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Description of the TBS patient’ report including explanations regarding its various components: TBS Score, TBS Reference Curve, TBS mapping, FRAX, TBS follow-up, etc.

TBS Follow Up Report

DXA System:

GE + Hologic

Document code:

MM-BR-130-GE-EN-01 MM-BR-129-HLX-EN-01

TBS report

Guidance Notes

On this page a TBS patients’ report is presented including explanations regarding its various components.

1. Header and Patient Data

Displays the Center header, the patient’s demographics, the date of the TBS exam and the physician requesting the examination.

2. Depiction of Examination Data

a. TBS Score - The absolute value of TBS or the TBS T-score (depending on the configuration) is given for the vertebrae analyzed.

b. TBS Reference Curve - Use this graph to compare the value of a patient with the reference population. Several TBS reference curves by gender and ethnicity are available (acc. to User’s Manual). -> A TBS L1-L4 value greater than 1.310 = low risk of fracture, bone structure may be considered normal -> A TBS L1-L4 value between 1.31 and 1.23 = Moderate risk of fracture, bone structure may be considered as partially degraded -> A TBS L1-L4 value less than or equal to 1.23 = Major risk of fracture, bone structure may be considered degraded*(1).

c. TBS Mapping - The local TBS values are represented in color and as a function of the heterogeneity of the bone structure: the TBS values of a well-structured bone appear green while those of a degraded structure appear in red. The color coding appears directly on the DXA image of the spine. This is only for visualization, not for diagnostic use.

3. Additional results

the table shows results in absolute values, T and Z score for L1,L2, L3, L4 and combinations thereof. The BMD value of the spine and the T-Score are also provided here.

4. FRAX

The new FRAX scores Ajusted for TBS are displayed in that section: FRAX score issued by DXA software are adjusted by taking TBS score and patient’s data into account(2).These new values should be considered in the light of national and international recommendations.

5. Comments

Space for physician’s comments.

6. Footer

he footer displays policy, software version, date of analysis and calibration details. Reminder: the examination is viable for patients over 20 years with a BMI between 15 and 37kg/m2.

1- Adapted from the meta-analysis by McCloskey et al. J Bone Miner Res. 2016, 31(5), 940-948.
2 - Adapted from Adjusting Fracture Probability by Trabecular Bone Score McCloskey et al. Calcif Tissue Int.,96(6), 500-509.
*Note: TBS thresholds might differ according to the selected reference curve.

TBS Follow-Up report

The Follow-Up Report displays the history of the results of all DXA tests performed by a patient in a given center and with a TBS value.

1. Header and Patient Data - Displays the centre header and patient demographics.

2. TBS Follow-up Graphic - TBS values display on the follow-up graphic graph to evaluate how TBS changes across time. This graph is identical to the reference curve used for TBS exam report except the x-axis is limited at the patient’s age for exam dates. The dotted lines represent the TBS LSC(1) on either side of your patient’s initial value. A change in TBS value between two examinations is significant only if it is greater than the LSC (positive and/or negative variation) limits.

3. Follow-up results - this table chronologically reports each examination taken into account for the TBS Follow- Up Report: the date of the examination, the age of the patient, the TBS value, the BMD value, the TBS variation compared to baseline (%), TBS variation compared to the previous exam (%), the TBS variation per year (%). An asterisk (*) appears in the table when the change in the TBS value between examinations exceeds the LSC limits set by default.

4. Footer - Legal notices and information about the software and exam are displayed here. The average value of the LSC used by the centre is also displayed.

Reminder of good practice for follow-up: to ensure that the TBS values of several examinations of the same patient can be compared, it is strongly recommended to use the same device for all examinations and to ensure proper positioning of the patient for each exam. As with the bone mineral density test, it is important not to over-interpret the results in case of significant fluctuations in weight (gain or loss), that could lead to potential non-clinical fluctuations of BMD.

1 - The LSC (Least Significant Change) displayed is the mean LSC calculated from data from 7 international clinical studies. The ISCD recommends that each bone densitometry centre calculate its own LSC. TBS iNsight should only be used for patient follow-up after the centre-specific LSC has been calculated.

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