1. Bone Density 101 Ben Williams DEXA Solutions, LLC
BS Biomedical Engineering (SLU)
17 years in the DXA industry

2. DXA – Dual-Energy X-Ray Absorptiometry
Most common method for determining bone density
Why not an exact science?
BMD = BMC (g)/A (cm^2)
Error
Variations between OEMs
Differences in technologists
Service performed incorrectly
T-Score and Z-Score
-1 and above = normal
Between -1 and -2.5 = Osteopenic
-2.5 and lower = Osteoporosis
Z-Score of 0 is average

3. DXA – Dual-Energy X-Ray Absorptiometry (continued)
Common measurement sites (reimbursed)
AP Spine
Femur (Dual Femur)
Forearm
LVA (lateral vertebral assessment)
Reimbursement varies
Additional Applications (currently no reimbursement)
Total Body and body composition
CoreScan
Pediatric
Orthopedic

4. Why a Needed Technology?
Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds
Osteoporosis is estimated to affect 200 million women
1 in 3 women over 50 will experience osteoporotic fractures, as will 1 in 5 men
$14 Billion/year cost in US only

5. OEMs and Models of Densitometers
GE Lunar
iDXA
Prodigy
DPX (NT, Duo, Bravo)
DPX (IQ, alpha, L)
Peripherals (Achilles)
Hologic
Discovery Series
Horizon
QDR Series
Peripherals (Sahara)
Norland
XR Models

6. System Overview – Lunar Basic Function and Setup
Lunar systems are controlled by DOS, WIN95/98/XP/7 workstation using the Encore Software (does have a service mode for troubleshooting and calibration – different passwords for different versions).
PC communicates to SBC Board via RS422/232 Serial card
SBC (controller for all modern models) gives commands (motion, x-rays, etc…)
Systems use 110V AC (20A dedicated outlet recommended by OEM)
Isolation transformer used to limit leakage currents
UPS used for isolation transformer and Scanner power
Printer for reports (unless configured to send electronically)

7. System Overview – Lunar 3 Sub Systems
X-Ray Generation
Tube
Power Supplies
X-Ray Detection
CZT Detector
Detector Electronics
Scanner Control
Motion Control
Error Detection
Communications with Host PC / Detector

8. System Overview – Lunar Schematic

9. System Overview – Lunar Common Failures
Tube Arc
Typically the tube, but could be caused by HVPS
HVPS Enable and Disable failures
Broken Cable
Shutter Failures
PC Failures
Deteriorated Detector (NT, Duo, Bravo, IQ)

10. System Overview – Lunar Troubleshooting
Error Log
Tools – Error Log – Print all errors
Arcing
Look for oil leaking from tube’s expansion chamber
Older models may need regreased
O-ring inside collimator deteriorates
Determine sub system (x-ray generation, detection or scanner control)
Verify voltages on DC Supply (+/- 12V and 5V)
Places to check voltage: DC Supply, DIB Board; Bulkhead connection

12. System Overview – Hologic Troubleshooting

13. System Overview – Hologic Troubleshooting

14. System Overview – Lunar Connectivity
Printed Reports
Generally using a color printer
PACS
Configure DICOM and Worklist
EMR (HL7 Work-Around)
Install Adobe Writer
Install, or connect to, EMR software
Create reports as .pdf
Upload to EMR

15. DXA Market Today Reimbursement down 70% in some areas
Many PC facilities not maintaining densitometers
Shift back toward traditional market
Used and refurbished markets growing

16. DXA Market Tomorrow
DXA offered primarily in traditional market facilities
Increase in availability overseas
Huge push in “preventative care”
Body Composition
Type to enter a caption.

17. If your having this kind of a day let us help.

18. Questions??? Ben Williams President DEXA Solutions, LLCF:
Customer Support: –3392