Dpx-Iq: Operator's Manual

DPX-IQ ™
Operator’s Manual
Software Version: 4.6

Documentation Version: 1/99C
Part Number: 5970
LUNAR Corporate Headquarters

313 West Beltline Highway
Madison, WI 53713 USA
+1 (800) 445-8627
+1 (608) 274-2663
+1 (608) 274-5374 (Fax)
LUNAR Europe N.V. LUNAR GmbH

avenue R. Vandendriessche, 18/9 Horbeller Strasse 33
1150 Brussels D-50858 Köln
Belgium Germany
+32-2-7770910 +49-2234-954590
+32-2-7791039 (Fax) +49-2234-273153 (Fax)
LUNAR France LUNAR Asia/Pacific

1, avenue d’Aix-en-Provence 54 Taylor Street
13410 Lambesc West Pennant Hills, NSW 2125
France Australia
+33-4-42 57 17 97 +61-2-9873-1091
+33-4-42 57 17 99 (Fax) +61-2-9871-3758 (Fax)
Internet Address: http://www.lunarcorp.com

The information in this manual is subject to change without notice. You may use or copy the software described in this manual only in accordance with the terms of your
software license, product warranty, or service contract agreements.
No part of this publication may be reproduced for any purpose whatsoever, stored in a retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording or otherwise, without the express written permission of LUNAR.
LUNAR makes no warranty of any kind with regard to this material, and shall not be held liable for errors contained herein or for incidental or consequential damages
in connection with the furnishings or use of this manual.
Read this manual thoroughly before using the system or attempting to service any components. Unauthorized service may void system warranties or service contracts.
Consult the LUNAR Customer Support Department before attempting any service: 800-334-5831.
LUNAR, DPX, and DPX-IQ are registered trademarks of LUNAR Corporation. All other product and brand names are registered trademarks or trademarks of their
respective companies.
Copyright© 1995, 1996, 1997, 1998, 1999

Lunar Corporation, Madison, Wisconsin. All rights reserved.
Software License Agreement

I. Software License
This software has been provided for use on a specific LUNAR Corporation instrument. You assume responsibility for the selection of the program to achieve your
intended results, and for the installation, use, and results obtained from the program.
Lunar Corporation (“LUNAR”) grants you a non-exclusive, non-transferable license to use the computer software recorded on diskettes (“Programs”) delivered with a
specific LUNAR instrument as follows:
You may:
1. Use the Program diskettes only on the instrument designated by the system serial number on the diskette label.
2. Make one (1) copy of each Program solely for backup purposes, provided that you reproduce on a label secured to such backup copy the Program name,
system serial number, copyright notice and all other information identifying LUNAR’s ownership.
You may not:
1. Modify, reverse engineer, decompile, or disassemble any Program or any part thereof or merge any part of any Program into another computer program.
2. Rent, sell, sublicense, assign, or otherwise transfer the Programs to a third party. In the event the instrument designated for the Programs is sold or
otherwise transferred to a third party, that party is not authorized to use the Programs unless they first pay to LUNAR the applicable license fee and agree
in writing to be bound by the terms and conditions of the current LUNAR Software License Agreement.
II. Title
This license is not a sale of the Programs. Title to and all copyrights in the Programs and any copies made by you remain the sole property of LUNAR.
III. Term
This Agreement shall continue until terminated by you or automatically terminated. You may terminate at any time by returning the Programs and any copies thereof.
Any unauthorized copying of the Programs or failure to comply with the terms and conditions of this Agreement will result in automatic termination of Agreement.
IV. Software Limited Warranty
LUNAR warrants that, to the best of our knowledge, the Programs provided with this license will perform as described in the Operator’s Manual for this software. This
limited warranty is contingent upon proper use of the Programs and does not cover any Program which has been modified, subjected to unusual physical or electrical
stress, or used on computer equipment not specified by LUNAR.
LUNAR does not warrant that the functions contained in these Programs will meet your requirements, or that the operation of the Programs will be uninterrupted or
error-free. Statements made about this software do not constitute warranties and shall not be relied upon by the buyer in deciding whether to purchase these Programs.
In no event shall LUNAR be liable to you for any damages arising out of the use or inability to use such Programs.
The sole and exclusive remedy in the event of defect is expressly limited to the replacement of the diskette(s) provided. If failure of the diskette(s) has resulted
from accident or abuse, LUNAR shall have no responsibility to replace the diskette(s) without additional cost to the customer.
LUNAR will consider this warranty to be void if you fail to comply with the terms in the Software License Agreement or if the software is used on computer equipment
not specified by LUNAR.
ii DPX-IQ Operator’s Manual

General Product Warranty
LUNAR warrants that its products shall be free from defects in workmanship and materials and shall conform to published specifications for a period of one (1) year
from the date of installation under normal use as prescribed in the Operator’s Manual for the product. This warranty does not apply to any products which have been
subjected to neglect, accident or modification or any use other than specified as standard operating procedure in the manual.
LUNAR densitometers are designed to work with specific computer models and operating systems. Operating a LUNAR densitometer with a computer or operating
system that does not meet LUNAR’s specifications voids the product warranty and could significantly affect system performance. LUNAR assumes no liability for
system failures caused by the use of computers or operating systems that have not been specified by LUNAR.
LUNAR’s sole obligation to the Buyer for products failing to meet this warranty shall be, at LUNAR’s discretion, to repair or replace the nonconforming product or part.
Any item, repaired or replaced, shall be warranted for the remaining warranty period or thirty (30) days, whichever is longer.
LUNAR provides no other warranties, expressed or implied, including but not limited to any implied warranties of merchantability or fitness for a particular
purpose, except as specifically provided in this warranty or as otherwise specifically stipulated in a written addendum.
In no event shall LUNAR be liable for loss of profits, indirect, special, consequential or other similar damages, arising out of any breach of this warranty.
LUNAR retains the right to void all warranties if payment is not received, as prescribed in the terms of purchase or lease.
General Product Information

The DPX-IQ bone densitometer is designed to estimate the bone mineral density of patients when medically indicated by their physicians. The User’s Manual provides
instructions for operating the software and scan table, system information, and maintenance information.
Variables Affecting Scan Results
Scan results can be affected by operator technique and patient variability:
• Operator technique refers to patient positioning and scan analysis. To minimize technique variables, 1) establish consistent positioning and scan analysis
routines by using anatomical landmarks when positioning patients, and 2) during analysis, manipulate raw scan data only when absolutely necessary.
• Patient variability refers to changes in the patient's medical history, metabolism, and diet. It also refers to diagnostic procedures that involve radionuclide
uptake and medical treatment, and the presence of external radiation (particularly the use of other radiation-generating devices in the vicinity of the
system). To minimize patient variability, 1) thoroughly familiarize yourself with the patient’s history, and 2) install the scanner in an environment
effectively shielded from other sources of external radiation.
Federal Law restricts this device to the sale, distribution, and use by or on the order of a physician.
Training Information
LUNAR or authorized LUNAR distributors provide individual, hands-on training as part of the installation procedure for your system. (LUNAR distributors provide
training for systems installed outside the United States.) An Applications Specialist provides information on software and hardware operations, and reviews the
warnings and cautions in this manual.
IMPORTANT: Only trained technologists should operate the system. New technologists should receive training prior to unsupervised operation of the
system. Additional training sessions are available on request for a nominal fee. For more information, contact the LUNAR Customer Support
Department at 800-334-5831, or your local LUNAR distributor.
Cautions for DEXA Determinations

You should be aware of the following factors which may affect the clinical accuracy of DEXA spine estimates: marked distortions of skeletal architecture—e.g.,
osteophytes, degenerative disc disease, spinal arthritis, spondylolisthesis, kyphoscoliosis, and vertebral fractures—and significant calcium deposits in the aorta can
falsely elevate spine bone mineral values. Regions that contain these dystrophic calcifications can be excluded from the scan analysis in some cases. The scanner can be
used to monitor changes in bone mineral over time in patients with these disorders, but caution must be taken in interpretation. Use DEXA estimates as an aid to other
methods in the evaluation of patient bone mineral status in the clinical setting.
In addition, spine estimates will be difficult to interpret for patients with orthopedic metal devices and previous surgical interventions, such as laminectomy and bone
grafts. Radiographic contrast material and radiopharmaceuticals used for myelograms, barium enemas, and other diagnostic tests prevent accurate estimates. Barium
clears the body within a few days, but the oil-based dyes used in myelograms several years ago may remain within the body for years. A three-day waiting period is
sufficient time for barium and most radiopharmaceuticals to be completely discharged from the body.
Femur estimates usually are not affected by most of the above mentioned factors for the spine. The most common complicating factors for femur estimates are prosthetic
devices and surgical implants in the region of the bone scan. Results may be adversely affected if the patient has difficulty with the desired 25° inward rotation of the leg
or with maintaining this position without movement.
Total Body estimates require consistent patient positioning for accurate results. The operator should pay particular attention to the location of the patient's arms, keeping
the positioning the same for each scan. Results may be affected if the patient moves during the scan.
DPX-IQ Operator’s Manual iii

Precautions for Daily Operation
• Do not attempt to operate the scanner without first reading this manual.
• Do not remove the assembly panels or attempt any repairs without prior instructions from authorized LUNAR personnel.
• Do not sit or lie on the scan table for purposes other than scanning.
• Perform the Quality Assurance procedure each morning. If any test fails, rerun the entire QA procedure. If a test fails again, contact the LUNAR Customer
Support Department. Also, call LUNAR if more than two failures occur in a one-week period.
• If the patient is or might be pregnant, always contact the patient’s physician before performing a scan.
• Remain in the room with the patient while a scan is in progress.
• Restrict access to the room to authorized personnel.
• Do not attempt to service any of the system’s electrical components while the scan table is turned ON. High voltage is used to produce x-rays.
• Read chapter 1 of this manual for radiation safety information.
• To stop the scanner in an emergency, press the emergency stop button on the scan arm. DO NOT use the emergency stop button to routinely abort a scan.
Using the DPX-IQ Operator’s Manual

Use this manual to help you complete daily acquisition and analysis procedures.
Chapter 1–System Overview gives scanner components, scanner safety information, and basic maintenance procedures.
Chapter 2–Basic Procedures gives procedures to complete common tasks. It gives an overview of key functions and the DPX-IQ interface, and basic acquisition and
analysis information.
Chapter 3–Quality Assurance gives procedures to complete Quality Assurance tests and pass/fail criteria for the tests.
Chapter 4–Default Settings gives procedures to set default settings for the program.
Appendixes A thru G give information to complete acquisition and analysis for each scan type: A (AP Spine), B (Femur), C (Lateral Spine), D (Total Body), E
(Forearm), F (Hand), and G (Orthopedic Hip). Appendix H (Specifications) gives technical specification information for the DPX-IQ system. Appendix I (Comparison
to Reference Population) gives reference data information, and appendix J (Precision and Accuracy) gives precision and accuracy information for the DPX-IQ scanner.
Supplemental Information
If you purchased Small Animal, Pediatric, DICOM, or Report Generator software options, a supplement for each option is delivered with your DPX-IQ scanner.
iv DPX-IQ Operator’s Manual

Declaration of Conformity
Manufacturer: Lunar Corporation
313 West Beltline Highway
Madison, WI 53713
USA
European Representative: Lunar Europe

Avenue R. Vandendriessche 18/9
3078 Everburg
Belgium
Product Description: DPX Series Bone Densitometers

(Includes DPX, DPX-MD, DPX-IQ
DPX+, DPX-alpha, DPX-L)
We hereby declare that the above described product conforms to the requirements
of the European Council Directive 93/42/EEC, Medical Devices Directive,
Annex II. This declaration is based on our Notified Body’s conformity assessment
and certification of this site’s quality system in accordance with the requirements
of 93/42/EEC, Annex II.
Report Number: E 9713748 E 01

Issued by: TUV Rheinland
Date 16.12.97
Kenneth D. Buroker Date

Director, Regulatory Affairs
This page left blank intentionally.
vi DPX-IQ Operator’s Manual

Table of Contents
Chapter 1: System Overview
1.1 Scan Table Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-1
Scan Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Scan Arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
1.2 System Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
1.2.1 Operator Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
Personnel Monitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
X-ray Shutter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
X-ray Power Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
1.2.2 Patient Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4
Pinch Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4
Laser Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4
Radiation Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-5
1.2.3 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-6
1.2.4 Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-8
1.2.5 Emergency Stop Button and Failsafe Circuit. . . . . . . . . . . . . . . . . . . . . . . . .1-9
Emergency Stop Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-9
Failsafe Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-9
1.2.6 Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-9
1.2.7 Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-10
1.2.8 Electrical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-10
1.2.9 Scattered Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-10
1.3 System Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-13
1.3.1 Clean the Scan Table Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-13
1.3.2 Archive Scan Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-13
1.3.3 Test the Emergency Stop Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-13
1.4 Preventive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-14
1.4.1 X-ray Tube and Laser Assemblies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-14
1.4.2 Daily Quality Assurance Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-14
1.4.3 Weekly Quality Assurance Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-14
Chapter 2: Basic Procedures

2.1 The DPX-IQ Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
2.1.1 Options Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
2.1.2 Common Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2
2.2 Start the DPX-IQ Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
2.3 Basic Acquisition Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
2.3.1 Patient Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
2.3.2 Basic Steps for Image Acquisition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Step 1: Select Scan Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Step 2: Add a Patient or Select a Patient . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Step 3: Position the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Step 4: Locate Scan Start Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Step 5: Scan the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
DPX-IQ Operator’s Manual Table of Contents vii

2.3.3 Add Patient or Select Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
Optional Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
2.3.4 Update Mandatory Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
2.3.5 Stop a Scan Image Acquisition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Start a New Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
End the Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
Continue the Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2.4 Basic Analysis Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2.4.1 Select Patient Scan File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
2.4.2 Adjust the Scan Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Filtering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Interpolation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Scaling Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Centering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Grey Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
2.4.3 Analyze the Scan Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
2.4.4 Print Analysis Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Examine Analysis Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
Print a DICOM Report (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2.5 Patient Trending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2.5.1 Chronological Results Screen Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
2.5.2 Graph and Print Patient Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
2.6 Archive Scan Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
2.6.1 Procedure to Archive Patient Scan Files . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Change Archive Destination and Directory . . . . . . . . . . . . . . . . . . . . . . 2-12
Chapter 3: Quality Assurance

3.1 Quality Assurance Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.1.1 Complete a QA Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.1.2 Collimation Ratio Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
3.1.3 Quality Assurance Warning Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
No Valid QA Results within the Past 48 Hours . . . . . . . . . . . . . . . . . . . . 3-3
No Valid QA Results within the Past 2 Weeks . . . . . . . . . . . . . . . . . . . . . 3-4
3.2 Spine Phantom Quality Assurance Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
3.2.1 Scan the Spine Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
3.2.2 Analyze the Spine Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
3.3 Monitor Precision Over Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Chapter 4: Default Settings

4.1 Print Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
4.1.1 Print Manager Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
4.1.2 Set the Delayed Print Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
4.1.3 Choose a Printer and Active Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
4.2 General Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
4.2.1 Report Heading. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
4.2.2 Miscellaneous Defaults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Patient ID Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Height/Weight Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Date Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Full Name on a Printout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Report Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
viii Table of Contents DPX-IQ Operator’s Manual

Display Country Field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4
Database Mini-Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4
Display Line Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4
Show Selected ROI Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Standardized BMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Vertebral Height Z-Score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
4.2.3 Printout Display Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Young Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Age Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Normals Graph Color Bars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Normals Graph Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Apply Weight Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
Apply Ethnic Origin Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
Age Regression Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
Bar 1 and Bar 2 Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7
4.3 Select Language. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-9
4.4 Select Reference Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-9
Appendix A: AP Spine Image Acquisition and Analysis

A.1 AP Spine Image Acquisition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
A.2 AP Spine Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
A.3 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6
A.3.1 Examine Labels and Intervertebral Space Markers . . . . . . . . . . . . . . . . . . . A-6
Examine Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6
Examine Intervertebral Space Markers . . . . . . . . . . . . . . . . . . . . . . . . . . A-6
A.3.2 Examine Baseline and Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-7
The Line Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-7
Examine Baselines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-8
Examine Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-9
A.3.3 Complete a Body ROI Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-10
Appendix B: Femur Acquisition and Analysis

B.1 Femur Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
B.2 Acquisition Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5
B.2.1 Position Rice Bags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5
B.2.2 Monitor the Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5
B.2.3 DualFemur™ Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6
Abort a DualFemur™ Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6
B.3 Femur Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6
B.4 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9
B.4.1 Insufficient Tissue Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9
B.4.2 Examine Neck ROI Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9
Correct Neck ROI Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9
Position the Neck ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-10
Appendix C: Lateral Spine Image Acquisition and Analysis

C.1 Lateral Spine Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
C.2 Install the Lateral Positioner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4
C.3 Lateral Spine Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4
C.4 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-7
C.4.1 Lateral Body ROIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-7
DPX-IQ Operator’s Manual Table of Contents ix

C.4.2 Label Body ROIs and Examine Space Markers . . . . . . . . . . . . . . . . . . . . . . C-7
Label Body ROIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-7
Examine Space Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-8
C.4.3 Examine Edge Markers and Lateral Body ROIs . . . . . . . . . . . . . . . . . . . . . C-9
Examine Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-9
Examine Lateral Body ROIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-10
Appendix D: Total Body Image Acquisition and Analysis

