int 2016; 27 (01) 219-228
• 26 Yamamoto M, Yamaguchi T, Yamauchi M, Kaji H, Sugimoto T. Diabetic patients have an increased risk of vertebral fractures independent of BMD or diabetic complications. J Bone Miner Res 2009; 24 (04) 702-709
• 27 Camacho PM, Petak SM, Binkley N. et al. American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2020 update executive summary. Endocr Pract 2020; 26 (05) 564-570
• 28 Caffarelli C, Tomai Pitinca MD, Al Refaie A, Ceccarelli E, Gonnelli S. Ability of radiofrequency echographic multispectrometry to identify osteoporosis status in elderly women with type 2 diabetes. Aging Clin Exp Res 2022; 34 (01) 121-127
• 29 Curry SJ, Krist AH, Owens DK. et al; US Preventive Services Task Force. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA 2018; 319 (24) 2521-2531
• 30 G Siregar MF, Jabbar F, Effendi IH, Alhair T, Prabudi MO, Faradina D. Correlation between serum vitamin D levels and bone mass density evaluated by radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women. Narra J 2024; 4 (01) e452
• 31 Cortet B, Dennison E, Diez-Perez A. et al. Radiofrequency echographic multi spectrometry (REMS) for the diagnosis of osteoporosis in a European multicenter clinical context. Bone 2021; 143: 115786
• 32 Al Refaie A, Baldassini L, Mondillo C. et al. Radiofrequency echographic multi spectrometry (R.E.M.S.): new frontiers for ultrasound use in the assessment of bone status—a current picture. Diagnostics (Basel) 2023; 13 (10) 1666
• 33 Diez-Perez A, Brandi ML, Al-Daghri N. et al. Radiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art-outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 2019; 31 (10) 1375-1389
• 34 Nelson HD, Humphrey LL, Nygren P, Teutsch SM, Allan JD. Postmenopausal hormone replacement therapy: scientific review. JAMA 2002; 288 (07) 872-881
• 35 Hung C, Muñoz M, Shibli-Rahhal A. Anorexia nervosa and osteoporosis. Calcif Tissue Int 2022; 110 (05) 562-575
• 36 Jerome CP. Hormonal therapies and osteoporosis. ILAR J 2004; 45 (02) 170-178
• 37 Lawson EA, Donoho DA, Blum JI. et al. Decreased nocturnal oxytocin levels in anorexia nervosa are associated with low bone mineral density and fat mass. J Clin Psychiatry 2011; 72 (11) 1546-1551
• 38 Barrionuevo P, Kapoor E, Asi N. et al. Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis. J Clin Endocrinol Metab 2019; 104 (05) 1623-1630
• 39 Vahia VN. Diagnostic and statistical manual of mental disorders 5: A quick glance. Indian J Psychiatry 2013; 55 (03) 220-223
• 40 Caffarelli C, Al Refaie A, De Vita M. et al. Radiofrequency echographic multispectrometry (REMS): an innovative technique for the assessment of bone status in young women with anorexia nervosa. Eat Weight Disord 2022; 27 (08) 3207-3213
• 41 Nijhuis WH, Eastwood DM, Allgrove J. et al. Current concepts in osteogenesis imperfecta: bone structure, biomechanics and medical management. J Child Orthop 2019; 13 (01) 1-11
• 42 Folkestad L, Hald JD, Ersbøll AK. et al. fracture rates and fracture sites in patients with osteogenesis imperfecta: a nationwide register-based cohort study. J Bone Miner Res 2017; 32 (01) 125-134
• 43 Deguchi M, Tsuji S, Katsura D, Kasahara K, Kimura F, Murakami T. Current overview of osteogenesis imperfecta. Medicina (Kaunas) 2021; 57 (05) 464
• 44 Caffarelli C, Al Refaie A, Mondillo C. et al. Radiofrequency echographic multispectrometry (REMS): a new option in the assessment bone status in adults with osteogenesis imperfecta. J Imaging 2023; 9 (10) 210
• 45 Ketteler M, Block GA, Evenepoel P. et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. Kidney Int 2017; 92 (01) 26-36
• 46 Fassio A, Andreola S, Gatti D. et al. Radiofrequency echographic multi-spectrometry and DXA for the evaluation of bone mineral density in a peritoneal dialysis setting. Aging Clin Exp Res 2023; 35 (01) 185-192
• 47 Sanz-Salvador L, García-Pérez MÁ, Tarín JJ, Cano A. Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture. Eur J Endocrinol 2015; 172 (02) R53-R65
• 48 World Health Organization. Guideline: calcium supplementation in pregnant women. Available at: https://www.who.int/publications/i/item/9789241505376. Accessed July 16, 2024
• 49 Degennaro VA, Brandi ML, Cagninelli G. et al. First assessment of bone mineral density in healthy pregnant women by means of radiofrequency echographic multi spectrometry (REMS) technology. Eur J Obstet Gynecol Reprod Biol 2021; 263: 44-49
• 50 Ramirez Zegarra R, Degennaro V, Brandi ML. et al. Longitudinal changes of the femoral bone mineral density from first to third trimester of pregnancy: bone health assessment by means of non-ionizing REMS technology. Aging Clin Exp Res 2024; 36 (01) 31
• 51 Jiang N, Xia W. Assessment of bone quality in patients with diabetes mellitus. Osteoporos Int 2018; 29 (08) 1721-1736