The impact of operator training on the accuracy of DXA lumbar spine analysis

Introduction: This study involving Dual-energy X-ray Absorptiometry (DXA) spine images investigated the effectiveness of an additional training session compared to basic instruction provided by the scanner manufacturer (by video) on student radiographers’ ability to make appropriate DXA analysis decisions. Lack of operator training can potentially lead to technical errors and inaccurate patient diagnosis which may be detrimental to their bone health and put them at risk of a fragility fracture in the future. Methods: Radiography students (n=24) attending the OPTIMAX research summer school in University College Dublin (UCD) participated. The students first watched a video that was provided with the DXA scanner software. This video explained the basic process of analysing a DXA spine image. Participant knowledge of understanding how to analyse a DXA spine image was then assessed by questionnaire. Immediately after the completion of the first questionnaire , an expert DXA radiographer (16 years experience) provided a training session on DXA lumbar spine analysis, giving a more in-depth, comprehensive and step-by step tutorial on how best to analyse DXA spine images and common pit-falls to be aware of. Lecture notes and a set of DXA guidelines (based on international best practice and on which the lesson was designed) were distributed during the training session. The participants repeated the questionnaire, with access to the tutorial notes and guidelines. Results: The results of the questionnaire responses pre- and post-training were calculated and demonstrated an improvement in the questionnaire scores post additional training. Data normality was checked by Shapiro-Wilks test and was shown to be parametric. The mean questionnaire score of the post-training group increased by 13.7%, and was shown to be statistically significant with a p value of. 0.002. Conclusion: The additional DXA training provided positively affected the student radiographers’ understanding on how to analyse DXA images.