D.1 Total Body Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1
D.2 Total Body Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3
D.2.1 Tissue Quantitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-6
Tissue Quantitation Results Printout . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-6
D.3 Analysis Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-7
D.3.1 Position Cuts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-7
D.3.2 Standard and Extended Research Analysis . . . . . . . . . . . . . . . . . . . . . . . . . D-8
Appendix E: Forearm Image Acquisition and Analysis

E.1 Forearm Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1
E.2 Acquisition Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3
E.2.1 Measure the Forearm Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3
E.2.2 Record the Scan Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-4
E.2.3 Position the Forearm Positioner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-4
Forearm Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-5
E.3 Forearm Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-5
E.4 Analysis Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8
E.4.1 Examine Bone and ROI Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8
Change Bone Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8
Change Region Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8
E.4.2 Examine Baseline and Edge Markers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8
Examine Baselines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-9
Examine Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-9
E.4.3 Examine ROI Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10
E.4.4 Examine ROI Heights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10
Ultradistal ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10
33% ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10
5mm ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-11
10% ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-11
Total ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-12
Appendix F: Hand Image Acquisition and Analysis

F.1 Hand Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-1
F.2 Hand Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-3
Appendix G: Orthopedic Hip Image Acquisition and Analysis

G.1 Orthopedic Hip Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-1
G.2 Orthopedic Hip Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-4
G.3 Analysis Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-6
G.3.1 Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-6
The Line Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-7
Examine Edge Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-7
G.3.2 Examine Reference Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-8
x Table of Contents DPX-IQ Operator’s Manual

G.3.3 Examine Standard Analysis ROIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-9
G.3.4 Examine Gruen Analysis ROIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-10
Modified Gruen Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-11
G.3.5 Extended Gruen Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-11
G.3.6 Offset, Perimeter, and Rim Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-12
Set an Offset Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-12
Set a Perimeter Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-12
Set a Rim Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-13
G.3.7 Histograms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-13
Longitudinal Histogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-13
Transverse Histogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-13
Appendix H: Specifications
H.1 Space Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-1
H.2 Component Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-2
H.2.1 Printer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-2
H.2.2 Other Output Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-2
H.2.3 Scan Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-3
H.3 Functional Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-3
H.3.1 General Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-3
H.3.2 Maximum Scan Area (Long x Transverse) . . . . . . . . . . . . . . . . . . . . . . . . . H-3
H.3.3 Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-4
H.4 Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-4
H.5 Power Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.5.1 Leakage Current . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.5.2 Scan Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.6 X-ray Generator Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.6.1 X-ray Generator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.6.2 LUNAR 8022 X-ray Tube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-7
H.6.3 LUNAR 2288 X-ray Tube Head Assembly . . . . . . . . . . . . . . . . . . . . . . . . . H-8
H.6.4 Laser Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-9
H.7 Compatible Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-10
Appendix I: Comparison to Reference Population

I.1 Reference Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-1
I.2 Reference Population Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-2
I.3 Age Adjustment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-7
I.4 Weight Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-8
I.4.1 %Young Adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-8
I.5 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-9
Appendix J: Precision and Accuracy

J.1 Precision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-1
J.2 Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-3
J.3 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-5
DPX-IQ Operator’s Manual Table of Contents xi

xii Table of Contents DPX-IQ Operator’s Manual
1 System Overview
Chapter 1 Contents
1.1 Scan Table Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
1.2 System Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
1.3 System Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13
1.4 Preventive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14
Revised 1/99C
Chapter 1:System Overview
1.1 Scan Table Assembly

NOTE: DO NOT attempt servicing the scan table assembly. Please call the
LUNAR Customer Support Department or your LUNAR distributor.
Figure 1-1 shows the basic components of the scan table assembly: ➊ scan table;
➋ scan arm; ➌ control panel and ➍ power switch.
➌
R
➊
➋
DPX-IQ
Figure 1-1. DPX-IQ scanner assembly
DPX-IQ Operator’s Manual System Overview 1-1

Scan Table
Use the scan table to position the patient during an image acquisition. In addition, the
x-ray source assembly and other electronics are contained inside the scan table.
Scan Arm
A laser light emitted from an aperture below the scan arm is used to locate the scan
start position for the detector. Position switches (given below) let you move the scan
arm until the laser light is located at the scan start position. The detector position is
different for each scan type.
Control Panel
NOTE: The control panel is the scan arm control panel and the computer
monitor.
The position switches, status lights, and emergency stop button are on the control
panel (figure 1-2).
DPX-IQ
EMERGENCY
STOP POWER X-RAY SHUTTER LASER Left Right
Back
Front
Figure 1-2. Scan arm control panel
• Position switches: The position switches move the scan arm and laser light to
the scan start position. The Back/Front switch moves the detector across the
width of the scan table. The Left/Right switch moves the scan arm down the
length of the scan table.
• Emergency Stop button: Use the red Emergency Stop button to stop the
scanner for emergencies.
• Status lights: The table below gives a description of the status lights.
Light Status (on)

Green (power) Power is supplied to the scan table.
Amber (x-ray) X-ray tube assembly is supplying x-rays.
Amber (shutter) Shutter is open.
Yellow (laser) Laser is on.
1-2 System Overview DPX-IQ Operator’s Manual

1.2 System Safety
Adhere to the safety precautions in this section and obey the basic safety guidelines
that follow at all times:
• Do not attempt to service the DPX-IQ scanner. Please call LUNAR Customer
Support or your LUNAR Distributor.
• When the scan table is not in use, make sure the Shutter Open light is off.
• Do not put excessive pressure on the scan arm.
• Use the scan table for image acquisition only; do not sit or lie on the scan table
for other purposes.
• Do not let liquids touch the computer or scan table mechanics and electronics.
1.2.1 Operator Safety

Personnel Monitors
Personnel monitors are not necessary to operate the laser.
It is not likely that you can receive more than 25% of the maximum permissible
x-ray dose from the DPX-IQ scanner. However, some facilities choose to use
personnel monitors. Refer to your city, county or state Health Department or
Radiation Safety Officer for your facility’s policy.
Film badges and thermal luminescent dosimeter (TLD) badges to monitor personnel
are obtained from a supplier accredited by the National Voluntary Laboratory
Accreditation Program for personnel dosimetry processing.
X-ray Shutter
When power to the scan table is interrupted during an image acquisition or Quality
Assurance procedure, the shutter closes and the x-ray tube stops supplying
x-radiation.
X-ray Power Supply

The x-ray tube assembly uses high voltage to supply x-rays. DO NOT touch internal
components when the scan table is on. DO NOT attempt to service
internal components.

1.2.2 Patient Safety
Pinch Points
Warning labels identify the location of pinch points (figure 1-3). When the scan arm is
in motion, make sure pinch points are clear at all times. Patient limbs must remain
inside the boundaries of the table top:
➊ A pinch point is made between the scan arm and the scan table.
➋ At the end of a Lateral Spine acquisition, a pinch point can be made between the
patient’s legs and scan arm.
➌ The scan arm makes a pinch point on both ends of the scan table.
!
➊ ! !
! !
Figure 1-3. Pinch points
Laser Safety
DO NOT STARE INTO THE LASER BEAM during image acquisition and Quality
Assurance procedures. The label that follows is located on the scan arm and shows the
location of the laser aperture.
Laser Aperture
p/n 3651
Rev.A
Laser Aperture

Radiation Safety
There are three types of radiation exposure: exposure to X-ray beam radiation,
scattered radiation, and leakage radiation.
• X-ray Radiation Exposure: Only the patient receives direct exposure to the X-
ray beam. Refer to table 1-1. The system makes radiation when electric voltage
is supplied to, and current flows through, the x-ray tube. During a scan, the
shutter opens to let a narrow beam of radiation pass through the scan table and
patient. The size of the radiation field at the table top is less than 4.0 mm in
diameter.
• Scattered Radiation Exposure: The primary source of radiation exposure to

the operator is scattered radiation. The isodose diagrams in section 1.2.9 show
typical radiation patterns caused by x-rays scattered from a patient’s body.
Operator exposure at one meter from the x-ray tube is less than 1 µGy/hr. The
average annual per capita background exposure in the U.S. is 1,400–3,000 µGy.
Currently, most areas require sufficient shielding to reduce exposure to the
general population to less than 5,000 µGy/year. Several areas have recently
adopted a more conservative limit of 1,000 µGy/year. The typical radiation
exposure from an AP chest film is 300 µGy. Use these values to compare the
relative risk of the bone densitometer.
The estimated yearly scattered radiation dose for the operator is approximately
<166.67 µGy per year. This assumes an estimated 10 patients per day, 2 scans
per patient, and average time of 2 minutes per scan, and 50 weeks per year, with
the operator 1 meter or more from the table. 166.67 µGy is approximately ½ the
typical exposure from an AP chest film.
• Leakage Radiation Exposure: Lead oxide shielding surrounds the x-ray tube
insert inside the tube housing assembly and reduces radiation levels around the
scan table. The leakage radiation from the x-ray tube assembly is low.
Table 1-1 shows DPX-IQ scan modes and related kV and current settings. In addition,
typical scan areas, irradiation times, and current time product are given. Only typical
values are given for these parameters because the use of automatic scan (DPX-IQ
SmartScan™) width values vary between patients to make sure minimum patient
exposure occurs. The skin entrance exposure is given for each scan mode.
NOTE: The typical scan times shown in the Mode window can be different
than those shown in table 1-1 because of different Scan Width and
Scan Length settings.
Table1-1: Current, kV, and exposure information for DPX-IQ scan modes.
Typical Scan Typical Typical Current Skin

Current Sample
Scan Mode1 kV Area Irradiation Time Product Entrance
(mA)2 Size
(cm x cm)4 Times (sec)3,4 (mAs) Exposure
µGy)
(µ
AP Spine Hi Res Fast 76 3.00 12 x 15 110 330 24 0.6 x1.2
AP Spine Hi Res Medium 76 3.00 12 x 15 210 630 48 0.6 x 1.2
AP Spine Hi Res Medium 76 0.75 12 x 15 210 158 12 0.6 x 1.2

Table1-1: Current, kV, and exposure information for DPX-IQ scan modes. (continued)
Typical Scan Typical Typical Current Skin

Current Sample
Scan Mode1 kV Area Irradiation Time Product Entrance
(mA)2 Size
(cm x cm)4 Times (sec)3,4 (mAs) Exposure
µGy)
(µ
Femur Hi-Res Fast 76 3.00 12 x 14 130 390 24 0.6 x 1.2
Femur Hi-Res Fast Medium 76 3.00 12 x 14 220 660 48 0.6 x 1.2
Femur Hi-Res Fast Medium 76 0.75 12 x 14 220 165 12 0.6 x 1.2
Lateral Spine Medium 76 3.00 12 x 12 270 810 77 1.2 x 1.2
Total Body Screening 76 0.15 54 x 150 290 44 0.1 4.8 x 19.2

Total Body Fast 76 0.15 54 x 150 580 87 0.2 4.8 x 9.6
Total Body Medium 76 0.15 54 x 150 1160 174 0.3 4.8 x 9.6
Hand Detail 76 0.15 3.8 x 4.3 450 68 1.2 1.2 x 1.4

Forearm Medium Total 76 0.15 8 x 11.5 440 66 2.4 0.6 x 0.6
Forearm Medium Shaft 76 0.15 8x2 80 12 2.4 0.6 x 0.6
Forearm Medium Distal 76 0.15 8 x 4.9 190 29 2.4 0.6 x 0.6
Ortho Hip Fast 76 3.00 10 x 20 260 780 48 0.6 x 1.2

Ortho Hip Fast 76 3.00 10 x 10 260 780 96 0.6 x 0.6
Ortho Hip Medium 76 3.00 10 x 20 490 1470 96 0.6 x 1.2
Ortho Hip Medium 76 3.00 10 x 10 480 1440 192 0.6 x 0.6
Ortho Hip Slow 76 0.75 10 x 20 940 705 48 0.6 x 1.2
Ortho Hip Slow 76 0.75 10 x 10 930 698 96 0.6 x 0.6
1
All modes are 76kV, ±3kV.
2
All mA ±48µA, all modes.
3
Imaging time measured from shutter open to shutter close, 90 to 100% of indicated value.
4
Size of scan area and irradiation time will vary with actual area scanned due to the automatic scan width feature.
1.2.3 Symbols
The symbols that follow are located on the scanner and give important
safety information.
Attention: shows the Operator’s Manual contains important safety

information such as the location of pinch point.
Emergency Stop Button: shows the location of the

emergency stop button.

Power On: shows the location of the Power On light.
Laser On: shows the location of the Laser On light. It is found only on
systems delivered internationally.
Shutter Closed: appears on the screen before acquisition while the

X-ray shutter is closed; at the same time, the Shutter open light on the
scan arm control panel is off. When this symbol appears with a green
background, the scanner is ready to begin the acquisition. A gray
background indicates that the shutter is closed and fully disabled and the
shutter will not be opened with the next keystroke.
Shutter Open: shows the location of the Shutter Open light on the scan
arm control panel. When this light is on, the X-ray shutter is open, and
this symbol also appears on the screen with a yellow background. The
shutter is open whenever the scanner is performing a quality control or
patient measurement.
X-ray Off/X-ray Source: appears on the screen while X-rays are off and
not being generated; at the same time, the X-ray On light on the scan arm
control panel is off. When this symbol appears with a green background,
the scanner is ready to begin making X-rays. A gray background
indicates that the source is fully disabled and X-rays will not be started
with the next keystroke. This symbol is also on the Tube Head Assembly
label with X-ray source information; refer to section 1.2.4.
X-ray On: shows the location of the X-ray On light on the scan arm
control panel. When this light is on, this symbol also appears with a
yellow background on the screen, indicating that the scanner is making
X-rays. During normal operation, the scanner will begin making X-rays
for a short period of time before the shutter is open and measurements
begin.
Type B Equipment: shows that the scanner has Type B protection

against electrical shock.
C A U T I O N Laser Caution: shows that the scanner uses a Class II laser. It

LASER RADIATION
DO NOT STARE INTO BEAM
is found on systems delivered in the United States.
POWER OUTPUT: 1.00mW MAX.
WAVELENGTH: 670nm
CLASS II LASER PRODUCT
This equipment complies with
21 CFR 1040.10 and 1040.11.

1.2.4 Labels
Corp. Madison, WI USA
Tube Head Assembly Label: This label gives tube head
DPX-series X-Ray Tube Housing Assembly
assembly and x-ray source characteristics information. It
Tube Housing Assembly Insert
MANUFACTURER: is located on the tube head assembly and the foot panel of
MODEL:
S/N:
the scanner.
MANUFACTURED
NOMINAL VOLTAGE: 76 kV
3.2mm Al/70kV .5mm

76 kV
A definition of each symbol on this label follows:
IEC 522/1976 .5mm
For USA: Complies with Radiation Performance
Standards in 21 USCFR Subchapter J p/n 5531 Rev. D
Inherent Filtration
Tube Insert
X-ray Source
Focal Point
Corp.
System Label: This label gives
313 West Beltline Hwy.
Madison, WI 53713 USA
100V~ 115V~
50-60 Hz
10A
system input power requirements and compliance
MDL
SN
230V~ 240V~ information. It is located on the foot panel of scanners.
50-60 Hz
p/n 7260 Rev. A
7.5A
The CE mark shows compliance with the Medical
Device Directive
!
Made in U.S.A. Patent Pending 93/42/EEC.
R
High Voltage Power Supply: This label gives high
Corp. Madison, WI USA
DPX series High Voltage Power Supply voltage power supply (x-ray generator) information. It
TYPE:
is located on the positive and negative power supplies
p/n 5532 Rev. B
MODEL:
and the foot panel of the scanner.
MANUFACTURER:
S/N:
MANUFACTURED:
For USA: Complies with Radiation Performance
Standards in 21 USCFR Subchapter J
LUNAR Corp. - Madison, WI USA

X-ray Controller: This label shows x-ray controller
DPX Series / EXPERT
X-Ray Controller
compliance. It is located on the system computer if
MODEL: XRC1 LUNAR shipped a computer with the scanner.
P/N 3204 Rev. D
S/N:
MANUFACTURED:
LUNAR P/N:
Complies with Radiation Performance
Standards in 21 USCFR Subchapter J
R Collimator Assembly: This label gives collimator

Corp.Madison, WI USA
DPX series For USA: assembly information. It is located on the collimator
p/n 5533, Rev. B
Collimator Assembly Complies with

MODEL S/N
Radiation and foot panel of the scanner.
Performance
Standards in 21
USCFR
MANUFACTURED Subchapter J

For USA Requirements: Warning Label and Radiation Symbol: The
WARNING: Warning label and Radiation symbol show that the
system uses ionizing radiation. Always obey
This X-Ray unit may be dangerous
p/n 5535 Rev. B

to patient and operator unless
instructions for safe operation.
safe exposure factors and
operating instructions are Radiation Symbol
observed.
1.2.5 Emergency Stop Button and Failsafe Circuit

If the hardware malfunctions, the scanner has two safety features for operator and
patient safety: an Emergency Stop button and a Failsafe Circuit.
Emergency Stop Button

NOTE: When the Emergency Stop Button is pushed during a scan, acquired
information is not saved to the database. You must scan the
patient again.
Push the Emergency Stop Button ONLY when the laser or motors must be stopped
immediately or if the kV and mA to the tube head must be turned off. When the
emergency stop button is pushed, power to the scan table motors, x-ray tube head,
shutter, and laser is turned off. You cannot start a scan or calibration until you reset the
button.
1. Push the Emergency Stop button. The program stops power to the scan table motors
and x-ray tube.
2. Push the Emergency stop button again to reset the system.
3. Select !. The system turns off the x-ray and the scan arm moves to the HOME
position. The Options screen is shown.
NOTE: If there is a hardware problem, DO NOT try to scan a patient. Call

the LUNAR Customer Support Department or your LUNAR
distributor.
Failsafe Circuit
During a diagnostic failure, the Failsafe Circuit stops power to the scan motors and
closes the x-ray shutter. A diagnostic failure number shows on the computer monitor:
record the failure number and select !. Call the LUNAR Customer Support
Department or your LUNAR distributor and give the failure number.
1.2.6 Registration
Government health departments can require medical facilities to register diagnostic
x-ray equipment. Many municipal and state health agencies require medical health
facilities to employ certified radiologic technologists to operate diagnostic x-ray
devices. Contact the Department of Health office in your city, state, or country for
registration guidelines and regulation compliance.

