Echos: The no-radiation method to determine bone density and quality

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How many times have you gone to get your bone density tested? If you have done it even once, you know that the procedure involves radiation.

Although many clinicians remind us that the radiation levels for many tests are low, I do know that women across the world are less accepting of continued use of radiation for diagnostics than we used to be.

As I thought more about a radiation-free diagnostic, it became clear to me that preventative care usually begins with a personal experience that motivates an individual.

If a 30-year-old person can get the data on their personal bone health when they are theoretically at their peak bone density, it seems to me that we would have an opportunity to intervene with healthy lifestyle choices and prevent a lot of problems down the line.

In my mind, radiation-free means that people could stay abreast of their bone health throughout their life.

About the Echolights Scan

I first read about the EchoS in October 2020, when Echolight S.P.A. opened an office in the US. Initially, I was curious about this radiation-free technology that determines bone density and quality for personal interest.

I wanted to know about my own bone quality, but I did not want to submit myself to more radiation. A lot of women I work with feel the same way.

I was impressed by the clinical data from Europe where the device was first used in a clinical setting in 2015. The FDA approved the Echolight in 2018. Let’s delve into what this new technology really is.

How Does REMS Technology Measure Bone Density?

Echolight Medical developed the first clinically available method for the direct non-ionizing (radiation-free) measurement of lumbar and femoral bone mineral density (BMD).

The device, EchoS, utilizes proprietary R.E.M.S. (Radiofrequency Echographic Multi Spectrometry) technology to scan the lumbar vertebrae and proximal femur. The EchoS rapidly generates a medical report that includes BMD, T-score, and Z-score.

In addition, the system automatically assesses the quality of bone micro architecture, independent of BMD, and provides a five-year probability of a major osteoporosis fracture.

For me, it’s a huge win to be able to monitor my osteoporosis more closely, with more frequent EchoS scans. I would like for my granddaughter and other women to be able to get a scan long before menopause to give them the data they need to spur their own preventative activities in regards to osteopenia and osteoporosis.

What Is the Fragility (Quality) Score?

The fragility score measures the quality (fragility) of the bone’s microarchitecture. Echolight’s proprietary score ranges from 1-100. The range is normal at 1 and fragile at 100, respectively.

One could have a low bone mineral density, but having a lower fragility score would indicate a stronger microarchitecture (quality) of the bone. The spectral model created frail and non-frail data from real patients over 10 years.

Here’s an analogy to help you understand the two parameters:

A stool made of wood is less dense than a stool made of steel. Let’s say the steel stool has uneven legs, while the wooden stool is reinforced with struts and bands (quality architecture). One would likely sit on the wooden stool rather than the steel stool given the choice.

My REMS Scan Experience

I recently recorded a video podcast with Vicki Baldwin, RT(R), RDMS, RVT. Vicki is a clinical Sales Specialist who performs demonstration exams, and she provided us with an Echolight Scanning device.

Vicki performed a bone and spine scan for four people on our podcast day. Flose was our first patient. She is a 28-year-old who is very health conscious. She had two fractures in her tibia in her teens and has been concerned about her bone density, but for obvious reasons, a DEXA did not make sense because of her age.

Amalia is a 39-year-old mom with an 18-month-old baby. She was very sick during her pregnancy and had a difficult time with nutrition and exercise. She was concerned about her bone density but did not want to receive the DEXA due to radiation concerns.

Virginia is a middle-aged woman who is very fit and active and quite petite. She was curious about her small stature and active life and what it means for bone density.

Finally, I was scanned at 62.5 years. I have moved from osteopenia to osteoporosis again. Although the change was disappointing, I was encouraged by the fact that my bone quality is very good.

As you all are familiar with the color coding that comes with many diagnoses, I had numbers in the red for density and numbers in the green for quality. I will be looking at all the reasons that may exist beyond aging for this change, but I will not be changing my activity level.

My weightlifting keeps my muscles and balance strong, and we know that NOT falling is half the battle. When I have fallen on the tennis court, I bounce right back up, so I know that my bone quality is holding me in good stead right now.

The great news is that I CAN monitor my bone density and quality more often now because we have a non-radiation method for getting information on our bones.

What’s in It for Us All

First, I know this may sound like a promotion for Echolight, but I have no financial stake in the company or the product or a medical or spa establishment that owns a machine. I do not own a machine either.

I simply see a huge public health education opportunity that should not be ignored. The benefit of a non-radiation method to assess bone quality and density means that young women will be able to have the data to make decisions regarding their bone health long before they are in osteopenia or osteoporosis.

It also means that women in our age group, that is, over 60, will be able to monitor their bone density and quality far more frequently.

The fact that many established medical practices have invested in DEXA scanners may mean that acceptance of the REMS technology will be slow. I truly believe that as consumers we need to ask for technology that can provide us with bone density and quality information quickly and safely.

If you want to learn more about our little test group experience, here’s my podcast detailing the REMS technology scan.

Are you concerned about osteoporosis? Have you done a bone density scan? How often do you undergo a DEXA? If you could, would you rather do a radiation-free scan? What do you think about this new REMS technology?