Official Positions of the International Society for Clinical Densitometry and Executive Summary of the 2007 ISCD Pediatric Position Development Conference

Abstract

The International Society for Clinical Densitometry (ISCD) convenes a Position Development Conference (PDC) every 2 yr to make recommendations for standards in the field of bone densitometry. The recommendations are based on clinically relevant issues in bone densitometry such as quality control, acquisition, analysis, interpretation, and reporting. In 2007, ISCD convened its first Pediatric Position Development Conference to address issues specific to the assessment of skeletal health in children and adolescents. Topics for consideration are developed by the ISCD Board of Directors and its Scientific Advisory Committee. Clinically relevant questions related to each topic area are assigned to task forces for a comprehensive review of the medical literature and subsequent presentation of the reports to an international panel of experts. For this PDC, the Expert Panel included representatives of the American Society for Bone and Mineral Research and International Bone and Mineral Society. The recommendations of the PDC Expert Panel are then reviewed by the ISCD Board of Directors. Recommendations that are approved become Official Positions of the ISCD. The Pediatric PDC was held June 20–21, 2007, in Montreal, Quebec, Canada. Topics considered were restricted to children and adolescents, and included DXA prediction of fracture and definition of osteoporosis; DXA assessment in diseases that may affect the skeleton; DXA interpretation and reporting; and peripheral quantitative computed tomography measurement. This report describes the methodology and results of the 2007 Pediatric PDC, and a summary of all ISCD Official Positions, including the ones recently adopted by this 2007 Pediatric PDC and the 2007 Lansdowne, Virginia, USA Adult PDC.

Introduction

The International Society for Clinical Densitometry (ISCD) is a multidisciplinary non-profit professional organization dedicated to enhancing knowledge of bone densitometry and its application to skeletal health. ISCD accomplishes this mission through educational venues (scientific meetings, courses, and publications), certification programs, and recommendations for the use of bone densitometry: the ISCD Official Positions. New Official Positions are considered biannually according to the PDC format. Previously established Official Positions are also re-evaluated periodically at the Position Development Conferences (PDC) as required by new developments in this field. The Official Positions are widely utilized by clinicians and technologists as a reference for quality control, acquisition, analysis, interpretation, and reporting. They form the basis for much of the material taught in the ISCD Bone Densitometry Courses.

Official Positions resulting from prior PDCs held biannually from 2001 to 2005 have previously been reported 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18. Most recently, PDCs were held in Montreal, Quebec, Canada (Pediatric PDC), on June 20–21, 2007, and in Lansdowne, Virginia, USA (Adult PDC), on July 20–22, 2007. This report describes the methodology and results of the Pediatric PDC and contains a summary of all ISCD Official Positions.

The Official Positions resulting from the PDC are established in order to enhance quality and clinical utility of bone densitometry worldwide. They provide clinicians, technologists, and researchers with a reference standard for skeletal health assessment. Since the field of bone densitometry is new and evolving, some clinically important issues that are addressed at the PDCs are not associated with robust medical evidence. Accordingly, some Official Positions are based largely on expert opinion. Despite limitations inherent in any process such as this, the ISCD believes it is essential to provide clinicians and technologists with the best distillation of current knowledge in the discipline of bone densitometry and provide an important focus for the scientific community to consider further research to resolve areas of ambiguity and/or ongoing controversy.

The ISCD wishes to acknowledge the extraordinary efforts of the PDC Task Force Chairpersons and members, who are a most distinguished group of international experts. The dedication of these individuals for the past 2 yr has been exemplary.