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2008 | 14 | 4 | 207-215

Article title

National protocol for quality assurance in DXA-bone densitometry


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Osteoporosis becomes largely one of the most important socially significant and costly diseases. Modern techniques (DXA, US) are applied for bone densitometry. The paper presents a protocol for quality assurance especially of DXA-bone densitometers including quality control made in compliance with international standards (ISCD, IOF). The methodology has been tested in practice by measurements on site-functional assessment, entrance dose, radiation protection, calibration, in-vitro precision. It is expected to raise the quality of the diagnostic process in concert with the EU Medical Directive 97/43 particularly for population screening and sensitive groups. The protocol is an essential part of the National Program for constraining osteoporosis which has been elaborated at the Ministry of Health and at present under implementation throughout the country. It aims at reducing the risk, factors spreading, at diminishing the fracture risk the morbidity and the mortality from osteoporosis. An integral multidisciplinary approach to the problem solving is applied as well as training on three levels - doctors, patients, population, which effectively will contribute for obtaining real results in preventing osteoporosis.









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1 - 1 - 2008
14 - 4 - 2009


  • National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
  • National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
  • National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria


  • Accreditation Guidelines for Bone Densitometry. Australian and New Zealand Bone and Mineral Society; June 2004.
  • Cawte SA, Pearson D et al. Cross-calibration, Precision and Patient Dose Measurements in Preparation for Clinical Trials using DXA of Lumbar Spine. BJR. 1999; 72: 354-362.
  • Council Directive 97/43/EURATOM of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466/Euratom. OJ L. 1997 Jul 9; 180: 22-27, 9.7.1997.
  • DXA Radiation Protection and Quality Assurance. Sentinel Training Course. Dublin: October 2006.
  • Baim S, Wilson CR, Lewiecki EM, Luckey MM, Downs RW, Lentle BC. Precision Assessment and Radiation Safety for Dual-Energy X-Ray Absorptiometry: Position Paper of the International Society for Clinical Densitometry. JCD. 2005; 8(4).
  • Kanis JA, Johnell O. Requirements for DXA for the Management of Osteoporosis in Europe. Osteoporosis Int. 2006; 16: 229-238.
  • Methodic Instruction for Quality Control of DXA Densitometers - Draft. NCRRP, MoH, Sofia, 2008.
  • Radiological Safety of DXA Bone Densitometry Equipment. Radiation Issue Notes. BC Centre for Disease Control, July 2001.

Document Type

Publication order reference


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