1.2.7 Facilities
Install a “Caution X-Radiation” sign in the area or room where the system is
operated. Because of low leakage levels of radiation from the x-ray tube assembly,
additional shielding in the walls, floor, or ceiling is not necessary. However, call your
state or local health and radiation safety departments for shielding requirements.
1.2.8 Electrical Safety

IEC 950 Certification: To maintain electrical safety, all computer equipment and
accessories connected to the scanner must comply with IEC 950, “Safety of
information technology equipment, including electrical business equipment,” and
must conform with IEC 801-5, “EMC Surge Immunity Requirements.” The computer
and accessories must have “CE” labels.
All peripheral devices, such as the printer and optical disk drives, must also comply
with these standards.
1.2.9 Scattered Radiation

Figures 1-4 and 1-5 show isodose diagrams for DPX-IQ scanners. Measurements at
the surface of the scan table side panels were at background (<1 µGy/hr). The
measurements were taken with a Victoreen 470A. The beam was attenuated through a
20.32 cm water phantom.

68.6 cm
Detector
50.8 cm
1 Gy/hr
38 cm
1 Gy/hr
Gy/hr
Gy/hr
17.8 cm
Water
Tube Head
Foot-end View
91.4 cm 30 cm 0 cm 30 cm 91.4 cm
50.8 cm 25.4 cm 30.5 cm 50.8 cm
68.6 cm
Gy/hr
50.8 cm
R
DPX-IQ
EMERGENCY
POWER ON X-RAY SHUTTER LASER Left Right
Back
Front
38 cm
Gy/hr Detector
Gy/hr 17.8 cm
Gy/hr
Water
DPX-IQ
R
Tube Head
129.9 cm 48.3 cm 0 cm 50.8 cm 111.8 cm
91.4 cm 25.4 cm 35.6 cm 91.4 cm

Front View
Legend
DPX-IQ scanner was run at 76 kV and 0.75 mA.
Figure 1-4. Isodose diagram of the 240-cm DPX-IQ scanner

68.6 cm
Detector
50.8 cm
1 Gy/hr
1 Gy/hr 38 cm
Gy/hr
Gy/hr
17.8 cm
Water
Tube Head
Foot-end View
91.4 cm 30 cm 0 cm 30 cm 91.4 cm
50.8 cm 25.4 cm 30.5 cm 50.8 cm
68.6 cm
1 Gy/hr 50.8 cm
R
DPX-IQ
EMERGENCY
POWER ON X-RAY SHUTTER LASER Left Right
Back
Front
38 cm
Gy/hr Detector
1 Gy/hr
17.8 cm
Gy/hr
Water
DPX-IQ
R
Tube Head
129.9 cm 48.3 cm 0 cm 50.8 cm 111.8 cm
91.4 cm 25.4 cm 35.6 cm 91.4 cm

Front View
Legend
Figure 1-5. Isodose diagram of the 180-cm DPX-IQ scanner

1.3 System Maintenance
1.3.1 Clean the Scan Table Environment

Vacuum and dust the system site weekly. Dust the surface of the system regularly and
use nonabrasive cleaners to remove dirt. Do not let liquids inside the scan table.
NOTE: DO NOT connect a vacuum cleaner to the same electrical outlet as

the scan table. The vacuum cleaner can cause power surges that
affect scan table electronics.
1.3.2 Archive Scan Files

At the end of each day, archive new scan files from your computer hard drive (in the
N:\ directory) to archive media. This procedure makes free space on your hard drive.
Refer to section 2.6 for more information.
1.3.3 Test the Emergency Stop Button

Test the Emergency Stop button once a month. Refer to the procedure that follows:
1. Start a standard aluminum spine phantom scan (refer to chapter 3).
2. When at least 5 lines have been scanned, push the emergency stop button. Make sure
the X-ray and Shutter lights are off, and the message that follows shows on the
computer monitor:
Diagnostic Failure #29-1
Emergency Stop Button

or Interlock Activated
Please correct the error

condition before continuing.
3. Push the emergency stop button again to reset the system.
4. Select"! to continue. The program resets the system. If the emergency stop
procedure does not work, call the LUNAR Customer Support Department or your
LUNAR distributor.

1.4 Preventive Maintenance
1.4.1 X-ray Tube and Laser Assemblies

There are NO USER-SERVICABLE COMPONENTS inside the x-ray tube head
and laser assemblies. DO NOT attempt on-site servicing. Call the LUNAR Customer
Support Department or your LUNAR distributor immediately if the system
malfunctions.
DO NOT attempt to maintain or repair the components and scan table. Doing so voids
all current warranty and service contracts.
1.4.2 Daily Quality Assurance Procedure

Complete system Quality Assurance procedures daily. Make sure each QA
procedure passes.
If your system does not pass a test, complete the Quality Assurance procedure again.
If the procedure fails a second time, call the LUNAR Customer Support Department
or your LUNAR distributor.
1.4.3 Weekly Quality Assurance Test

LUNAR recommends you use the spine phantom to complete a Quality Assurance
test once a week. Refer to chapter 3 for more information.

2 Basic Procedures
Chapter 2 Contents
2.1 The DPX-IQ Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2.2 Start the DPX-IQ Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
2.3 Basic Acquisition Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
2.4 Basic Analysis Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
2.5 Patient Trending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
2.6 Archive Scan Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Revised 1/99C
Chapter 2:Basic Procedures
2.1 The DPX-IQ Interface

Like most computer-based systems, the DPX-IQ uses a computer monitor and
keyboard to interface with the program. During the program, the computer monitor
shows options that let you operate the program. To operate the program, use the
keyboard to select an option—in this manual, the term “select” is the act of pressing a
key to operate the program.
2.1.1 Options Screen

When you start the LUNAR program, an options screen is shown (figure 2-1). The
options that follow are shown for each scan type (AP Spine, Femur, Total Body, and
so on). Select one of these options:
# Scan Patient to scan a patient.
$ Analyze Scan to analyze a patient scan file.
% System Quality Assurance to complete a system quality assurance test.

Refer to chapter 3.
& Database Utilities to access database options; for example, to archive

patient files and change the default database directory. Refer to section 2.6.
' Change Default Settings to customize the software: for example; the report
heading, miscellaneous defaults, and the printout display. Refer to chapter 4.
DPX-IQ Operator’s Manual Basic Procedures 2-1

( Select Scan Type to access the necessary scan type to acquire or analyze.
) Print Manager to access the print manager program. Refer to chapter 4.
* Select Language to change the language shown on the screen and the
printed reports.
+ Select Reference Population to access the reference databases necessary to

compare BMD results.
, Exit to leave the LUNAR program and go back to the Windows desktop.
Figure 2-1. Options screen
2.1.2 Common Keys

The common keys that follow are shown on many screens during the
DPX-IQ program:
• Use the arrow keys (-.) to highlight an option. The arrow keys let you move
up and down lists shown on the screen.
• Use the escape key (!) to move to the next screen. During analysis, use ! to
save changes.
2-2 Basic Procedures DPX-IQ Operator’s Manual

• Use the home key (/) to go back to the previous screen. Changes made
during analysis are not saved if you select this key. However, changes made in
the Verify Values window during acquisition are saved.
• Use the page up and page down keys to select specified options shown during
the program.
2.2 Start the DPX-IQ Program

1. Turn on the scanner for one hour. LUNAR recommends you leave the scanner on at
all times.
2. Turn on the printer, computer, and monitor.
3. At the Windows Desktop, double click on the LUNAR icon. The Options screen is
shown.
2.3 Basic Acquisition Procedures

Information given in this section is applicable to all scan types. Refer to appendixes A
thru G for specified acquisition procedures.
2.3.1 Patient Considerations

Obey the patient considerations that follow before you start a patient scan:
• Clothing Restrictions: Make sure the patient removes items that can attenuate
the x-ray beam, such as clothing with zippers, snaps, buckles, and buttons.
Require patients to wear a jogging suit to the exam or give them an examination
gown when they arrive.
• Radionuclides and Radiopaque Agents: Make sure the patient has not
ingested or been injected with radionuclides or radiopaque agents in the past 3–5
days. If the patient has taken tests that use such agents, postpone the scan until
all traces of the element have left the patient’s body. A 72-hour waiting period is
usually long enough for most agents to leave the patient’s body. However,
consult your radiation safety officer (RSO).
• Pregnancy Restrictions: If it is necessary to scan a pregnant patient, the fetus

can be exposed to small amounts of radiation. Postpone the scan until the end of
pregnancy if clinical management is not affected.
The decision to subject a fetus to radiation exposure must be made by the

referring physician, noting that 1) bone quality for most patients does not
significantly change during pregnancy, and 2) in the advanced stages of
pregnancy, the fetus’ mineralized bone can interfere with measurements of the
mother’s spine and femur.

2.3.2 Basic Steps for Image Acquisition
Five basic steps are required to complete a scan image acquisition. These steps are
briefly given in this section. Refer to appendixes A thru G for more information.
Step 1: Select Scan Type

At the Options screen, select ( and highlight the necessary scan type. Select !.
Step 2: Add a Patient or Select a Patient

At the Options screen, select #. The Patient Directory Screen is shown. Complete
one of the procedures that follow:
• Add a Patient—If the patient was not scanned before, you must record
mandatory patient information.
• Select a Patient—If the patient was scanned before, select the patient at the
Patient Directory screen.
NOTE: Refer to section 2.3.3 to add or select a patient.
Step 3: Position the Patient

The patient must be in the correct position before you start the scan. Each scan type
has a specified patient position.
Step 4: Locate Scan Start Position

You must use the laser light to locate the scan start position for the detector. A correct
scan start position makes sure the program accurately scans the region of interest.
There is a specified scan start position for each scan type. When X-ray beams are on,
the X-ray on symbol appears on the screen; refer to section 1.2.3.
NOTE: It is not necessary to locate a scan start position for total body
image acquisition.
Step 5: Scan the Patient

After you position the patient and laser light, start the scan. A shutter below the scan
table opens to let the x-ray beams scan the image. During the scan, the scan arm
moves until the scan region is acquired by the program. After the scan, the shutter
closes and x-rays turn off. Make sure the patient does not move during
scan acquisition.
NOTE: If you notice problems in the display image during acquisition,

complete the scan and analyze the image. (Refer to section 2.4.) The
problems should be corrected in the analysis. If not, perform another
scan. If this happens repeatedly, contact LUNAR Customer Support.

2.3.3 Add Patient or Select Patient
1. At the Options screen, select #. The Patient Directory screen is shown.
2. Was the patient scanned before?
• If yes, use the arrow keys to select the patient. Select !. The Mandatory
Information screen is shown. Make sure patient information is correct. (Refer to
section 2.3.4 to update mandatory information.) Continue with step 7.
• If no, select &. An empty Mandatory Information screen is shown. Continue

with step 3.
3. Record patient name, middle initial (optional), and last name. Select 0 after
each field.
NOTE: If necessary, you can delete a patient name from the Patient
Directory. Exit the program before you start the scan and select
/ until the Options screen is shown. Then select"& and use the
Delete Patient option.
4. Record the patient’s birth date, height, and weight (up to 300 lbs. or 136.4 kg). Select
0 after each record.
NOTE: To record patient height, use whole numbers and make sure
decimals greater than 0.5 are rounded to the next highest number.
5. Select ! or " to record patient gender. Select 0.
6. Select the number that relates to the patient’s ethnicity. Select 0.
7. Select !. The Acquisition screen is shown.
Optional Information
Disease and fracture codes can be recorded as optional information. In addition, select
# from the Mandatory Information screen to record other optional information.
Optional information is not necessary to complete an image acquisition.
2.3.4 Update Mandatory Information

Use the Scan Patient program to update mandatory information for the current patient
scan file and database information for future scans.
1. At the Options screen, select #. The Patient Directory screen is shown.
2. Select the patient name. Select"!. The Mandatory Information screen is shown.
3. Move the cursor to the necessary field.
4. Record the new information. Select 0 to move the cursor to the next field.
5. Select ! to save changes.

2.3.5 Stop a Scan Image Acquisition
At the Acquisition screen, select #"to stop a scan. After the scan stops, you can start
a new scan, end the scan, or continue the scan.
Start a New Scan

1. Select # to stop the scan. Select # to end the scan.
2. Select $ two times. Locate the scan start position again or change the scan setup:
• Locate scan start—select #. The detector and scan arm move to the initial
start position. Select ! to start the scan again.
• Change scan setup—select $. A message shows that the system is shutting

down the x-ray.
WARNING: Do not allow the scan arm to make a pinch point between the table
and the patient’s legs. Make sure positioners are removed before
you continue.
3. Select !. The scan arm and detector move to the HOME position. The Acquisition
screen is shown. Change the scan values and select ! to start the scan.
4. Continue the acquisition procedure.
End the Scan

To end a scan, select #, then select # two times. During a femur scan, make sure
25 lines are acquired past the top of the greater trochanter before you end the scan.
Continue the Scan

If changes to the scan start position or values are not necessary, select # then $ to
continue the scan. The scan continues from the point it was stopped.
2.4 Basic Analysis Procedures

The term “analysis”, as used in this manual, refers to the procedures necessary to
make sure the program gives reproducible results. AT ALL TIMES, let the program
perform the analysis unless the scan image obviously must be changed. Refer to
appendixes A thru G for specified analysis procedures.
Select the applicable scan type before you start a scan analysis:
1. At the Options screen, select (.
2. Use the arrow keys to highlight the necessary scan type. Select !.
3. The Options screen for the scan type is shown.

2.4.1 Select Patient Scan File
1. At the Options screen, select $. The Patient Directory screen is shown.
2. Select the patient name. Select !.
3. Select the patient scan for analysis. Select !. The Mandatory Information screen
is shown.
4. Make sure the mandatory information is correct. If necessary, refer to section 2.3.4 to
update the information.
5. Select !. The Bone Results screen shows the scan image.
6. Continue the analysis procedure as specified in appendixes A thru G.
2.4.2 Adjust the Scan Image

Use the program to get the best image quality possible. Placement of ROIs around
bone edges is easier if the image quality is good.
At the Bone Results screen, select # to access the Image Values screen. The Image
Values screen shows the options that follow. After you select an option, select & to
change the image.
Type
The options for Type are Bone and Soft. Bone shows a skeletal image and Soft shows
a soft tissue image. Soft is an option for the Total Body scan type only.
Filtering
Filtering smoothes grey scale image values so bone edges and intervertebral spaces
are easy to see. The default setting for filtering is Smoothed.
NOTE: The Enhanced filtering option is given for Hi-Res scan modes only.
Interpolation
Interpolation smoothes the grey scale pixel values for a scan image. Interpolation
makes a difference in image quality when the scaling factor is greater than 100%. The
default setting for all scan types is On.
Scaling Factor
Scaling Factor lets you enlarge or reduce the size of a scan image. The default setting
is 100%.
Centering
Centering lets you enlarge and center part of the scan image in the scan window. In
addition, you can reduce the image.
1. Make sure Centering is highlighted on the screen.
2. Select 1. Use the arrow keys to move the center of the grid to the area of the scan
image to be centered.

NOTE: The image is automatically centered if Scaling is 100% or less.
3. To enlarge or reduce an image, complete the steps that follow:
• Use the Page Up key to enlarge the scan image. If necessary, select & to
enlarge the image to fit inside the scan image window.
• Use the Page Down key to reduce the scan image. If necessary, select & to
reduce the image to fit inside the scan image window.
Grey Scale
Grey scale lets you change the scan image shown on the screen and on the results
printout. Dense areas of the scan are shown as white (cortical bone) and the less dense
areas are shown as black (soft tissue). All points between black and white are shown
as grey.
NOTE: Light blue regions indicate an artifact (a very dense, non-bone

region). Belt buckles, buttons, and zippers can cause blue regions to
appear on the scan image.
2.4.3 Analyze the Scan Image

In most cases, the software will accurately analyze the scan image. However, unusual
anatomy or incorrect patient positioning may require you to complete manual
adjustments to the scan image, such as ROI or edgemarker positions. Refer to the
applicable appendix for the scan type (A thru G) for procedures to analyze and, if
necessary, adjust the scan image.
2.4.4 Print Analysis Results

You can select the number of Analysis Results and Ancillary reports printouts at the
Print Options screen. The number of printouts you select is used as the default until
the number is changed.
1. From the Analysis Results screen, select $. The Print Options menu is shown.
2. Record the number of reports necessary in the Results and Ancillary Printouts field.
3. Select ! to print the reports.
Examine Analysis Results

The Analysis Results reports give important information necessary to examine the
results of the scan image analysis. The use of this information is left to the discretion
of the user. A definition of common terms shown on the report follows:
• BMD (Bone Mineral Density)—The BMD value gives a measurement of bone

mineral found in the region of interest. BMD is measured in grams per
centimeter squared (g/cm2).
• BMC (Bone Mineral Content)—The BMC value gives a measurement of bone

mineral found in the region of interest. BMC is measured in grams (g).

