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All TBS features and main arguments. Included, in greater detail:

  • What is TBS iNsight and what is TBS: the main arguments.
  • TBS compatibilities with different DXA systems.
  • Main evidence of TBS clinical validation.
  • How TBS can be a significant aid to better characterize your patient’s risk profile.
  • Short grid to understand the risk of fracture based on a combined model of TBS and BMD.
TBS iNsight v3 - Information sheet

DXA System:

GE + Hologic

Available also in:

Document code:


TBS iNsight v3.0


Boost The Performance Of DXA & Add Value To Your Clinical Practice with TBS

TBS iNsight™ - an advanced imaging software for bone densitometers (DXA) - enhances the ability to predict osteoporotic fracture.

The result - expressed as a Trabecular Bone Score (TBS) - derives from a patented algorithm that evaluates spatial variations of the gray-levels in the AP spine DXA scan. TBS provides an indirect, yet highly correlated, index of bone microarchitecture. TBS predicts fractures independently of bone mineral density (BMD), clinical risk factors and FRAX®.

TBS’ maximum impact is observed in patients with osteopenic/normal BMD values who display low TBS scores and consequently have a higher combined risk profile or in patients whose fracture risk is close to the intervention threshold. Moreover TBS shows potential in patients with secondary osteoporosis: While BMD is often limited to identify patients with secondary OP who are at risk for fractures, TBS can be used as an aid in the diagnosis of osteoporosis and other medical conditions leading to altered trabecular bone microarchitecture.

TBS iNsight software

  • calculates an index of microarchitecture in routine clinical practice
  • incorporates FRAX adjusted for TBS
  • shows monitoring trend curve for patients’ follow up data including LSC
  • allows retrospective analysis of patients’ DXA scans
  • enables automatic data export
  • communicates with PACS systems thanks to DICOM module (optional)
  • displays patient reports in various languages
  • offers online training & certification
  • includes TBS iNstats module to identify your patient management
  • is calibrated by using an unique TBS phantom.

TBS iNsight software license is assigned to a specific DXA system.


Hologic Systems

Current compatible bone densitometers with TBS iNsight:

  • Horizon™ , Discovery™ , Delphi™, QDR 4500™ Series (all models)

Current BMD software versions compatible with TBS iNsight

  • QDR™ Workstation versions up to 12.7, APEX™ versions up to 5.6

GE Lunar Systems

Current compatible bone densitometers with TBS iNsight

  • iDXA™ Prodigy™ Series (all models)

Current BMD software versions compatible with TBS iNsight

  • enCORE™ versions from 8.10 to 17.10

Clinical Validation

  • Several hundreds of peer-reviewed publications
  • Included in international and national guidelines (e.g. ISCD, ESCEO, DVO, NOGG)
  • TBS adjusted FRAX
  • Thousands of TBS users worldwide
  • Ethnicity reference curves for men and women derived from huge study cohorts (e.g. NHANES) integrated in the software.

TBS  differentiates expert DXA clinics and can increase patient referrals.

TBS is...

FAST no additional scan time, immediate results

SAFE no additional radiation to patients, derived from routine DXA exams

EASY automatic TBS report with BMD, TBS, FRAX adjusted for TBS


Same BMD but Different TBS

Two patients can have similar BMD but could display different structure (see graphic below)(1) and subsequently have different fracture risk. According to scientific societies «decision-making about the patients to be treated and the treatments to be prescribed must be based on clinical judgement using the recommendations and all available clinical information.»(2)


Risk stratification of TBS and BMD could improve the assessment of fracture risk, particularly in osteopenic patients and patients with secondary osteoporosis. The following interpretation table and patients with secondary osteoporosis. The following interpretation table presents the level of risk expressed as the number of major osteoporotic fractures per 1000 women/year (based on a study conducted on 30,000 women). It shows that for a given BMD category the risk may almost double depending on TBS.


TBS is a risk factor for future low trauma fracture independent of BMD and clinical risk factors.

TBS should be interpreted in accordance with the recommendations of national & international societies, e.g. NOF(1), ESCEO(4), ISCD(5) and GRIO(6).

1- Adapted from Silva et al. JBMR 2014. 29(3): 518–530

2- NOF Clinician’s Guidelines to prevention and Treatment of Osteoporosis 2010 – Last update in april 2014

3- Adapted from Hans et al. JBMR 2011; 26(11): 2762-9 and meta-analysis from McCloskey et al. JBMR. 2016, 31(5): 940-948.

4- Harvey et al. Bone, 2015. (78): 216–224.

5- ISCD - Last update in june 2015 with TBS integration

6- GRIO Research and Information Group on Osteoporosis

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