Metriscan ™ has been called ‘Newer, more sophisticated’ as compared to DXA.


First, we need a starting point… a bone density test helps tell where you are now, so you can make an effective, do-able plan to improve or maintain your bone health.

What type of test is this?

We use a self-contained, portable, tabletop unit made by Alara, Inc., called MetriScan™. Alara is a California company, creating leading-edge imaging systems for physicians and dentists. Alara also makes the new non-film dental imaging equipment, where the x-ray image is produced directly on the computer.

With a growing number of women suffering from osteoporosis, and the expense involved with DXA tests, MetriScan™ meets the clinical challenge of quickly and diagnosis of osteoporosis and prediction of bone fractures. enable fast (= 2min) detection of osteoporosis in an office based environment.

Using a single energy X-ray system the MetriScan™ measures Bone Mineral Density (BMD) by Radiographic Absorptiometry (RA) of the phalanges. High-quality digital images show a direct correlation with traditional dual-energy X-ray absorptiometry (DXA).

The testing method is called ‘digital radiographic absorptiometry’. According to the American Medical Association, it is well-established and very accurate. It estimates the relative bone mineral density of the middle part of the 2nd, 3rd, and 4th fingers of the non-dominant hand.

Is there any research that validates this type of test?

Yes, and we’ve linked a few throughout this page. The American Journal of Medicine reported “Recently, computerized image processing has been applied to radiography, with the result that current RA techniques applicable to a routine clinical setting are as precise and accurate as dual-energy or single-energy x-ray absorptiometry (DXA or SXA). In addition, recent studies demonstrate that the strength of association between low bone mass measured by RA and fracture risk is comparable to that for other forms of bone mass measurement. The relatively low cost and lack of need for specialized equipment make RA a highly attractive option for the diagnosis of osteoporosis that is available to specialist and nonspecialist physicians alike.”

In addition, this method was validated in one of the largest epidemiological studies in the bone density field, and published in Archives of Internal Medicine in 1997.

Phalangeal (fingers) bone density testing was performed on 3481 women, who were then followed for sixteen years. Phalangeal bone density at baseline was measured using photodensitometry (PD), and “later reanalyzed by radiographic absorptiometry (RA), a newer, more sophisticated technique.” (MetriScan™)

The study concluded that phalangeal bone densitometry is a significant predictor of future hip fractures .

The test itself takes less than 1/3 of a second; on-screen results are available is less than one minute, with a printout less than a minute after that.

The scores reported – the T-Score and Z-Score – are based on the accepted values and categories defined by the World Health Organization.

More recently, in April 2005 at the National Osteoporosis Foundation Symposisium MetriScan ™ was reported to be a convenient, effective osteoporosis screening method.

Is MetriScan™ safe?

MetriScan™ has been approved by every state – as well as by FDA, Medicare, and everyone else who has to approve this sort of thing.

Secondary or scatter radiation is so low it is not measurable. The workings are completely enclosed and shielded. Even air passages are designed to shield the computer from normal room light, like a photographer’s darkroom would be – this is required for the internal laser to function properly.

MetriScan™ is the safest bone density testing equipment available, meeting the most stringent quality and accuracy standards. There are no known adverse reactions to the use of this equipment.

With MetriScan™, a person would need nearly 40 tests per hour, 8 hours a day, 5 days a week, 50 weeks a year to reach this limit. This is a remarkable level of safety, compared with other testing equipment (DXA, CT, etc).

Very accurate. Alara, Inc., is the company that engineered MetriScan™.

‘Alara’ stands for “AsLowAsReasonablyAchievable.” Of all the testing methods available, x-ray is the one with highest accuracy.

In tests done to measure and compare the accuracy of bone testing equipment, MetriScan’s™ results are among the best. MetriScan™ has the highest documented accuracy when compared with other equipment.

The US Nuclear Regulatory Commission is the agency in charge of this sort of thing, and they have set the effective exposure level for the public at 100 mrem/year.

With MetriScan™, a person would need nearly 40 tests per hour, 8 hours a day, 5 days a week, 50 weeks a year to reach this limit. This is a remarkable level of safety, compared with other testing equipment (DXA, CT, etc).

Is MetriScan™ accurate?

Very accurate. Alara, Inc., is the company that engineered MetriScan™.

‘Alara’ stands for “AsLowAsReasonablyAchievable.” Of all the testing methods available, x-ray is the one with highest accuracy.

In tests done to measure and compare the accuracy of bone testing equipment, MetriScan’s™ results are among the best. MetriScan™ has the highest documented accuracy when compared with other equipment.

FDA approved MetriScan™ for diagnosis of osteoporosis, not just as a screening tool. Also, MetriScan is approved for monitoring changes in bone mass over time — accurately comparing this year’s scores with last year’s.

MetriScan™ won an engineering award for design the year it was introduced.

I had a test where I put my heel in a box for a few minutes. What about this?

