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.