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IVA

Vertebral Fracture Assessment using IVA (Instant Vertebral Assessment)

Background and Problem

  • Bone density testing via DXA predicts fracture risk
  • Previous fracture is an independent risk for future fracture
  • Previous vertebral fracture results in a:
    • 5-fold increase risk of next vertebral fracture
    • 3-fold increased risk of fracture at any site
    • 2-fold increased risk of hip fracture
    • increase in morbidity, mortality, and cost
  • Previous vertebral fractures are common
    • 13% of Caucasian women 65-69
    • 25% of caucasiam women > 50
    • 33% of Caucasian women >75
    • 20% of US males >50
    • 10% of Hispanic/American and Japanese/American women > 50
  • Problem - previous vertebral fractures are under-recognized
    • Clinically – only 1 in 4 vertebral fractures is recognized
    • Radiographically – may not be listed if X-ray was done for other reasons 
  • Summary – vertebral fractures are common, morbid, mortal, costly, and missed
  • Solution – Vertebral Fracture Assessment using IVA (Instant vertebral Assessment) Technology
  • Uses the DXA machine to do a 10 second high quality scan of the thoracic and lumbar spine at the same time as the DXA
  • Uses specialized software to perform semi-quantitative and quantitative vertebral fracture assessment 
  • System-wide protocol development, evaluated, and published
    • 24% of patients had at least 1 fracture
    • 11% of patients had risk increased to high based on IVA results
    • additional cost ~$40 – covered by most insurers
  • Integrated DXA report includes fracture risk assessment and recommendations based on DXA and IVA (if indicated per protocol)

IVA Availability

  • Mobile DXA, GWV DXA, Mt. Pocono DXA
  • Coming soon – Lewistown DXA, State College DXA, Danville Radiology DXA
  • Physician Ordering - simply order a DXA
    • IVA will be performed automatically if indicated per protocol
    • You will receive a single integrated DXA Consultative report

References

Rea JL et al.  Visual assessment of vertebral deformity by x-ray absorptiometry: a highly predictive method to exclude vertebral deformity.  Osteoporos Int 2000;11:660-668.

Olenginski TP, Newman ED, Hummel JL, Hummer M.  Development and Evaluation of a Vertebral Fracture Assessment Program using Instant Vertebral Assessment (IVA) and its Integration with Mobile DXA.  J Clin Densitometry 2005 (in press).

Dubboeuf F, bauer DC, Chapurlat RD et al.  Assessment of vertebral fracture using densitometric morphometry.  J Clin Densitom 2005;8:362-368.