What you describe is an ultrasound test for bone density. The error rate can be as high as 30%, much higher than the error rate with MetriScan™ or DXA.

Ultrasound (used on the heel or wrist) is based on a technology that works very well for soft-tissue diagnosis, and works poorly with bone.

Ultrasound has been approved by FDA, Medicare, etc., for use only as a screening device for osteoporosis.

According to the American Medical Association, ultrasound cannot be used to diagnose osteoporosis or other bone condition, and it cannot be used to monitor bone density changes over time.

The National Osteoporosis Foundation, (pages 4 and 5) agrees – in a continuing education paper for doctors, they report ultrasound is

  • inexpensive
  • portable
  • easy to use…

and it has

  • “Inconsistent readings;
  • Significant rate of false negatives;
  • Cannot be used for diagnosis;
  • Cannot be used to monitor treatment;
  • Cannot be used to accurately screen women under 65.”

Moreover, they write “It has an intrinsic high degree of variability from one measurement to the next. Even repeat measurements of the same person within a few hours will commonly show a 10-20% variance. This makes it impossible to follow a patient…” (to accurately measure changes over time.)

Because of this, I suggest you simply disregard the ultrasound results, and get a test with accurate, accepted equipment such as MetriScan™ or DXA.

How does MetriScan ™ compare with a ‘real’ bone density test, the DXA table, the one at the hospital?

DXA stands for ‘Dual-Energy-X-ray-Absorptiometry‘. Physicians sometimes call DXA the ‘real’ test, because DXA is what they were taught 20 to 30 years ago while still in medical school.

But things change, especially in the field of computers.

Just as with other computers, MetriScan™ was developed from an older, well-known, well-established technology, which has become smaller, faster, more accurate, and less expensive than the older equipment.

For example:

  • MetriScan™ uses only one x-ray tube, (‘Single-Energy-X-ray-Absorptiometry’) rather than two, so the exposure level is much lower than DXA; therefore, MetriScan™ is among the safest equipment available.
  • MetriScan™ error rates are lower than DXA; accuracy has been determined to be as high or higher than DXA in predicting hip fracture. So MetriScan™ is also among the most accurate equipment available.

MetriScan™ is the fastest available

MetriScan™ is used in hospitals and in physician’s offices for convenient, affordable, accurate determination of bone density.

Older technologies, still used by hospitals and imaging centers, include:

  • The CAT scan—has a high level of radiation,
  • it is very accurate,
  • very expensive,
  • and commonly used in research settings.
  • The DXA table — uses two x-ray tubes, radiation exposure is much higher than MetriScan ™
  • it is reasonably accurate
  • less expensive than a CAT scan

Both are far more expensive than MetriScan™.

Does MetriScan™ hurt? Is MetriScan ™ convenient?

The MetriScan™ test is both quick and painless. And yes, very convenient. We save you time & money, and frustration, all of which has value to you. For example:

  • No appointment is needed.
  • This test is quick, accurate, painless.
  • No waiting weeks for results.
  • No insurance to fuss with.
  • You may share the results with your own doctor. Or not – it is up to you.
  • And, there may be natural methods we can teach you that can slow, stop, or reverse bone loss. Osteoporosis and osteoporosis can be reversed in many cases. Early awareness is important.

How long before I get the results?

About two minutes. We provide two copies of your printed results, one for yourself with personal notes, plus a copy attached to a ‘Dear Doctor’ letter describing the test & results in a technical format.

We will go over your results with you, answering any questions you have. We often give extra information such as handouts and websites you can use to become more aware and better informed.

Will I understand the results?

Yes. One of the results pages is color-coded and we go over it with you personally. This allows you to read it later and still understand it.

I laid on a table at the hospital—they checked my spine and hips. How can your one-second MetriScan™ test be better?

Just like with other computers, bone density technology has improved. Elizabeth Smoots MD, Albert Einstein HealthCareNetwork , says, “With the advent of new technology more people can get a jump-start on osteoporosis. New tests can detect osteoporosis far earlier than in the past, when preventive measures may still help.”

MetriScan™ is smaller, faster, uses less radiation, has higher reproducibility, and is less expensive. MetriScan™ was engineered and designed with technology from the older, full-body DXA tables still used in hospitals.

DXA has a large, well-established distribution, and is still popular among doctors. We chose to invest in newer, updated, safer, accurate equipment that doesn’t require the large staff and maintenance expense of DXA. (And we chose not to deal with the insurance industry, in order to keep our fees low.)

I was told I have osteoporosis in my left hip (or my spine) but my right hip (or other area) is fine. What does that mean?

If something appears to be osteoporosis, and it is only in one hip, or any other single area for that matter, you may have been positioned improperly during the test, or there may be another problem & you might want a second opinion. Positioning on the table is a known problem with DXA equipment, in fact the most common, and it contributes to an error rate as high as 12%.

