Osteoporosis International

, Volume 7, Issue 6, pp 570–574 | Cite as

Evaluation of the European spine phantom in a multi-centre clinical trial

  • B. Lees
  • S. W. Garland
  • C. Walton
  • J. C. Stevenson
Original Article


The European Spine Phantom (ESP) has recently been developed as a universal standard for instruments measuring bone density. The ESP is composed of three semi-anthropomorphic hydroxyapatite vertebrae of varying densities surrounded by soft tissue equivalent plastic designed to resemble human bone and soft tissue when scanned on bone densitometers. In multi-centre studies it is particularly important to verify that each participating bone densitometer is performing in a stable and linear fashion. The aim of this study was to evaluate the ESP within the context of a multi-centre clinical trial. Eighteen centres in the UK and Canada with dual-energy X-ray absorptiometry (DXA) instruments (Lunar DPX, DPX-alpha and DPX-L) participated in the study. The ESP was scanned 10 times on each instrument without repositioning using standardized protocols. The precision of the bone mineral density (BMD) measurements (L1–3) expressed as a coefficient of variation ranged from 0.4% to 1.1% (mean 0.7%). The mean BMD of each instrument was expressed as a percentage difference from the overall mean and ranged from −1.33% to 1.33%. Linear regression analysis showed that all instruments behaved in a linear fashion across the range of densities with correlation coefficients all ≥0.999 and standard errors of the estimate <1.5% of the mean BMD ESP value. The data from this study demonstrate that the ESP is a useful phantom for assessing the linearity, stability and differences between DXA instruments from one manufacturer.


Bone densitometry Dual-energy X-ray absorptiometry (DXA) Phantoms Precision 


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Copyright information

© European Foundation for Osteoporosis and the National Osteoporosis Foundation 1997

Authors and Affiliations

  • B. Lees
    • 1
  • S. W. Garland
    • 1
  • C. Walton
    • 1
  • J. C. Stevenson
    • 1
  1. 1.Wynn Division of Metabolic MedicineImperial College School of Medicine at the National Heart and Lung InstituteLondonUK

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