• Area—This value identifies the area of the scan region measured in cm2.
• % Young-Adult—This value compares a patient’s BMD with the expected

peak bone mass for a subject of approximately 20–40 years old.
• T-Score (T)—This value is the difference between the patient’s BMD and the
mean young adult value of the reference population, divided by the reference
standard deviation (SD). A T-score of -2 means the patient is 2 SDs below the
mean young adult value of the reference population.
• % Age-Matched—This value compares the patient’s BMD with the expected

values of a reference group of the same age and sex.
• Z-Score (Z)—This value is the difference between the patient’s BMD and the
mean age-matched value of the reference population, divided by the reference
standard deviation (SD). A Z-score of -2 means the patient is 2 SDs below the
mean age-matched value of the reference population.
Print a DICOM Report (optional)

If you have purchased the DICOM software option, complete the procedure that
follows to print a DICOM report:
1. Analyze the scan image as specified in appendixes A thru G.
2. At the Analysis Results screen, select ALT-T. A DICOM report for the scan image is
sent to the REPORT subdirectory.
Refer to the DICOM Operator’s Manual for instructions to access and print the
DICOM report.
2.5 Patient Trending

The Chronological Results screen lets you show, graph, and print results of patient
scans over time in chronological order.
1. At the Options screen, select &. The Database Utilities screen is shown.
2. Select #. The Patient Directory screen is shown.
3. Use the arrow keys to highlight the necessary patient scan files.
4. Select !. The Chronological Results screen shows a list of results for all of the
patient's scans.

2.5.1 Chronological Results Screen Options
The options that follow are shown on the Chronological Results screen.
# Regional Results—select to show results for all regions of the scan you
select on the Chronological Results screen.
$ Change Region—select to show the necessary scan regions on the

Chronological Results screen.
% Change Headings—select to show BMD values and %YN, %AM, and

Reference Pop or to show BMC, Area, and BMD values.
& Graph—select to graph the results of one scan type for one patient.
' Print—select to print the Chronological Results screen for one patient.
2.5.2 Graph and Print Patient Results

1. At the Chronological Results screen, select the necessary scan type. (For example, to
graph the chronological results of a patient’s AP spine scans, highlight one of the AP
spine scans listed.)
2. Make sure the displayed regions and headings are correct.
3. Press &. The Choose Y Axis menu is shown.
4. Select the type of axis and select !. The graph is shown (figure 2-2).
5. The squares on the graph relate to results shown on the left side of the screen. The
highlighted square relates to scan values highlighted in the list. To highlight a
different scan press % and use the arrow keys.
6. Select ' to print the graph.
Figure 2-2. Patient results graph

2.6 Archive Scan Files
When you archive scan files, the Archive program 1) copies the scan files from the
active database directory (such as N:\DB_DATA) to the archive disk, and 2) removes
the scan files from the active database directory. The archive process DOES NOT
remove PATIENT DATABASE records (biographical information and scan
summaries) from the active database directory.
2.6.1 Procedure to Archive Patient Scan Files

Complete the procedure that follows to archive patient scan files to the applicable
archive disk: Jaz*, Zip*, or floppy disk. The default directory for the archive files is
set during system installation.
*Jaz and Zip are trademarks of Iomega Corporation.
NOTE: Use the IQNW computer to archive files if you have an

IQNET system.
1. At the Options screen, select &. The Database Utilities screen is shown.
2. Select %. The Patient Directory screen shows scan files related to patient name.
3. Select one of the options that follow:
• To archive ONE patient file, locate and highlight the patient’s name and
select '.
• To archive ALL patient files, select (.
4. Have you archived files before?
• If yes, insert the archive disk, as shown on the screen, in the applicable drive.
• If no, or if the current archive disk is full, write the volume label as shown on the
screen (for example, 6001LRC0001) on an empty, FORMATTED disk. Insert
the disk in the applicable drive.
5. Select ! to archive the file(s). The Patient Directory screen is shown after the files
are archived. The names of archived patients are shown in green.
6. Is it necessary to archive more scan files?
• If yes, return to step 3.
• If no, select / to go back to the Database Utilities screen.
7. Store the archive disk in a safe place to prevent damage or loss of scan data.

Change Archive Destination and Directory
At the Database Maintenance screen, you can change the drive destination and
directory used to archive patient files.
1. At the Database Utilities screen, select (.
2. Move the cursor to the line that follows:
Archive Drive.: a:\ar_data\
3. Type over the line to record the name of the directory and/or drive destination. Follow
the directory name with a backslash (\ ).

3 Quality Assurance
Chapter 3 Contents
3.1 Quality Assurance Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.2 Spine Phantom Quality Assurance Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
3.3 Monitor Precision Over Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Revised 1/99C
Chapter 3:Quality Assurance
3.1 Quality Assurance Tests

Complete a Quality Assurance (QA) test each morning before you scan a patient. The
procedure lasts 10–15 minutes and makes sure quality scans are acquired. Save all
QA printouts.
If a QA test fails, the message that follows is shown:
Unsuccessful Quality Assurance

Repeat procedure suggested
Complete the QA tests again. If a test fails two times, call the LUNAR Customer
Support Department or your LUNAR distributor. DO NOT try to scan a patient until a
successful QA test is complete.
3.1.1 Complete a QA Test

Use the standard to complete a QA test (the standard is a block of tissue-equivalent
material with three bone-simulating chambers of known bone mineral content).
1. At the Options screen, select %. The System Quality Assurance screen is shown.
2. Remove the pad from the scan table.
3. Position the calibration standard on the table (figure 3-1):
➊ Put the standard inside the rectangle on the scan table.
➋ Position the standard so the brass-colored part of the standard faces upward and
is toward the front of the scan table. DO NOT move the standard after the
test starts.
DPX-IQ Operator’s Manual Quality Assurance 3-1

➊
➋
Figure 3-1. Calibration standard position
4. Select !.
5. Select any key and make sure the Power On, X-ray, and Shutter lights are on. If the
lights are on, select $ to start the QA test.
6. After the test, the program prints the results (figure 3-2). Make sure the printout shows
that all tests pass. Refer to the correct results that follow:
• The detector peak, and the high keV and low keV peaks, are no more than 50
units above or below the previous peak settings.
• Each Functional Measurement has a spillover of less than 9%. A spillover

between 9–10% is marginal, and spillover of more than 10% is failing.
• The Standard Values have CV values of 2.0% or less. Mean values do not change
from the expected value by more than 5%.
If these conditions are not successful, an error message shows on the bottom of
the printout and on the screen.
7. Save the printout.
3-2 Quality Assurance DPX-IQ Operator’s Manual

QUALITY ASSURANCE RESULTS
X-Ray Voltage (kVp) 76.0 Date 01/01/98

X-Ray Current (uA) 150.0 System 0000
DETECTOR
C AMPLIFIER COUNTS COUNTS

O SETTING LOW keV HIGH keV
U
N 265 59862 1882
T 315 66818 1466
S 365 61837 5421
415 49942 22550
465 59495 58717
515 71869 66958
565 66845 59814
615 46454 49888
665 24989 57616
715 11056 78989
AMPLIFIER SETTING 765 4861 68768
PROCEDURE VALUE EVALUATION

--------------------- ---------------- ------------
Lights - Pass
Peak Setting 520 units Pass
Background (Low keV) 2 cps
(High keV) 1 cps Pass
Beam Stop Action - Pass
Percent Spillover 8.33 % Pass-Good
Chi Square 2 Pass
Air Counts (Low keV) 748500 cps Pass
(High keV) 467236 cps Pass
Air Ratio 0.62 Pass
Transverse Mechanics 10948/10949 steps Pass
Longitudinal Mechanics 13378/13378 steps Pass
Tissue Value 1.313 Pass
Collimation Ratio 4.254 Pass
1 2 3 4 5 MEAN SD %CV
------ ------ ----- ------ ------ ----- ------ ------
LARGE BM 276.6 277.0 277.1 277.2 277.3 277.0 0.25 0.09
WIDTH 500 499 499 498 499 499 0.63 0.13
MEDIUM BM 203.3 206.8 206.4 205.2 205.5 206.0 0.58 0.28
WIDTH 434 434 429 429 432 432 2.24 0.52
SMALL BM 147.0 146.9 147.5 146.5 147.6 147.1 0.42 0.28
WIDTH 366 364 363 362 362 363 1.50 0.41
Figure 3-2. Quality Assurance printout
3.1.2 Collimation Ratio Test

If the system fails the Collimation Ratio test, you cannot access the forearm and small
animal acquisition programs. A warning message shows when you try to enter either
program. Call the LUNAR Customer Support Department if your system fails the
collimation ratio test.
NOTE: Scan modes turned off by a Collimation Ratio failure are not shown
in the Mode window during scan acquisition.
3.1.3 Quality Assurance Warning Messages

If you do not complete daily QA tests, a warning message shows on the screen.
No Valid QA Results within the Past 48 Hours

If you start a scan, and did not complete a QA procedure in the last 48 hours, a
warning message is shown. Complete a QA test when this message is shown: 1) select
! to access the Acquisition screen, or select / to go back to the Options screen;
and 2) select % to begin a QA procedure.

No Valid QA Results within the Past 2 Weeks
If you try to start a scan, and did not complete a QA procedure in the last 2 weeks, a
warning message is shown. The program does not let you continue until a QA
procedure is completed. Select ! to go back to the Options screen and select % to
start the QA test.
3.2 Spine Phantom Quality Assurance Test

As part of your weekly quality assurance tests, scan the aluminum spine phantom to
monitor the accuracy and precision of the scanner over time.
The phantom represents the typical density range and size of a normal human spine.
The spine phantom (figure 3-3) consists of vertebrae L1 through L4. Parts of vertebrae
T12 and L5 are landmarks used by the DPX-IQ program during analysis.
T12
L1
L2
L3
L4
LUNAR XXXX
L5
Figure 3-3. Spine phantom
3.2.1 Scan the Spine Phantom

1. At the AP Spine Options screen, select #. The Patient Directory screen is shown.
2. Have you scanned the spine phantom before?
• If yes, highlight “Spine Phantom” at the Patient Directory screen and select !.
The Mandatory Information screen is shown. Continue with step 5.
• If no, select &. A blank Mandatory Information screen is shown. Continue

with step 3.
3. Record the information that follows in the Mandatory Information screen:
• First Name: Spine
• Middle Initial: None
• Last Name: Phantom

• Birth Date: Record the current date minus 40 years. For example, if today's date
is June 15, 1998, type 06/15/1958. DO NOT change this date for future spine
phantom scans.
• Height: 170cm
• Weight: 70kg
• Sex: Male
• Ethnic Group: White
4. Select #. The Optional Information screen is shown. Record the information

that follows:
• Facility ID: Record the phantom number given on the L5 region of the
spine phantom.
• Department ID: Record your system number.
5. Select !. The Spine Acquisition screen is shown. Select #. The Mode Window
is shown.
6. Highlight the Hi Res Medium 750µA scan mode. Select !.
7. Select $. The QA Values screen shows information from the last Quality Assurance
Test.
NOTE: Refer to the QA printout before this scan if you think the values are
not correct. Call LUNAR Customer Support or your Distributor.
8. Select / to go back to the AP Spine Acquisition screen.
9. To scan the encapsulated or water bath spine phantom:
• If encapsulated, place the spine phantom on the scan table. Continue with step
11. (Do not remove the scan pad from the table.)
• If water bath, remove the scan pad from the scan table. Fill the water bath with
15 cm of room temperature water. Secure the lid to the top of the container and
place the water bath on the scan table. Place the spine phantom in the water bath
with the L5 region nearest the foot of the table.
10. Position the spine phantom (figure 3-4) in the center of the scan table (➊) parallel to
the patient compressor strap (➋). Make sure the straps on the encapsulated spine
phantom holder are not in the scan region or remove the lid from the water
bath container.

➋
➊
Figure 3-4. Spine phantom position
11. Position the phantom so T12 is toward the head of the scan table (figure 3-5).
L5 L4 L3 L2 L1 T12
Figure 3-5. Spine phantom
12. Select !. The scan arm and detector move to the HOME position.
13. Select !. The scan arm and detector move to the approximate start position and the
program turns on the laser light.
WARNING: Each Lunar scanner is equipped with a Class C A U T I O N

LASER RADIATION
II Laser that is less than 1 milliwatt in strength. POWER OUTPUT: 1.00 mW MAX
WAVELENGTH: 670 nm
DO NOT STARE INTO THE BEAM. This equipment complies with

21 CFR 1040.10 and 1040.11.
14. Position the laser light (figure 3-6) in the middle of L5 (➊) and in the center of the
phantom(➋). Select ! to start the scan.

➊
LUNAR XXXX
Figure 3-6. Localizer light position
15. Monitor the first few lines to make sure the detector position is correct. The scan starts
in region L5 and moves across the phantom. THE DETECTOR MUST NOT SCAN
AIR DURING THE ACQUISITION.
16. Was the scan completed using the encapsulated or water bath phantom?
• If encapsulated, remove the phantom from the scan table.
• If water bath, secure the lid on the container and remove it from the table. Install
the scan pad on the table.
17. Select ! to go back to the AP Spine Options screen.
3.2.2 Analyze the Spine Phantom

The procedure that follows assumes you are familiar with AP spine scan analysis.
Refer to appendix A for more information.
1. From the AP Spine Options screen, select $. The Patient Directory screen is shown.
Select the Spine Phantom. Select !.
2. Select the phantom scan file for analysis. Select !. The Mandatory Information
screen is shown.
3. Select !. The Bone Results screen is shown.
4. Select $. The Spaces/Labels screen is shown. Make sure the space markers above
L2 and below L4 are 88 scan lines apart.
5. Select ). The Profiles screen is shown. Examine edge markers.
6. Select ! to save changes. The Bone Results screen is shown.
7. Select !. The Analysis Results screen is shown.
8. Select # to save changes.
9. Select $ and record the necessary number of Analysis Results and/or Ancillary
reports. Select ! to print the reports.
10. Review the scan mode. You will find this mode on the Analysis Results report on the
second line below the image. Verify that the scan mode is the same as the one used for
previous scans.

11. Record the BMD value of region L2-L4. This value must be within 3% of the average
BMD value. If the average BMD values repeatedly vary by more than 3%, call the
LUNAR Customer Support Department.
12. Save the analysis printouts.
3.3 Monitor Precision Over Time

The Chronological Results screen lets you show, graph, and print results of spine
phantom scans over time in chronological order.
1. At the AP Spine Options screen, select &. The Database Utilities screen is shown.
2. Select #. The Patient Directory screen is shown.
3. Use the arrow keys to highlight the necessary phantom scan file.
4. Press !. The Chronological Results screen shows a list of results for all of the
phantom scans.
5. Refer to section 2.5 to print and graph your results.