Osteoporosis does not show up in only one place. Osteoporosis is systemic – it affects all the bones of the body, not just one or two. It is that reason that we can measure the fingers and have an indication of what is going on in the spine or hip. It is the same reason other equipment has been developed to test the heel, wrist, spine, and hip.

My grandmother has osteoporosis but my mother doesn’t. What does that mean for me?

We don’t know, and we wouldn’t want to guess. The argument regarding the heredity factor in osteoporosis remains heated after decades, but the current information suggests that heredity is far less important than lifestyle.

As you read through this site, you’ll understand why we don’t place much weight on the genetic association with osteoporosis – we are convinced it is related to lifestyle choices.

And since you can’t change your genes, and the test results will give you a sense of how your lifestyle is affecting your bone density…

We suggest this…

Get tested – get your own results. Find out who YOU are. Remove your uncertainty, and replace it with knowledge. With accurate information you can make new & better decisions based on facts as they relate to you.

Why doesn’t my doctor know about MetriScan?

Your busy physician probably just barely has enough time to keep up to date in his own field of interest – which probably is not osteoporosis. None of us can do much more than that.

MetriScan™ uses radiographic absorptiometry (RA), a newer, more sophisticated technique. This developed from the older DXA technology still being used today. MetriScan™ is every bit as ‘real’ as the DXA.

We often discover that physicians are not aware of MetriScan™, and they don’t recommend it simply because they don’t know about it – even though MetriScan™ has clear benefits over DXA.

MetriScan™ was approved for use by FDA in May 2000, and is now being used by physicians all over the world.

A word of caution… If your doctor is not aware of MetriScan™, that may indicate he or she has not stayed current with changes in the field of osteoporosis; they may not be the best resource for current, accurate advice about osteoporosis.

How can you tell by checking my fingers whether I have osteoporosis in my hips?

One of the body’s primary balance mechanisms is the blood stream, ‘the river of life’. The blood stream carries many things, including calcium and other minerals to and from all areas of the body.

Conditions such as too much protein in the diet, or a dark cola habit, cause us to lose a little calcium from the blood stream each day. (Both of these situations remove calcium from the blood and send it out of the body through the kidneys.) So your brain sends a message to the blood stream, “Hey, you’re low on calcium… pick some up as you flow through the calcium warehouse.”

Bone is the calcium warehouse, and the river of life does as it is told, taking a little calcium from the bone in order to maintain balance.

Day after day, as we lose more calcium than we can absorb, this eventually results in lower bone density.

Osteoporosis is a systemic condition – if you have it in one bone, you have it in all the bones.

Only a few bones in the body are tested with any of the equipment currently available – femur, lumbar vertebra, heel, wrist, and fingers.

Bone loss happens in a fashion that maintains our ability to equalize stress loads, and not deplete certain areas at the exclusion of others.

In other words, calcium is not removed from just one shelf in the warehouse (such as the left hip) to replenish the blood stream.

Instead, a little is taken from this bone, and a little from that bone, so as to not create any single area that is weak.

Because of this, measuring the fingers with MetriScan bone density testing equipment gives an accurate, reliable demonstration of bone density.

MetriScan performs this test quickly, with very low exposure, low cost, minimal error rate, high reproducibility, and accurate, immediate results.

 

I’m only 25… Why should I be tested?

There are many factors related to osteoporosis, including heredity (which we can’t control); and lifestyle choices, such as nutrition, water, exercise (which we can control); and menopausal hormone changes, (which we can sometimes control).

We should have a T-Score in the normal range during the ages of roughly 25-35. We have seen T-Scores in young women that are far below where they should be. Once we discover why the scores are low, then we can make recommendations that will help reverse this process so that low bone density does not become a problem at 65.

Most of the interesting research being done in osteoporosis is with people between about 7 and about 30. From the Yale School of Nursing we learn “It is imperative that female adolescents achieve adult peak bone mass prior to the age of 30, and the bone-building years before the age of 18 are especially important.”

From The Journal of School Nursing, we learn “Although osteoporosis typically surfaces in later life, peak bone mass attained before age 20 is a key factor in its prevention.”

Regarding early bone loss and risk of fracture, from Grace Wyshak of the Harvard School of Public Health and Harvard Medical School: “Our findings have implications both for the health of teenagers and for the health of women at later ages.”

And you may have read that “Osteoporosis should no longer be considered only a geriatric disease, but rather a pediatric disease with geriatric consequences.” This was written in an editorial over 5 years ago by Dr. Neville Golden, in the Archives of Pediatrics and Adolescent Medicine.
Test results supply a ‘Z-Score’; this offers some predictability regarding your future bone density.

With this data, we may see, for example, that other women of your age are predicted to have mild or moderate osteoporosis as they age.

The predictability curve of the ‘Z-Score’ shows a vision of the future. If you don’t like what you see, your best opportunity to change that future requires wellness-based actions, such as your exercise program at Curves.

 

We are convinced that prevention of disease
is best started at age 25 than at 65.

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