Bi-directional Axial Transmission measurements is an easy to apply methodology allowing risk assessment of fracture in elderly

Accurate measurement of cortical bone parameters may improve fracture risk assessment and help clinicians on the best treatment strategy. The objective of this crosssectional study was to evaluate the performance of a Bi-Directional Axial Transmission (BDAT) device used by trained operators in a clinical environment with elderly subjects. The device, positioned at one-third distal radius, provides two velocities: VFAS (first arriving signal) and VA0 (first anti-symmetrical guided mode). Moreover, two parameters are obtained from an inverse approach: Ct.Th (cortical thickness) and Ct.Po (cortical porosity). The areal bone mineral density (aBMD) was obtained using DXA at the femur and spine. Eighty seven (65 women, 22 men) from Marien Hospital and St. Anna Hospital (Herne, Germany) were included in this study. Age ranged from 41 to 95 years, while body mass index (BMI) ranged from 17 to 47 kg.m-2. We found the ratio CtPo/Ct.Th to be predictive for non vertebral after sex, BMI and age adjustment (OR=2.62, AUC=0.83), comparable to femoral aBMD (OR=3.48, AUC=0.82). The fracture risk assessment by BDAT method in elderly, in a clinical setting, suggests the benefit of the affordable and transportable device for the routine use.