4 Default Settings
Chapter 4 Contents
Default settings are values the LUNAR program automatically uses. You can change
some of the default settings to customize the program. Change default settings to
relate to values you use most often.
Chapter 4 includes the sections that follow:
4.1 Print Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

4.2 General Default Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
4.3 Select Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
4.4 Select Reference Population. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
Revised 1/99C
Chapter 4:Default Settings
4.1 Print Manager

The Print Manager program has a delay option which lets you specify the date and
time you want to print scan analysis or Quality Assurance results.
4.1.1 Print Manager Options

At the Options screen, select ) to access the Print Manager screen. The Print
Manager screen shows the options that follow:
# Print Options—select to turn the Delay option On or Off, set the delayed print
time, set printer types, set the active port, and set image color and quality.
$ Mark Report—select to mark (choose) reports to be printed immediately. A

pound sign (#) is shown next to each report that is marked. Select ! to print
the reports.
% Delete Report—select to delete a report from the Print Manager.
& Mark All—select to print all reports immediately. A pound sign (#) is shown
next to all reports. Select ! to print all of the reports.
DPX-IQ Operator’s Manual Default Settings 4-1

' Delete All—select to delete all reports from the Print Manager screen and the C:\
PRNTMNGR directory. If you delete all files, you must analyze the patient scan files
again to get analysis reports. Deleted reports are not automatically printed.
NOTE: Reports are removed from the Print Manager screen and from C:\
PRNTMNGR when they are printed.
4.1.2 Set the Delayed Print Time

1. At the Print Manager screen, select #. The Print Options menu shows the Delay
field highlighted.
2. Select %&to turn On the Delay option. Select 0.
3. Record the time necessary to start printing (select 0 to move from line to line):
• Record the hour—the program uses a 24-hour format. For example, to start
printing at 7:00 p.m., type “19”. To set a time before 10:00 a.m., type a zero
before the hour number.
• Record the minute—type two numbers for the minute. For example, “08”for
eight minutes.
4. Select the number key which relates to the day of the week necessary to print the
reports. Select 0.
NOTE: If you select ' - Daily, the program prints reports each day at the
selected time.
5. Select !, then / to go back to the Options screen.
6. After a scan analysis, select the number of printouts. The Print Manager program
prints the analysis reports at the selected time and date.
4.1.3 Choose a Printer and Active Port

The Print Options menu lets you select the type of printer the system uses and sets the
active port.
If you have more than one printer, you can connect each printer to its own port. An
Applications Specialist does this during system installation. LUNAR software lets
you use three printer ports. You can set the active port to LPT1 (Port1), LPT2 (Port2),
or LPT3 (Port3). A standard computer has one port: Port2 and Port3 are optional.
If you set the Print Delay option, only scans assigned to the active port are printed at
the delayed print time. To print the other reports, you must change the active port.
1. At the Options screen, select ). The Print Manager screen is shown.
2. Select #. The Print Options menu is shown.
3. Highlight the Port1 Printer.
4-2 Default Settings DPX-IQ Operator’s Manual

4. Select 0. The Printer Type menu is shown. Highlight the necessary printer.
Select !.
5. Do you have more than one printer?
• If yes, highlight Port2 and complete step 4 again. If necessary, complete this step
again for Port3. Continue with step 6.
• If no, continue with step 6.
6. Highlight Active Port. Select the number that relates to the necessary Printer Port.
7. Select !, then / to go back to the Options screen.
4.2 General Default Settings

Select ' at the Options screen to access the Default Settings screen. The Default
Settings screen lets you change the settings that follow: Report Heading,
Miscellaneous defaults, and Printout Display. Each default is given in this section.
4.2.1 Report Heading

The Report Heading is shown on the Default Settings screen after you select '. The
report heading has three lines of information which let you personalize analysis
printouts: a typical heading can show the name of your institution, department or
physician's name, and address of your institution.
NOTE: The Report Heading option is shown as # on the Miscellaneous

and Printout Display screens.
To change the heading, move the cursor to each line and record the necessary
information. Select / then (&to save changes.
4.2.2 Miscellaneous Defaults

1. At the Default Settings screen, select $ to show miscellaneous default options.
Each default is given on the pages that follow.
2. Move the cursor to a default setting. The default's options are shown.
3. Select the number key that relates to the necessary default setting. Select / then
( to save changes.
Patient ID Type
Patient ID Type sets the format used to identify patients. The current ID is shown at
the top of the Bone Results, Verify Values, Profiles, Analysis Results screens, Results
printouts, and Ancillary printouts. The default setting is “Last Name.” Other possible
options are listed on the screen when you highlight Patient ID.

Height/Weight Units
Height/Weight Units sets the measurement used to record the patient’s biographical
information in the Mandatory Information screen. Measurement units are shown on
the Results and Ancillary printouts.
Date Format
Date Format sets the display of dates thru the LUNAR program and on the Results
and Ancillary printouts:
• The dd.mm.yy format shows the date as day.month.year (16.01.91).
• The default setting is mm/dd/yy. This format shows the date as month/day/year
(01/16/91).
Full Name on a Printout

Full Name On Printout lets you show or remove the patient’s full name from the
Results and Ancillary printouts. It is shown below the Patient ID at the top of the
printouts. The default setting for the program is “Yes.”
Report Type
Report Type lets you set the type of report that is printed after scan analysis.
NOTE: Option 4, sBMD, is given only for AP Spine L2–L4, Total Femur, and
Femur Neck analysis.
Display Country Field

Display Country Field lets you show the patient’s country of residence on the
Optional Information screen. The default setting for the program is “No.”
Database Mini-Menus
Database Mini-Menus let you add information to menus on the Mandatory and
Optional Information screens.
1. Select % to show the Disease Mini-Menu, ) to show the Treatment Mini-Menu, or

* to show the Insurance Mini-Menu.
NOTE: You can change fields 8 and 9 on the Disease and Treatment Mini-
Menus and fields 4 thru 9 on the Insurance Mini-Menu. You cannot
change the other codes.
2. Highlight the necessary field. A cursor shows in the field.
3. Record the information and select 0.
4. Select /"to go back to the Miscellaneous Defaults screen.
Display Line Profiles

Set this value to “Yes” to show Line Profiles for AP spine (refer to appendix A) or
forearm (refer to appendix E) scan image analysis.

Show Selected ROI Only
Show Selected ROI Only sets the ROIs shown in the Type IQ Results Printout. If set
to “Yes,” only the ROI you select shows on the first page of the printout. All ROIs
continue to be shown on the Ancillary page printout.
Standardized BMD
Standardized BMD sets the information shown on the Analysis Results screen during
scan analysis. If set to “Yes,” the Standardized BMD shows on the Analysis Results
screen for AP Spine L2–L4, total femur, and femur neck.
Vertebral Height Z-Score

Vertebral Height Z-Score sets the information shown on the Analysis Results screen
during AP Spine analysis only. If set to “Yes,” the Vertebral Height Z-Score shows on
the Analysis Results screen and the Results printouts.
4.2.3 Printout Display Options

1. At the Report Heading screen, select %. The Printout Display screen is shown.
2. Highlight the value to be changed, then select % to turn the option ON or ) to turn
the option OFF. Each option is given in this section.
3. Select /"to exit Default Settings, # to change the Report Heading, or $ to

change Miscellaneous Values.
Young Display
Young Display shows the Reference graph on the printout (➊ in figure 4-3). In
addition, it shows % Young Adult and T-Score below the Reference Graph.
Age Display
Age Display shows the Age-Matched Regression Bar on the Reference Graph (➋ in
figure 4-3). In addition, it shows % Age Matched and Z-Score below the
Reference Graph.
Normals Graph Color Bars

Normals Graph Color Bars shows the color bars on the Reference graph. The color
bars give standard deviations from the mean % Young Adult value.
Normals Graph Type

Normals Graph Type selects one of two types of graphs: Lunar Standard and WHO
Fracture Risk. Lunar Standard, the default setting, is shown in figure 4-1 below.

Figure 4-1. Lunar Standard Graph Display for AP Spine
WHO Fracture Risk is available for AP spine, Femur, and Total Body scan analysis.
Fracture Risk replaces the standard analysis graph with one designed to assess
fracture risk using World Health Organization categories. Refer to figure 4-2 below.
There are three different risk regions on the graph. BMD values in the green region (❶
in figure 4-2) show a “normal” risk. Values in the yellow region (❷ in figure 4-2) are
categorized as “osteopenia,” and values in the red region (❸ in figure 4-2) are
categorized as “osteoporosis.” The footnote on the Results Report explains the T-
scores associated with each category. The T-score represents the patient’s BMD result
above or below a reference “Young Adult” mean; it is given in standard deviation
(SD) units.
There is no specific level of BMD where the risk of fracture increases; instead, there
is a continuous gradient of risk. BMD values should be considered together with other
risk factors in patient evaluation (low body weight, fracture history, corticosteroid
use, use of long-acting tranquilizers, a history of falling). In particular, patients with a
prior history of osteoporotic fracture should be considered to have double the risk of
future fracture at any density level.
❶
❷
❸
Figure 4-2. WHO Fracture Risk Graph Display for AP Spine

Apply Weight Adjustments
Apply Weight Adjustments lets you set body weight into the final Age-Matched
comparison. This option lets the program compare patient BMD with his/her Age-
Matched reference population.
Apply Ethnic Origin Adjustments

Apply Ethnic Origin Adjustments lets you include ethnic origin in the final Age-
Matched comparison. Normal values for Blacks are typically 6% greater than those
for Caucasians. Although Asian values are approximately 7% lower than Caucasian
values (because of smaller body sizes), the values for U.S. women of Asian descent
are similar to Caucasian values.
Age Regression Line

Age Regression Line shows the line in the center of the Age-Matched
Regression Bar.
Bar 1 and Bar 2 Options

The Bar 1 and Bar 2 options (➌ in figure 4-3) show the lines above and below the Age
Regression Line. You can set the bars to show a specified standard deviation from the
Age Regression Line.
1. At the Print Display menu, select Bar 1.
2. Select % to turn Bar 1 on.
3. Highlight Solid/Clear option. Select % for a solid blue bar. Select )&for a clear bar.
4. Highlight the standard deviation option. Record the necessary standard deviation
value for the Age Regression Line. The default standard deviation for Bar 1 is 1.00.

4.6d
❶
❷
❸
Figure 4-3. Analysis Results report

4.3 Select Language
The Select Language option lets you set the language shown on the screen and on
results printouts. Seven languages are given: English, French, German, Japanese,
Spanish, Italian, and Portuguese. English is the default language.
NOTE: These options are available only if you installed the language
options.
1. At the Options screen, select *. The Select Language menu is shown.
2. Highlight the necessary language, and select !1.1 The program shows the language
on the Options screen.
4.4 Select Reference Population

The LUNAR program lets you compare patient bone mineral density (BMD) to a
database of reference information. You can choose from several national databases.
Use of the reference population comparisons is fully at the discretion of the
clinician.
NOTE: These options are available only if you installed the reference
population options.
1. At the Options screen, select +. The Select Reference Group menu appears.
2. Highlight the necessary regional database and select !. The program compares
BMD of the AP spine, lateral spine, femur, total body, and forearm to information
from this population until you select a different one.


A AP Spine
Appendix A Contents
A.1 AP Spine Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
A.2 AP Spine Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
A.3 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6
Revised 1/99C
Appendix A:AP Spine Image Acquisition and Analysis
A.1 AP Spine Image Acquisition

1. Refer to section 2.3.3 to add or select a patient.
2. At the AP Spine Acquisition screen, select # to examine scan values. The Mode
window is shown. Refer to table A-1to make sure the scan mode you select is correct
for scan region thickness. Highlight the applicable mode and select !.
Table A-1: AP spine scan modes.
Entrance
Thickness Imaging Time
Mode Exposure
(cm) (minutes)
µGy)
(µ
Hi Res Fast 3000µΑ 15–22 1 24
Hi Res Medium 3000µΑ 22–30 2 48
3. Examine the other scan values and select / to go back to the AP Spine Acquisition
screen.
4. Select !. The scan arm moves to the HOME position.
5. Help the patient lie on the scan table. Select !. The scan arm and detector move to
the approximate start position and the program turns on the laser light.

LASER RADIATION
WAVELENGTH: 670 nm

21 CFR 1040.10 and 1040.11.
DPX-IQ Operator’s Manual AP Spine A-1

6. Position the patient's legs on the support block until the patient's thighs are at a
60°–90° angle (figure A-1). The support block helps separate vertebrae and straighten
the lower back.
WARNING: If the patient is uncomfortable when positioned, end the scan

procedure. DO NOT complete the scan if the patient is
uncomfortable.
Figure A-1. Patient position
7. Position the laser light (figure A-2) approximately 5 cm below the patient's navel (➊),
and in the same longitudinal plane as the patient’s midline (➋).
➊ ➋
Figure A-2. Laser light position
8. Select ! to start the scan. Monitor the first lines to make sure the detector position
is correct (figure A-3):
• The patient’s spine is in the center of the scan image.
• The top of L5 (➊) is in the scan image.
• The scan shows 5–15 lines of the iliac crest (➋).
If the detector position is not correct, select # to stop the scan. Refer to
section 2.3.5.
A-2 AP Spine DPX-IQ Operator’s Manual

9. Select ! to go back to the AP Spine Options screen.
➋
➊
Figure A-3. AP spine scan image
A.2 AP Spine Analysis

NOTE: In most cases, the software will accurately analyze the scan image.
However, unusual anatomy or incorrect patient positioning may
require you to complete manual adjustments to the scan image, such
as ROI or edgemarker positions.
The procedure that follows gives the basic steps necessary to complete an AP spine
image analysis. Refer to section A.3 for more information.
1. Refer to section 2.4.1 to select a patient scan file for analysis.
2. At the Bone Results screen, make sure the space markers and labels are correct. Are
changes necessary?
• If yes, select $. The Spaces/Labels screen appears. Use the options shown on
the screen to change space markers and label vertebrae.

3. Select ). The Profiles screen is shown. Make sure the position of the baseline and
edge markers are correct. Are changes necessary?
• If yes, use the options shown on the screen to change the baseline and/or
edge markers.
NOTE: Refer to section A.3.3 to analyze Body ROIs.
5. Use the arrow keys to highlight the region to be shown on the Analysis Results screen.
6. Select !. The Analysis Results screen is shown. Refer to figure A-4, which shows
the two possible graphic styles you may see. For AP spine analysis, you can choose to
display a WHO Fracture Risk graph (shown on the right) instead of the Lunar
Standard graph (shown on the left). Refer to section 4.2.3 for an explanation of the
Fracture Risk graph and for more information about changing Printout Display
Options in the General Default Settings.
reports (figures A-5 and A-6). Select ! to print the reports.
Figure A-4. Analysis Results screen

Figure A-5. AP Spine Analysis Report
Figure A-6. AP Spine Ancillary Report

A.3 Analysis Information
During an AP Spine analysis, refer to the information that follows to help you
complete the analysis procedure.
A.3.1 Examine Labels and Intervertebral Space Markers

Examine labels and intervertebral space markers at the Spaces/Labels screen: at the
Bone Results screen, select $.
Examine Labels
The program automatically labels L1 thru L4. In addition, you can label L5, T11, and
T12. The program calculates results for vertebrae labeled L1, L2, L3, or
L4 only.
Make sure the program labeled the necessary vertebrae. To change labels, complete
the procedure that follows:
1. At the Spaces/Labels screen, select %. The Select Labels window is shown.
2. Use the arrow keys to select the necessary label(s). Select ! to save changes.
Examine Intervertebral Space Markers

Make sure the program has correctly positioned intervertebral space markers
(figure A-7): the space markers are between the vertebral bodies (➊) and located at
the lowest point of bone density as shown on the histogram (➋).
To position a space marker, use the arrow keys to select the marker and select $.
Refer to the histogram and use the options shown on the screen to move the marker.
Select ! to save changes.
Figure A-7. Intervertebral Space Marker position

A.3.2 Examine Baseline and Edge Markers
Select ) at the Spaces/Labels screen to examine baseline and edge markers: the
Profiles screen shows the Line Profile.
NOTE: The Line Profile is an optional feature. Refer to chapter 4 to activate

the “Display Line Profile” option.
The Profiles screen shows an image of the spine and a Line Profile (figure A-8). The
Line Profile uses baselines and edge markers to identify soft body tissue and dense
bone. Baselines and edge markers let the program calculate accurate BMD results.
Figure A-8. Spine image and profile
The Line Profile

The Line Profile shows the information that follows (figure A-9):
➊ Baseline: The baseline is the horizontal line at the bottom of the profile. The
points below the baseline identify soft tissue the program does not use to
calculate results.
➋ High Density Points: The high points on the profile identify high density points
(bone) the program uses to calculate results.
➌ Edge Marker: The circles on the left and right side of the analysis region
identify the edge markers. The high density points contained inside the area
between the edge markers and above the baseline are used to calculate results.
➍ Soft Tissue Points: The low points on the profile identify soft tissue the
program does not use to calculate results.

➋
➊
➌
➍
Figure A-9. Line Profile
Examine Baselines
Make sure the baseline is located in the average of soft tissue points for the analysis
region. The program typically positions the baseline correctly: change the baseline
ONLY if you are sure it is not correct.
Figure A-10 illustrates correct baseline position. When you change the baseline, the
program automatically changes the edge markers. Change the baseline first AT ALL
TIMES if it is necessary to change the baseline and edge markers.
To change the baseline, select # to move the baseline up or $ to move the

baseline down.
Figure A-10. Correct baseline position

Examine Edge Markers
Make sure the edge markers are positioned above the baseline to include only high
density points. Do not include soft tissue points in the analysis region.
Figure A-11 shows an edge marker position that is not correct: the left edge marker
includes unwanted soft tissue (➊), and is positioned on the baseline (➋).
NOTE: Calcification, fat deposits, and dense substances can cause

unwanted soft tissue points to be shown on the Line Profile.
➋
Figure A-11. Incorrect Edge marker position
Figure A-12 shows correct edge marker position. The edge marker has been moved so
soft tissue is not included in the analysis region.
To change an edge marker, use the keys % or ) to select an edge marker. Use the
arrow keys to position the edge marker.
Figure A-12. Correct Edge marker position

A.3.3 Complete a Body ROI Analysis
Body ROIs help the program isolate cortical bone in the vertebral endplates from the
analysis results. The program uses the position of intervertebral (IV) space markers
and edge markers to make vertebral body ROIs. As a result, the program changes the
position of body ROIs if you change the baselines, IV markers, or edge markers.
1. At the Spaces/Labels screen, select +. The Body ROIs Analysis screen is shown.
2. A message is shown if you changed baselines and edge markers during the last
analysis. Complete one of the steps that follow:
• Select (&to let the software position the ROIs.
• Select + to not change the ROIs. To remove or add ROIs, select option &
or '.
NOTE: If you select /, the Bone Results screen is shown and changes
done in the Spaces/Labels screen are deleted.
3. Make sure the ROIs are correct (figure A-13):
➊ The top and bottom of each ROI are immediately inside the vertebral endplates.
➋ The sides of each ROI are immediately inside the edges of the narrowest part of
the vertebral body.
4. Is it necessary to change the ROIs?
• If yes, use the Move, Rotate, and Expand options to position an ROI.
➋ ➋
Figure A-13. Body ROIs
6. Highlight the region to be shown on the Analysis Results screen.

