SpineAnalyzer™ is an accurate and precise method of vertebral fracture detection and classification on dual-energy lateral vertebral assessment scans

• Vertebral fracture assessment (VFA) using Dual-energy X-ray Absorptiometry (DXA) offers a low-dose opportunity for diagnosis.
• Agreement between VFA software (SpineAnalyzer™) and expert readers is high.
• Intra-rater precision of SpineAnalyzer™ applied to upper thoracic vertebrae is poor, but good elsewhere.
• SpineAnalyzer™ is reproducible and accurate for vertebral height measurement and fracture quantification from VFA scans.

Osteoporotic fractures of the spine are associated with significant morbidity, are highly predictive of hip fractures, but frequently do not present clinically. When there is a low to moderate clinical suspicion of vertebral fracture, which would not justify acquisition of a radiograph, vertebral fracture assessment (VFA) using Dual-energy X-ray Absorptiometry (DXA) offers a low-dose opportunity for diagnosis. Different approaches to the classification of vertebral fractures have been documented. The aim of this study was to measure the precision and accuracy of SpineAnalyzer™, a quantitative morphometry software program. Lateral vertebral assessment images of 64 men were analysed using SpineAnalyzer™ and standard GE Lunar software. The images were also analysed by two expert readers using a semi-quantitative approach. Agreement between groups ranged from 95.99% to 98.60%. The intra-rater precision for the application of SpineAnalyzer™ to vertebrae was poor in the upper thoracic regions, but good elsewhere. SpineAnalyzer™ is a reproducible and accurate method for measuring vertebral height and quantifying vertebral fractures from VFA scans.