Interest in bone densitometry methods has recently experienced a resurgence within the medical community. Physicians have become more interested than ever before in the diagnosis and treatment of degenerative diseases of bone such as osteoporosis. The public perception of osteoporosis and its prevention has been recently heightened. Because osteoporosis is widespread, especially in women, and leads to an increase in fractures in our population, many re­ searchers and clinicians are strongly motivated in their search for more sensi­ tive and accurate methods of diagnosis. This book was written for physicians, scientists, engineers, medical phy­ sicists, and others desiring an introduction or further understanding of this exciting field. Beginning with the early development of x-ray film methods for assessing bone status, the field has steadily grown throughout the years. Novel and interesting devices have been designed for the measurement of bone mass, bone density, cortical thickness, and other parameters of bone changes. Both qualitative and quantitative bone methods are described. The techniques include imaging devices such as CT and radiography as well as fixed point methods in which bone characteristics of a region of interest are analyzed.

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1 Introduction.- Composition of Bone Tissue.- Bone Strength and Bone Mass.- Bone Mass Measurements.- 2 Radiographic Film Methods.- Radiographic Diagnosis (Radioscopy).- Trabecular Indices.- Principles of Radiogrammetry.- Combined Cortical Thickness.- Barnett-Nordin Index.- Cortical Area.- Percent Cortical Area.- Exton-Smith Index.- Principles of Metacarpal Measurements.- Magnification Techniques.- Vertebral Measurements.- Radius Measurements.- Precision and Accuracy (Radiogrammetry).- Clinical Measurements.- Radiographic Photodensitometry.- Precision and Accuracy (Photodensitometry).- Videodensitometry.- 3 Single-Photon Absorptiometry.- Principles of Measurement.- X-ray Tube Sources for SPA.- Multiwire Proportional Counters.- Two-Dimensional SPA.- Precision and Accuracy (SPA).- Effects of Adipose Tissue.- Clinical Measurements.- SPA in Children.- Fracture Risk.- Radiation Dose to Patients.- 4 Dual-Photon Absorptiometry.- Principles of Measurement.- Instrumentation and System Design.- Beam Hardening and Crossover Corrections.- Correction for Fat.- Precision and Accuracy.- Total-Body Bone Mineral Measurements.- Clinical Measurements.- Fracture Threshold.- Radiation Dose to Patients.- 5 Quantitative Computed Tomography.- Monoenergetic (Gamma) CT.- Precision and Accuracy (Gamma-CT).- Single-Energy X-ray Quantitative CT.- Precision and Accuracy (Single-Energy X-ray CT).- Beam-Hardening Effects.- Partial Volume Effects.- Effects of Marrow Fat.- Dual-Energy X-ray Quantitative CT.- Precision and Accuracy (Dual-Energy CT).- Clinical Measurements.- Radiation Dose to Patients.- 6 Scattering Methods in Densitometry.- Compton-Scatter Imaging Methods.- Fixed-Point Compton-Scatter Methods.- Dual-Source/Dual-Detector Methods.- Dual-Source/Single-Detector Methods.- Single-Source/Single-Detector Methods.- Single-Source/Dual-Detector Method.- Finite Geometry Effects.- Multiple Scattering.- Clinical Measurements.- Coherent/Compton-Scatter Methods.- 7 Activation Analysis Methods.- Principles of Measurement.- Partial-Body NAA.- Precision and Accuracy (NAA).- Clinical Measurements.- Radiation Dose to Patients (NAA).- Proton Activation Analysis (PAA).- Muonic X-ray Excitation.- 8 Clinical Applications and Comparison of Methods.- References.