7. Select !. The Analysis Results screen is shown.
9. Select $ and record the number of Analysis Results and/or Ancillary reports
necessary. Select ! to print the reports.


B Femur
Appendix B Contents
B.1 Femur Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
B.2 Acquisition Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5
B.3 Femur Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6
B.4 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9
Revised 1/99C
Appendix B:Femur Acquisition and Analysis
B.1 Femur Image Acquisition

The procedure that follows gives the basic steps necessary to complete a femur image
acquisition. Refer to section B.2 for more information.
2. At the Femur Acquisition screen, select # to examine scan values.
3. Select [1] for a right femur, [2] for a left femur, or [3] for a DualFemur™ scan.
4. Select .. The Mode window is shown. Refer to table B-1 to make sure the scan mode
you select is correct for scan region thickness. Highlight the applicable mode and
select !.
Table B-1: Femur acquisition modes.
Entrance
Mode Exposure
(cm) (minutes)
µGy)
(µ
Hi Res Fast 3000µΑ 15–22 2 24
NOTE: If the patient is less than 12 cm thick in the scan region, place tissue-
equivalent material (such as rice bags) over and around the region.
If you use this material, make sure there is at least 15 cm of soft
tissue and tissue-equivalent material in the entire scan region for a
750µA scan and a combined total of 18.75 cm for a 3000µA scan.
DPX-IQ Operator’s Manual Femur B-1

5. Examine the other scan values and select / to go back to the Femur Acquisition
screen.
7. Position the patient on the scan table (figure B-1):
➊ Palms are flat on the scan pad next to the body, or both hands placed on the
upper chest.
➋ The patient’s body is in the center of the scan pad as shown by the centerline.
➌ The patient's head is approximately 2.5 cm (1 inch) below the horizontal line on
the scan pad.
➊ ➋
➌
Figure B-1. Patient position
8. The DPX-IQ unit includes one of the two foot braces shown in figures B-2 and B-3.
Follow the instructions for your model’s brace. (If your unit has both foot braces, use
the brace shown in figure B-3.)
• If you have the brace shown in figure B-2, place the foot brace so the vertical
part is about 3 centimeters away from the center line. The patient’s hips and
shoulders should be centered on the center line with the pelvis square on the
table. The angled side of the brace should be toward the leg to be scanned.
Figure B-2. Foot brace position for brace with vertical side
B-2 Femur DPX-IQ Operator’s Manual

• If you have the brace shown in figure B-3, position the foot brace in the center of
the scan table. Use the centerline on the scan table as a reference.
Figure B-3. Foot brace position for braces that are angled on both sides
9. Secure the patient’s feet to the foot brace.
• Do not remove the patient’s shoes.
• If you are using the brace shown in figure B-2, strap the foot of the leg to be
scanned to the angled side of the brace as shown. Make sure the ENTIRE leg is
rotated to the angle of the brace. Strap the other foot to the vertical portion of the
brace as shown.
• If you have the brace shown in figure B-3, make sure the foot brace is still
centered on the scan table. Rotate the ENTIRE leg until the foot is positioned at
an angle against the foot brace.
10. Select !. The scan arm and detector move to the approximate starting position and
the program turns on the laser light.

LASER RADIATION
WAVELENGTH: 670 nm

21 CFR 1040.10 and 1040.11.
NOTE: During a DualFemur™ scan, the program scans the left femur first.
You must position the laser light for the left femur before you start
the scan.
11. Position the laser light approximately 7–8 cm below the patient's greater trochanter
where the transverse plane and the center of the leg intersect (figure B-4): ➊ laser
light position; ➋ transverse plane (Pubic Symphysis); and ➌ center of leg.

➋
➊
➌
Figure B-4. Laser light position
12. Select ! to start the scan. Monitor the first few lines to make sure the detector
position is correct. If the detector position is not correct, select # to stop the scan.
Refer to section 2.3.5. A correct (fully completed) scan image includes the greater
trochanter, femoral neck, and ischium (figure B-5).
13. The program acquires the scan image until the autostop feature stops the scan
approximately 3 cm above the greater trochanter. A message is shown which asks you
if you want to continue the scan on the same femur:
• If it appears that less than 25 lines of the scan are acquired above the greater
trochanter, select Y to continue the scan. The program continues the scan until
the value you recorded for the scan length setting is acquired.
• If the scan continued enough above the greater trochanter, select N to end the
scan, or to continue to scan the right femur during a DualFemur™ scan (refer to
section B.2.3).
14. Select ! to go back to the Femur Options screen.
Figure B-5. Femur scan image
15. After the scan, remove the patient’s feet from the foot brace and help the patient off
the scan table.

B.2 Acquisition Information
During a femur image acquisition, refer to the information that follows to help you
complete the acquisition procedure.
B.2.1 Position Rice Bags

A common tissue-equivalent material is white, uncooked rice. LUNAR recommends
you use 10 cm of rice to equal 8 cm of soft tissue. The minimum tissue equivalent
thickness must be 15 cm for 750µA scans and 18.75 cm for 3000µA scans. Figure B-
5 shows the correct position of rice bags:
➊ Soft tissue of leg
➋ Femur
➌ If necessary, use two rice bags to get 18.75 cm of tissue equivalent material (for
a 3000µA scan).The top rice bag is tight against the leg to prevent air gaps. Let
the patient hold the bag(s) in position if necessary.
➋
➊
15 cm 18.75 cm
Figure B-6. Rice bags (numbers are for a 3000µA scan)
B.2.2 Monitor the Scan

After the scan is started, monitor the first few scan lines to make sure the detector is
positioned correctly.
If white lines are shown on the scan image, stop the scan and make sure there is at
least 15 cm of tissue equivalent material around the patient’s leg next to the greater
trochanter (refer to section B.2.1). Position the laser light again and start the scan.

B.2.3 DualFemur™ Acquisition
NOTE: DualFemur acquisition is not available for the Compact DPX-IQ. In
software versions earlier than 4.6d, DualFemur acquisition begins
with the right femur.
During a DualFemur™ acquisition, the program acquires the left femur first: you
must position the laser light for the left femur before you start a DualFemur™
acquisition. When the scan is started, the program 1) acquires a scan image for the
left femur, 2) automatically moves the scan arm and detector to locate the start
position for the right femur, and 3) acquires a scan image for the right femur.
User intervention is NOT required between left and right DualFemur™ scans.
However, the program may not locate the start position for the right femur due to
incorrect patient positioning or unusual anatomy. If the program can not locate the
start position, a message is shown which prompts you to “Adjust position for the
Right Femur.”
Abort a DualFemur™ Acquisition

Abort during acquisition: Select # to abort the scan while the program is
acquiring the left or right femur. Refer to section 2.3.5 for more information.
Abort between left and right femur scans: You can select # to abort the scan
while the scan arm and detector are moving to locate the right femur start position.
The message that follows is shown:
Continue with SmartFemur positioning (Y/N) ?
Select Y to continue the right femur scan. If you select N, the message that follows is
shown:
Manually adjust start position for the right femur (Y/N) ?
Select Y to manually adjust the start position for the right femur, or select N to abort
the right femur scan. If you select N, the left femur scan is still available for analysis.
B.3 Femur Image Analysis

require you to complete manual adjustments to the scan image or
ROI position.
The procedure that follows gives the basic steps necessary to complete a femur image
analysis. Refer to section B.4 for more information.
NOTE: If you are analyzing DualFemur™ scans, both the left and right
femur scans have the same acquisition date as shown on the Scan
Directory screen.

2. At the Bone Results screen, make sure the position of the Neck ROI appears correct.
Refer to section B.4.2 for the criteria for correct ROI placement. Is the Neck ROI
positioned correctly?
• If yes, continue with step 6.
• If no, select $. The Auto Analysis screen is shown. Continue with step 3.
3. Use the options shown on the screen to position the Neck ROI.
4. Select +. The program determines the optimal position for the Neck, Ward’s
triangle, and greater trochanter ROIs and repositions them based on your changes.
NOTE: The default ROI for the program is Total. A Total ROI is comprised
of all bone included in the Neck, Shaft, and Greater Trochanteric
ROIs. Refer to section B.4.2 for a description of these ROIs.
7. Select !. The Analysis Results screen is shown (figure B-7). Refer to figure B-7,
which shows the two possible graphic styles you may see. For Femur analysis (neck
or total), you can choose to display a WHO Fracture Risk graph (shown on the right)
instead of the Lunar Standard graph (shown on the left). Refer to section 4.2.3 for an
explanation of the Fracture Risk graph and for more information about changing
Printout Display Options in the General Default Settings.
reports (figures B-8 and B-9). Select ! to print the reports.
Figure B-7. Analysis Results screen

Figure B-8. Femur Analysis Report
Figure B-9. Femur Ancillary Report

B.4 Analysis Information
During a femur image analysis, refer to the information that follows to help you
complete the analysis procedure. Follow the instructions given ONLY if the program
did not position ROIs correctly.
B.4.1 Insufficient Tissue Messages

One of the messages that follow can show on the Bone Results screen: “Insufficient
Pelvis Separation”; “Insufficient Tissue Above Neck”; or “Insufficient Tissue Below
Neck”. Typically, these messages occur because of uncommon patient anatomy or
because the scan was acquired incorrectly (because of a bad starting location, aborting
too soon, etc.). If the Bone Results Screen shows one of these messages, refer to the
procedure in section B.1 to complete the scan again.
B.4.2 Examine Neck ROI Position

The Bone Results screen shows four ROIs (figure B-10): ➊ Neck ROI; ➋ Ward's
Triangle ROI; ➌ Shaft ROI; and ➍ Trochanteric ROI.
The program lets you change the position of the Neck ROI only. The other ROIs are
positioned automatically by the program.
➊ ➋
Figure B-10. Femur ROIs
Correct Neck ROI Position

Refer to the information that follows to make sure the position of the Neck ROI is
correct (figure B-11):
➊ soft tissue should be contained in all four corners of the ROI.
➋ the ROI is perpendicular to the femoral neck.

➌ the ROI, ideally, should not contain part of the ischium. Part of the ischium can
be contained in the ROI if there is a clear separation between the ischium and the
femoral neck.
➍ the ROI does not include any portion of the trochanter.
➊ ➋
Figure B-11. Correct Neck ROI position
Position the Neck ROI

Complete the procedure that follows only if the program did not position the Neck
ROI correctly:
1. Select $ from the Bone Results screen.
2. Select # to move, $ to expand, or % to rotate the ROI to position the ROI

(figure B-12): make sure the ROI is
➊ perpendicular to the axis of the femoral neck, and
➋ near the proximal (top) end of the femoral neck.
3. Select + then !. The program finds the area that contains the lowest bone density
and positions the other three ROIs.

➊
Figure B-12. Position Neck ROI


C Lateral Spine
Appendix C Contents
C.1 Lateral Spine Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
C.2 Install the Lateral Positioner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4
C.3 Lateral Spine Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4
C.4 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-7
Revised 1/99C
Appendix C:Lateral Spine Image Acquisition and Analysis
C.1 Lateral Spine Image Acquisition

2. At the Lateral Spine Acquisition screen, select # to examine scan values. The Mode
window is shown. Hi Res Medium 3000µA is the only scan mode given. Select ! to
set the mode.
NOTE: The patient must be between 12–30 cm thick in the scan region.
Patients more than 30 cm thick can not be scanned by the detector.
3. Examine the other scan values and select 1/ to go back to the Lateral Spine
Acquisition screen.
5. Set the scan pad on the table and install the lateral positioner (refer to section C.2).
6. Refer to figure C-1 to complete the steps that follow:
• set a foam cylinder (➊), or pillow, on the table for the patient's head and a
tapered foam wedge (➋) for the waist.
• position the patient’s knees toward the chest until the back is against the lateral
positioner.
• make sure the patient’s spine is parallel to the scan table (➌): position the
support wedge below the waist until the patient’s hips and shoulders create a
straight line parallel to the scan table.
DPX-IQ Operator’s Manual Lateral Spine C-1

➌
➋
Figure C-1. Correct spine position
7. Refer to figure C-2 to complete the steps that follow:
• Pull the compressor strap (➊) over the patient's torso and secure it to the back of
the positioner.
• Set a foam wedge between the patient's thighs and the bottom of the positioner,
and below the knees (➋). Make sure the patient's back is flat against the
positioner and adjust the strap so the patient does not roll forward during
the scan.
• Position a foam wedge (➌) between the back of the patient’s thighs and the
positioner to hold their knees in place during the scan.
• Make sure the patient's arms are not inside the scan path.
Figure C-2. Patient position
C-2 Lateral Spine DPX-IQ Operator’s Manual

LASER RADIATION
WAVELENGTH: 670 nm

21 CFR 1040.10 and 1040.11.
9. Position the laser light in the center of the patient's illiac crest.
10. Select !. Monitor the first few scan lines to make sure the detector position is
correct (figure C-3):
• The posterior element for L4 (➊) is shown on the scan image.
• At least 2.5 cm of soft tissue is shown on the anterior side (➋) of the vertebrae.
• The scan contains 5–10 lines of the illiac crest (➌).
• If the detector scans air, white lines are shown on the edges of the scan image. If
this occurs, scan the patient again. Make sure the patient's back is against the
positioner and start the scan in the center of the patient's illiac crest.
section 2.3.5.
L2
L3
➋
➊ L4
Figure C-3. Correct lateral spine scan image
11. Continue the scan past the top of L2. Select # to stop the scan and select + two
times. Select (. The scan arm moves to the HOME position.
12. After the scan,
• remove the patient compressor strap from the positioner. Secure the strap to the
scan table handle.
• remove the support wedges, and
• help the patient off the scan table.
13. Select ! to go back to the Lateral Spine Options screen.

C.2 Install the Lateral Positioner
Make sure the scan pad is on the table and install the lateral positioner (figure C-4):
• Pull the patient compressor strap (➊) across the table and secure it to the handle
on the front of the scan table.
• Set the lateral positioner (➋) on top of the patient compressor strap.
• Slide the positioner against the bracket (➌) until the knobs fit into the round end
of the keyhole slots.
• Slide the positioner toward the head (➍) of the table until the knobs fit into the
narrow end of the keyhole slots.
➍
➌
Figure C-4. Lateral positioner
C.3 Lateral Spine Image Analysis

The procedure that follows gives the basic steps necessary to complete a lateral spine
analysis. Refer to section C.4 for more information.
2. At the Bone Results screen, make sure the labels, space markers, and body ROIs are
correct. Are changes necessary?
• If yes, select $. The Auto Analysis screen is shown. Continue with step 3.

3. To change
• labels and space markers, select *. The Spaces/Labels screen is shown. Select
$ to change intervertebral space markers or % to change labels.
• edge markers, select ). The Profiles screen is shown. Change edge markers
ONLY when you know they are wrong.
4. Select +. The Auto Analysis screen is shown. Make sure the ROI positions are
correct.
7. Select !. The Analysis Results screen is shown (figure C-5).
reports (figures C-6 and C-7). Select ! to print the reports.
Figure C-5. Analysis Results screen

Figure C-6. Lateral Spine Analysis Report
Figure C-7. Lateral Spine Ancillary Report

C.4 Analysis Information
During a lateral spine analysis, refer to the information that follows to help you
C.4.1 Lateral Body ROIs

The program uses lateral body ROIs to include only vertebral bodies for analysis.
NOTE: The program only calculates results for vertebrae labeled L2, L3,
or L4.
Each ROI has two areas the program uses to generate analysis results (figure C-8):
➊ Body ROI (B)—The Body ROI contains all of the vertebral body. The program
supplies BMD results for the area inside the ROI. Body ROIs are labeled “B” by
the program: the Body ROI for L2 is labeled B2, L3 is labeled B3, and L4 is
labeled B4.
➋ Middle ROI (M)—The Middle ROI contains the middle part of the Body ROI.
The program supplies results for the middle part of the ROI only. Middle ROIs
are labeled “M” by the program: the Middle ROI for L2 is labeled M2; L3 is
labeled M3; and L4 is labeled M4.
➊ ➋
Figure C-8. Body and Middle ROIs
C.4.2 Label Body ROIs and Examine Space Markers

At the Auto Analysis screen, select * to label body ROIs and examine space
markers: the Spaces/Labels screen is shown.
Label Body ROIs

1. At the Spaces/Labels screen, select %. The Select Labels window is shown.
2. Use the arrow keys to select the labels. As a reference (figure C-9), use the illiac crest
(➊) at the bottom of the scan image as a landmark: the vertebra immediately above the
illiac crest is L4 (➋).

➋
Figure C-9. Labels
Examine Space Markers

Examine space markers (figure C-10) to make sure they are between the vertebral
bodies (➊) and located at the lowest point of bone density as shown on the histogram
(➋).
If a space marker is not correct, use the arrow keys to select the marker and select $.
Refer to the histogram and use the options shown on the screen to move the marker.
Select"! to save changes.
➊ ➋
Figure C-10. Space markers

C.4.3 Examine Edge Markers and Lateral Body ROIs
Examine profiles before lateral body ROIs at all times. If you change a profile, make
sure you examine the position of the body ROIs.

At the Auto Analysis screen, select ) to verify profiles. The Profiles screen shows
the edge markers (➊) on the scan image (figure C-11). Make sure that each profile is
positioned along the edges of the vertebral bodies.
NOTE: If the profiles are not displayed on the screen, select &.
If it is necessary to change a profile, select %&or ) and use the arrow keys to move
the profile. Make sure you select + to examine the placement of body ROIs.
Figure C-11. Profiles

Examine Lateral Body ROIs
Examine lateral body ROIs at the Auto Analysis screen: select $ at the Bone
Results screen or + at the Profiles screen.
Refer to the information that follows to examine the position of each ROI
(figure C-12):
• The ROI contains only bone (➊).
• The top and bottom edges of the ROI are in the center of the vertebral endplates
(➋). The endplates are the light grey regions at the top and bottom of each
vertebra. An equal amount of high density (light grey) bone is above and below
the ROI.
If it is necessary to position an ROI, select the Move (#), Expand ($), or

Rotate (%) options and use the arrow keys to position the ROI.
➋
Figure C-12. Correct ROI position

D Total Body
Appendix D Contents
D.1 Total Body Image Acquisition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1
D.2 Total Body Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3
D.3 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-7
Revised 1/99C
Appendix D:Total Body Image Acquisition and Analysis
D.1 Total Body Image Acquisition

An autostop feature stops the scan after the detector scans the patient’s feet. The
program lets you scan up to 205 lines. Because of the 205 line limitation, you should
not perform a total body scan on a patient taller than 1.96 meters.
The procedure that follows gives the basic steps necessary to complete a total body
image acquisition. Refer to section D.2 for more information.
NOTE: Make sure the patient removes all attenuation materials before you
start the acquisition procedure.
2. At the Total Body Acquisition screen, select # to examine scan values. The Mode
Window is shown. Refer to table D-1 to make sure the scan mode you select is correct
for scan region thickness. Highlight the applicable mode and select !.
Table D-1: Total Body scan modes.
Entrance
Mode Exposure
(cm) (minutes)
µGy)
(µ
Fast 150µΑ 15–22 21 0.3
Medium 150µΑ 22–28 42 0.6
Screening 150µΑ∗ 15–28 6 0.1
*Use the screening mode for fast image acquisition if you do not have time to use another mode.
3. Examine the other scan values and select / to go back to the Total Body
Acquisition screen.
DPX-IQ Operator’s Manual Total Body D-1

4. Select !. The scan arm and detector move to the head of the scan table.
5. Refer to the information that follows to position the patient (figure D-1):
• The patient’s body is in the center of the scan pad as shown by the
centerline (➊). Make sure the patient’s body is straight.
• The patient's head is approximately 2.5 cm below the horizontal line on the
scan pad (➋).
• Use the straps to secure the patient’s legs and feet (➌).
• The patient's arms are against the side of the body with palms (➍) against the
scan table.
Figure D-1. Patient position
6. Select ! to start the scan. The scan arm and detector move to the start position.
7. Make sure the patient’s head and feet are shown in the scan image (figure D-2):
• If the patient’s feet are not shown, select $ to continue the scan: the scan starts
again from where it stopped until it reaches 205 lines. If it is not necessary to
continue the scan, select #, +, then (.
• If all of the patient’s body is shown, select #.
NOTE: An autostop feature automatically stops the scan after the detector
passes the patient’s feet.
8. Remove the patient’s feet and legs from the straps. Help the patient off the
scan table.
9. Select ! to go back to the Total Body Options screen.
D-2 Total Body DPX-IQ Operator’s Manual

Figure D-2. Total body scan image
D.2 Total Body Image Analysis

The procedure that follows gives the basic steps necessary to complete a total body
analysis. Refer to section D.3 for more information.
2. At the Bone Results screen, make sure the cut positions are correct. Are changes
necessary?
• If yes, select $. The Auto Analysis screen is shown. Continue with step 3.
3. Select #. Use the options shown on the screen to change cut positions.
4. Select !. The Bone Results Screen is shown.
6. Select !. The Analysis Results screen is shown. Refer to figure D-3, which shows
the two possible graphic styles you may see. For Total Body analysis, you can choose
to display a WHO Fracture Risk graph (shown on the right) instead of the Lunar
Standard graph (shown on the left) when you are doing a Total analysis. Refer to
section 4.2.3 for an explanation of the Fracture Risk graph and for more information
about changing Printout Display Options in the General Default Settings.

NOTE: If the warning message “Excessive Averaged Points Detected” is
shown at the bottom of the Analysis Results screen, call
LUNAR Customer Support.
7. Select #"to save changes.
reports (figures D-4, D-5, and D-6). Select ! to print the reports.
Figure D-3. Analysis Results screen
Figure D-4. Total Body Analysis Report (page 1)

Figure D-5. Total Body Analysis Report (page 2)
3.6y
Figure D-6. Total Body Ancillary Report

D.2.1 Tissue Quantitation
You can show a soft tissue scan image on the Analysis Results screen and report.
1. At the Bone Results screen select #. The Image Values screen is shown.
2. Highlight Type and select ).
3. Select &. The soft tissue scan image is shown (figure D-7). Adjust the grey scale
limits as you would the bone image to create an acceptable image. Refer to section
2.4.2.
4. Select /"to go back to the Bone Results screen.
Figure D-7. Soft tissue scan image
Tissue Quantitation Results Printout

You can show tissue quantitation results in the Body Composition section of the
Ancillary results printout. The tissue information combines fat and lean soft tissue.
Other tissue data in the report combines soft tissue and bone tissue.
Tissue quantitation gives the information that follows:
• R-Value of regions with sufficient soft tissue—this value gives the ratio of
38-keV attenuation to 70-keV attenuation in soft tissue. A typical R-Value is
1.28 thru 1.38. A higher value shows a leaner patient.
• Fat as a percentage soft tissue only (fat and lean tissue combined) for
each region.
• Fat as a percentage of body mass (soft tissue and bone mass) for each region.
• Total soft tissue content in grams (fat and lean tissue combined).
• Fat tissue content in grams.

D.3 Analysis Information
During a total body analysis, refer to the information that follows to help you
D.3.1 Position Cuts

Position the cuts to get results for anatomical areas. If only total body results are
necessary, you do not have to position cuts.
Position the cuts at the Auto Analysis screen: select"$ at the Bone Results screen.
Use the page up and page down keys to highlight a cut, then use the arrow keys to
move the cut. Select # for precise cut position.
NOTE: It is necessary to position cuts as precise as possible for the

Extended Research Analysis option.
The Auto Analysis screen shows the anatomical cut regions. The correct position for
each cut follows (figure D-7):
➊ Center—Position the center cut in the center of the body image.
➋ Neck—Position the neck cut immediately below the chin.
➌ Ribs—There is a left and right rib cut shown on the scan image. Position each
cut as close to the spine as possible. Do not include the spine in the rib region.
➍ Arms—There is a left and right arm cut shown on the scan image. Position each
arm cut so it passes through the center of the arm socket and as close to the body
as possible. Do not include the hands inside the arm cut regions. Do not include
the pelvis or femur outside the arm cut regions.
➎ Pelvis—Position the pelvis cut immediately above the pelvis and make sure the
lines on both sides of the cut pass through the femoral necks. Make sure the top
line of the pelvis cut DOES NOT touch the pelvis.
➏ Pelvis Tip—Position the pelvis tip cut below the pelvis and make sure the lines
on both sides of the pelvis cut pass through the femoral necks.
➐ Lumbar—Position the lumbar cut to contain the last vertebra above the pelvis.
Make sure the spine is not included in the pelvis cut region.
➑ Dorsal—Position the dorsal cut immediately below T12 (to identify T12, locate
the ribs that extend from it).

➊
➋
➑
➌
➐
➎
➏
Figure D-8. Cut regions
D.3.2 Standard and Extended Research Analysis

Total body analysis has a Standard Analysis and an Extended Research
Analysis option:
• Standard Analysis is the default mode. It gives accurate total body results for
patients who weigh less than 75 kg.
• Extended Research Analysis is recommended for patients who weigh more than
75 kg. It is necessary to carefully position cuts for Extended Research Analysis.
Refer to section D.3.1.
To change analysis modes:
1. At the Bone Results screen, select $. The Auto Analysis screen is shown.
2. The mode NOT in use is shown next to option $. Select $ to change the analysis
mode.
3. Select !. The message that follows is shown:
Change Cuts Now?

(Y/N)

4. Is it necessary to get total body results or results for specific anatomical sites?
• If total body, select +. The program processes information from the current cut
positions and the Bone Results screen is shown.
• If specific anatomical sites, select ( and refer to section D.3.1 to position the
cuts. When finished, select !. The program processes information from the
new cut positions and the Bone Results screen is shown.
5. Select !. The Bone Results screen is shown. Select # to save changes.


E Forearm
Appendix E Contents
E.1 Forearm Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1
E.2 Acquisition Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3
E.3 Forearm Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-5
Revised 1/99C
Appendix E:Forearm Image Acquisition and Analysis
E.1 Forearm Image Acquisition

The procedure that follows gives the basic steps necessary to complete a forearm
image acquisition. Refer to section E.2 for more information.
2. At the Forearm Acquisition screen, select #. The Verify Values window is shown.
3. Record or examine the following information:
• Forearm Length—the length of the forearm to be scanned.
• Patient Side—the arm to be scanned, left or right. (LUNAR recommends the

patient’s non-dominant arm.)
• Scan Mode—150µA is the only scan mode available. Select ! when the Scan
Mode window is shown.
• Scan Width—width of the arm to be scanned. Make sure the width is large
enough to scan the patient's forearm.
• Scan Length—record Total, Distal, Shaft, or Manual. (LUNAR recommends

Total scan length.)
4. Select /. The Forearm Acquisition screen is shown.
6. Remove the scan pad and set the forearm positioner on the scan table.
DPX-IQ Operator’s Manual Forearm E-1

7. Seat the patient in a chair next to the scan table. Make sure the patient’s back is
straight and the shoulder is aligned with the vertical center (➊ in figure E-1) of the
positioner.
8. Refer to the instructions that follow to position the patient’s forearm:
• Position the forearm so the palm of the hand is against the positioner.
• Tell the patient to make a loosely clenched fist.
• Adjust the velcro straps to secure the arm in place. Make sure the straps are not
inside the scan area.
Figure E-1. Forearm position
LASER RADIATION
WAVELENGTH: 670 nm

21 CFR 1040.10 and 1040.11.
10. Position the laser light (figure E-2) in the center of the patient’s wrist (➊) in line with
the ulna styloid process (➋). If it is necessary to use Manual scan length, position the
laser light in the center of the forearm at the exact scan start location.
Figure E-2. Laser light position
E-2 Forearm DPX-IQ Operator’s Manual

position is correct (figure E-3): make sure the top of the ulna styloid process (➊) is
shown in the first 10 scan lines acquired.
section 2.3.5.
12. After the scan stops, select $ to continue the scan for 15–20 more lines. Select #.
13. After the scan, remove the patient’s arm from the positioner. Select ! to go back to
the Forearm Options screen.
Figure E-3. Correct forearm scan image
E.2 Acquisition Information

During a forearm image acquisition, refer to the information that follows to help you
complete the acquisition procedure.
E.2.1 Measure the Forearm Length

Measure the forearm (figure E-4 from the ulna styloid process (➊), the protrusion on
the wrist) to the elbow (➋).
Figure E-4. Measure the forearm

E.2.2 Record the Scan Length
Select # at the Forearm Options screen to record the scan length in the Verify
Values window.
To select the scan length, refer to the four scan sites that follow (figure E-5):
• Total—scans the entire forearm shaft from the wrist to the 33% shaft site (➊).
LUNAR recommends that you use the Total scan length.
• Shaft—scans the 33% shaft site (➊).
• Distal—scans the distal end of the forearm and includes the Ultradistal site (➋),
the 5 mm site (➌), and the 10% site (➍).
• Manual—lets you record the necessary scan length.
➊ ➍ ➋
Figure E-5. Forearm scan site locations
E.2.3 Position the Forearm Positioner

The forearm positioner is necessary to prevent arm movement during the scan. Set the
forearm positioner in the center of the scan table and against the scanner side rail.
Figure E-6 shows the correct position of the forearm positioner and patient’s forearm.
Figure E-6. Forearm positioner

Forearm Position
Position the forearm as follows (figure E-7):
• The ulna styloid process is inside the grid (➊) and the forearm is centered inside
the red section of the grid (➋).
• The patient's shoulder is aligned with the vertical center line (➌).
• The patients bones must be parallel to the horizontal lines on the positioner; feel
the patient's bones to make sure they are in the correct position.
➊
R
➌ ➋
Figure E-7. Correct forearm position
E.3 Forearm Image Analysis

The procedure that follows gives the basic steps necessary to complete a forearm
image analysis. Refer to section E.4 for more information.
3. Make sure the Bone and ROI labels are correct. Are changes necessary?
• If yes, select *. The Labels screen is shown. Use the options shown on the
screen to change bone and ROI labels.

4. Select ). The Profiles screen is shown. Make sure the edge markers are correct. Are
changes necessary?
• If yes, use the options shown on the screen to change edge markers.
5. Select"+. The Auto Analysis screen is shown. Is it necessary to edit the forearm
length?
• If yes, select +. The Forearm Length window is shown. Record the length of
the patient’s forearm and select !.
6. Make sure the Reference Point and ROI positions are correct. If changes are
necessary, use the options shown on the screen to position the reference point and
ROI.
9. Select !. The Analysis Results screen is shown (figure E-8).
reports (figures E-9 and E-10). Select ! to print the reports.
Figure E-8. Analysis Results screen

Figure E-9. Forearm Analysis Report
Figure E-10. Forearm Ancillary Report

E.4 Analysis Information
During a forearm image analysis, refer to the information that follows to help you
E.4.1 Examine Bone and ROI Labels

Select * at the Auto Analysis screen to examine bone and ROI labels. The Labels
screen is shown. Once you have examined and/or changed labels, select ! to save
changes. The Bone Results screen is shown.
Change Bone Labels

Select 2 or 3 to change the bone labels. The labels shown on the screen are given as
follows: left bone radius, right bone ulna; left bone ulna, right bone radius; radius
only; and ulna only.
Change Region Labels

To change the region labels, select #. The Select Labels window is shown and gives
the label combinations. Each line contains a combination of the Region labels in the
order shown on the scan image.
Highlight the necessary labels. Select !. The program changes the labels on the
scan image.
E.4.2 Examine Baseline and Edge Markers

At the Auto Analysis screen, select") to examine the baseline and edge markers at
the Profiles screen. The screen shows the scan image and Profile (figure E-11). The
Profile shows areas of the analysis region the program uses to calculates results.
Please refer to section A.3.2 for more information on the line profile.
NOTE: The Line Profile is an optional feature for forearm analysis. Refer to
chapter 4 to activate the “Display Line Profile” option.
Figure E-11. Scan image and profile

Examine Baselines
Make sure the baseline is located in the average of soft tissue points for the analysis
region. The program usually positions the baseline correctly: change the baseline
ONLY if you are sure it is not correct.
When you change the baseline, the program automatically changes the edge markers.
Change the baseline first AT ALL TIMES if the baseline and edge markers
require positioning.
To change the baseline, select # to move the baseline up or $ to move the

baseline down.
Please refer to section A.3.2 for more information on baselines.

Make sure the edge markers are positioned above the baseline to include only high
density points. Refer to the information that follows for correct edge marker position
(figure E-12):
➊ The first edge marker is positioned on the first bone point after the soft
tissue points.
➋ The second edge marker is positioned on the last bone point before the soft
tissue points start.
➌ The third edge marker is positioned on the first bone point after the soft tissue
points between the two bones.
➍ The fourth edge marker is positioned on the last bone point before the soft tissue
points start.
➊ ➋ ➌ ➍
Figure E-12. Edge marker position

E.4.3 Examine ROI Position
Examine ROI position at the Auto Analysis screen: select $ at the Bone Results
screen. The Auto Analysis screen shows the ROI(s) on the scan image.
Refer to the basic ROI position rules that follow (figure E-13):
• Each ROI contains four bone edges: the left and right ulna (➊) edges and the left
and right radius (➋) edges.
• The Reference Point (➌) is positioned on the first scan line where the radius and
ulna meet as you move up the forearm to the wrist.
Figure E-13. Reference point and ROI position
E.4.4 Examine ROI Heights

The height of each ROI is shown on the right side of the Auto Analysis screen. Refer
to the information that follows to examine the height of each ROI.
Ultradistal ROI
The recommended height of the ultradistal ROI is 15 mm. If the radius endplate is
contained in the ROI, move the Ultradistal ROI down until the endplate is not
included (figure E-14).
33% ROI
The recommended height of the 33% ROI is 20 mm and is centered at 33.33% of the
total arm length as measured at the ulna styloid process (figure E-14).

Figure E-14. Correct position of Ultradistal and 33% ROI
5mm ROI
The recommended height of the 5mm ROI is 1.5 mm and is positioned on the scan
image where the ulna and radius are 5 mm apart (figure E-15): this distance is given
on the right side of the Auto Analysis screen.
10% ROI
The recommended height of the 10% ROI is 15 mm. The ROI is centered at 10% of
the total arm length as measured at the ulna styloid process (figure E-15).
Figure E-15. Correct position of 5 mm and 10% ROI

Total ROI
The Total ROI contains the 33% ROI (➊ in figure E-16), the Ultradistal ROI (➋), and
the area between them (➌).
Figure E-16. Total ROI

F Hand
Appendix F Contents
F.1 Hand Image Acquisition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-1
F.2 Hand Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-3
Revised 1/99C
Appendix F:Hand Image Acquisition and Analysis
F.1 Hand Image Acquisition

The scan mode for hand image acquisition is 150µA detail. A scan with a sample size
1.2 x 2.4 typically lasts 9 minutes with a skin entrance exposure of 1.2 µGy.
2. At the Hand Acquisition screen, select # to examine values. Record or examine the
information that follows:
• Patient Side—record the hand to be scanned, left or right
• Mode—The Mode window shows the 150µA detail mode. Select ! to set
the mode.
• Scan Width—select Manual for scan width. Measure the width of the hand at its
widest point. Add 20 mm and record the value in the Scan Width field.
Select 0.
• Scan Length—select Manual for the scan length. Measure the length of the
hand from the distal tip of the ulna styloid process to the tip of the middle finger.
Add 20 mm and record the value in the Scan Length field.
NOTE: Use the same scan width and scan length values for future scans of
the patient.
3. Select / to go back to the Hand Acquisition screen.
4. Select !. The scan arm and detector move to the HOME position.
5. Remove the pad from the scan table.
DPX-IQ Operator’s Manual Hand F-1

6. Seat the patient next to the scan table. Position the patient’s hand in the center side of
the scan table (figure F-1); DO NOT use the forearm positioner. Make sure the
patient’s hand is flat on the table with fingers slightly apart.
Figure F-1. Hand position
LASER RADIATION
WAVELENGTH: 670 nm

21 CFR 1040.10 and 1040.11.
8. Position the laser light (figure F-2) in the center of the wrist (➊) immediately distal to
the ulna styloid process (➋).
➊ ➋
Figure F-2. Laser light position
position is correct (figure F-3).
section 2.3.5.
F-2 Hand DPX-IQ Operator’s Manual

Figure F-3. Correct hand scan image
10. After the scan, remove the patient’s hand from the scan table. Select ! to go back to
the Hand Options screen.
F.2 Hand Image Analysis

1. Refer to section 2.4.1 to select a scan file for analysis.
3. Select !. The Analysis Results screen is shown (figure F-4).
4. Select # to save the analysis results.
5. Select $ and record the number of Analysis Results and/or Ancillary reports
necessary (figures F-5 and F-6). Select ! to print the reports.
Figure F-4. Analysis Results screen
DPX-IQ Operator’s Manual Hand F-3

HAND RESULTS
LUNAR CORPORATION
313 W. BELTLINE HWY., MADISON, WI 53713
HAND, S4317 LEFT FOREARM BONE DENSITY
FACILITY: Lunar Corporation Acquired: 07/11/1997 (4.4 )

34 Years 12/30/1963 Analyzed: 01/09/1998 (4.6b)
71.9in 180.0lbs White Male Printed: 01/09/1998 (4.6b)
Physician: Dr. Smith hand_s00.p01
Reference Data Not Available
1,7 2 3
BMD Young-Adult Age-Matched
Region g/cm2 % T % Z
TOTAL 0.422 - - - -
Image not for Diagnosis

0.15ma:Detail DPX-L 1.2x2.4mm 0.84mm
738379:421915 274.96:205.19:146.09
%Fat = 4.3 (1.388)
1 - See appendix on precision and accuracy.

Statistically 68% of repeat scans will fall within ±1 SD. (0.02 g/cm2)
Comments:
®
DPX
#0001
Figure F-5. Hand Analysis Report
HAND RESULTS
LUNAR CORPORATION
313 W. BELTLINE HWY., MADISON, WI 53713
HAND, S4317 LEFT FOREARM BONE DENSITY
FACILITY: Lunar Corporation Acquired: 07/11/1997 (4.4 )

34 Years 12/30/1963 Analyzed: 01/09/1998 (4.6b)
71.9in 180.0lbs White Male Printed: 01/09/1998 (4.6b)
Physician: Dr. Smith hand_s00.p01
ANCILLARY HAND RESULTS**

Total Bone Calcium (g).. 21.99
Air Points.............. 3482
Tissue Points........... 5893
Bone Points............. 1808
Total Points............ 9375
R-Value Points.......... 1422
**Ancillary results for research purposes only, not clinical use.
®
DPX
#0001
Figure F-6. Hand Ancillary Report
F-4 Hand DPX-IQ Operator’s Manual

G Orthopedic Hip
Appendix G Contents
G.1 Orthopedic Hip Image Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-1
G.2 Orthopedic Hip Image Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-4
G.3 Analysis Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-6
Revised 1/99C
Appendix G:Orthopedic Hip Image Acquisition and Analysis
G.1 Orthopedic Hip Image Acquisition

2. At the Orthopedic Hip Acquisition screen, select # to examine values. Record or

examine the information that follows:
• Porous Length—Record the length of the porous coating. If you do not know
the porous length use the default value of 0.
• Implant Length—Record the length of the patient’s implant. If you do not

know the implant length use the default value of 100.
• Patient Side—Record the hip being scanned, left or right.
• Mode—Highlight the applicable mode for patient thickness (table G-1).

Select !.
• Scan Width—Use the default value of 150 if you do not have a specified
scan width.
• Scan Length—Use the default value of 100 if you do not have a specified
scan length.
DPX-IQ Operator’s Manual Orthopedic Hip G-1

Table G-1. Orthopedic hip scan modes.
Entrance
Mode Exposure
(cm) (minutes)
µGy)
(µ
Fast 3000µΑ 15–22 4 48
Medium 3000µΑ 22–30 6 96
Slow 750µΑ 12–15 2 48
NOTE: If the patient weighs less than 50 kg, position tissue-equivalent

material around (and if necessary immediately above) the thigh in
the scan area.
3. Select /. The Hip Acquisition screen is shown.
5. Help the patient on the scan table. Make sure the patient’s body is in the center of the
scan pad and the patient’s head is approximately 2.5 cm below the horizontal line on
the scan pad.
7. Set the foam positioner (➊) under the knee of the leg to be scanned (figure G-1).
Figure G-1. Knee positioner
8. Secure the foot of the leg to be scanned to the straight, vertical side of the foot brace.
Make sure the patient’s toes point up (figure G-2). Refer to the information that
follows to position the patient:
• Gently move the patient’s leg through a small range of movement. Make sure the
leg is in a neutral position without rotation—slightly flexed with the patella
immediately above the joint. Make sure the patient is comfortable.
WARNING: If the patient is uncomfortable in this position, stop the scan

procedure. DO NOT perform the scan if the patient
is uncomfortable.
• Move the foot brace and the patient’s leg until the femur of the leg to be scanned
is parallel to the center line on the scan pad.
G-2 Orthopedic Hip DPX-IQ Operator’s Manual

Figure G-2. Foot brace
9. Position the laser light in the longitudinal center of the patient’s thigh below the
greater trochanter.
position is correct (figure G-3):
➊ The scan must have a minimum of 10–20 lines (12–24 mm) of the femoral shaft
before it reaches the implant.
➋ Continue the scan until at least 5 lines show above the top of the
greater trochanter.
NOTE: If white lines show on the edges of the scan image, there is not
enough soft tissue around the scan region. There must be a minimum
of 15 cm (12 cm is sufficient for the 750µΑ mode) of soft tissue to get
valid results. If necessary, position tissue-equivalent material on the
outside of the patient’s leg in the scan region. Refer to section B.2.1
for more information.
If the position of the detector is not correct, select # to stop the scan. Follow the
screen prompts to position the detector again and start the scan.

➋
Figure G-3. Orthopedic hip scan image
11. After the scan, remove the patient’s foot from the foot brace and help the patient off
the scan table.
12. Select ! to go back to the Orthopedic Hip Options screen.
G.2 Orthopedic Hip Image Analysis

The procedure that follows gives the basic steps necessary to complete an orthopedic
hip image analysis. Refer to section G.3 for more information.
2. At the Bone Results screen, select $. The Auto Analysis screen is shown. Select the
type of analysis:
• Select ( for a Gruen Analysis or ' for an Extended Gruen Analysis.
• For a Standard Analysis, continue with step 3.
3. Select ). The Profiles screen is shown. Make sure the edge markers are correct.
4. Select +. The Auto Analysis screen is shown. Make sure the ROIs and the
Reference Point positions are correct.
5. Select !. The Bone Results screen is shown (figure G-4).
6. Select ) to save changes.

7. Select * and record the necessary number of Analysis Results and/or Ancillary
reports (figures G-5 and G-6). Select ! to print the reports.
Figure G-4. Bone Results screen
Figure G-5. Orthopedic Hip Analysis Report

Figure G-6. Orthopedic Hip Ancillary Report
G.3 Analysis Information

During an orthopedic hip image analysis, refer to the information in this section to
help you complete the analysis procedure.
G.3.1 Edge Markers

Select ) from the Auto Analysis screen to examine orthopedic hip edge markers:
the Profiles screen shows the scan image and Line Profile (figure G-7).
The Line Profile shows areas of the analysis region the program uses to calculate
results. The Line Profile uses edge markers to separate bone from the hip implant for
analysis results.
NOTE: The line profile is an optional feature for orthopedic hip analysis.
See chapter 4 to activate the “Display Line Profile” option.

The Line Profile
The Line Profile shows the information that follows:
• Baseline—The program calculates results from the area above the baseline (➊).
• High Density Points—The High Points on the profile show areas of high
density: dense bone (➋) and implant material (➌).
• Edge Markers—The edge markers (➍) are used to isolate the bone from the
implant. The high points contained inside the area between each pair of markers,
and above the baseline, are used to calculate results.
• Soft Tissue Points—The low points on the profile (➎) show areas of
soft tissue.
➋
➍
➊
➎
Figure G-7. Line Profile

Refer to the information that follows to make sure the edge marker positions are
correct (figure G-8):
• Pelvis Edge—If the pelvis is shown on the scan image, the markers are on each
edge of the pelvis bone points (➊ and ➋).
• Left Femur Edge—The left femur edge marker (➌) is on the last soft tissue
point before the bone points start up to the implant points.
• Left Implant Edge—The left implant edge maker (➍) is on the first
implant point.
• Right Implant Edge—The right implant edge marker (➎) is on the last
implant point.
• Right Femur Edge—The right femur edge marker (➏) is on the point
immediately after the bone points join the soft tissue points.
NOTE: Change edge markers only if they are obviously not correct. Let the
program calculate the edges for you.

Figure G-8. Edge marker placement left femur
G.3.2 Examine Reference Point

Make sure the Reference Point (➊) is immediately next to the lesser trochanter
(figure G-9). Make sure the horizontal line of the Reference Point is in the center of
the lesser trochanter and is parallel to the femoral shaft. In addition, the vertical line of
the Reference Point touches the curve of the lesser trochanter.
NOTE: Only Standard Analysis uses a Reference Point.
Figure G-9. Reference Point

G.3.3 Examine Standard Analysis ROIs
Standard Analysis calculates BMC, Area, and BMD values for four ROIs labeled A,
B, C, and D on the scan image. Make sure the height of each ROI is 20 mm. The width
of each ROI relates to the bone edges within each ROI.
Refer to the information that follows to examine the position of Standard Analysis
ROIs (figure G-10):
• ROI C is positioned by the program so its bottom edge is at the top of the
lesser trochanter.
• ROI D is immediately below ROI C. The bottom edge of ROI C and the top edge
of ROI D touch each other. The straight line shown where the two ROIs touch is
at the top of the lesser trochanter.
• ROI B is next to ROI C. One side of ROI B touches one side of ROI C. The
straight line shown where the sides touch is in the center of the femoral shaft.
• ROI A is directly above ROI B. The bottom edge of ROI A touches the top edge
of ROI B.
Figure G-10. Standard Analysis ROIs

G.3.4 Examine Gruen Analysis ROIs
Gruen analysis calculates BMC, Area, and BMD values of seven ROIs for the implant
labeled 1 through 7. The program uses the length of the patient’s implant to position
the ROIs.
Refer to the information that follows to examine the position of Gruen Analysis ROIs
(figure G-11):
• ROI 4 is positioned at the bottom of the implant. The top line of the ROI is at the
implant tip. The height of ROI 4 relates to implant and scan length settings.
• ROIs 3 and 5 are immediately above ROI 4. The edges of ROI 3 and ROI 5 touch
each other in the center of the implant shaft. The height and width of ROIs 3 and
5 relate to porous coating length (if applicable), implant length, and scan width
settings.
• ROIs 2 and 6 are immediately above ROIs 3 and 5. There is no space between
the bottom of ROI 2 and the top of ROI 3. In addition, there is no space between
the bottom of ROI 6 and the top of ROI 5. The lines of ROI 2 and ROI 6 touch
each other and meet in the center of the implant shaft. The height and width of
ROIs 2 and 6 relate to porous coating length (if applicable), implant length, and
scan width settings.
• ROIs 1 and 7 are immediately above ROIs 2 and 6. There is no space between
the bottom of ROI 1 and the top of ROI 2. In addition, there is no space between
the bottom of ROI 7 and the top of ROI 6. The lines of ROI 1 and ROI 7 should
touch each other. The height and width of ROIs 1 and 7 relate to porous coating
length (if applicable), implant length, and scan width settings.
NOTE: The height of ROIs 1, 2, 6, and 7 is one-third the length of the

implant if a modified Gruen analysis is not being completed.
Figure G-11. Standard Gruen ROIs

Modified Gruen Analysis
The program completes a modified Gruen analysis after you enter the length of the
porous coating on the patient’s implant during acquisition or analysis. A modified
Gruen analysis measures the density of bone around the implant. During a modified
Gruen analysis, the program moves the boundary between ROIs 1 and 7 and ROIs 2
and 6 to match the porous coating level (figure G-12). Once at the correct level, ROIs
1 and 7 include all the bone around the porous coating. The remaining ROIs contain
bone not affected by the porous coating.
After the boundaries are set, the program divides the implant length equally between
ROIs 2 and 6 and ROIs 3 and 5. The program positions ROI 4 below the distal tip of
the implant.
Figure G-12. Modified Gruen ROIs
G.3.5 Extended Gruen Analysis

The Extended Gruen analysis mode calculates BMC, Area, and BMD values for the
seven Gruen zones. In this mode, the program divides six of the seven ROIs into thirds
(the program does not include ROI 4).
The program places ROIs 1a–1c and 7a–7c in the top third of the implant, ROIs
2a–2c and 6a–6c in the middle third of the implant, and ROIs 3a–3c and 5a–5c in the
bottom third of the implant. ROI 4 is below the distal tip of the implant
(figure G-13).

Figure G-13. Extended Gruen analysis ROIs
G.3.6 Offset, Perimeter, and Rim Options

At the Auto Analysis screen, select ) to access the Offset, Perimeter, and Rim
options from the Profiles screen.
The Offset, Perimeter and Rim options let you isolate BMD values for regions of bone
next to the implant. When you set these values, the BMD values given at the Bone
Results screen are calculated for areas between the Offset, Perimeter, and Rim edge
markers instead of the area between the bone edge markers.
Set an Offset Value

The Offset option sets the distance from the implant to the bone region. For example,
if you select an Offset value of 4 mm, the program shows a set of edge markers 4 mm
from the implant.
1. At the Profiles screen, select '. The number following “Offset =” below the line
profile is highlighted in green.
2. Record the necessary distance (0–10mm) from the Offset edge markers to
the implant.
3. Select 0 to save changes. The program shows the offset edge markers.
Set a Perimeter Value

The Perimeter option sets the width of the bone region. When you set this value, the
program shows a set of edge markers the distance you selected from the Offset
edge markers.
1. At the Profiles screen, select (. The number following “Perimeter =” below the line
2. Record the width (0–10mm) necessary for the bone region.
3. Select 0. The program shows a set of edge markers the distance you specified
from the Offset edge markers.

Set a Rim Value
The Rim option sets the distance between the edge marker and the outer edge of the
bone region.
1. From the Profiles screen, select ). The number following “Rim =” below the line
2. Record the distance (0–10mm) necessary between the bone edge and the
edge marker.
3. Select 0. The program shows a set of edge markers the distance you specified
from the outside edge of the bone region.
G.3.7 Histograms
Longitudinal Histogram
At the Auto Analysis screen, select * to access the Longitudinal Histogram. The
Longitudinal Histogram (figure G-14) shows the density of bone next to the implant.
Use this histogram to monitor bone remodeling along the entire length of the implant.
The program calculates BMD values for the bone regions and shows the values below
the histogram.
Figure G-14. Longitudinal Histogram screen
Transverse Histogram
At the Longitudinal Histogram screen, select & to access the Transverse Histogram
screen (figure G-15). Use this histogram to monitor bone remodeling next to
the implant.
The Transverse Histogram gives the bone density of regions next to the implant, much
like the Longitudinal Histogram. However, the bone region on the Transverse
Histogram screen cannot be more than 12 mm tall. In addition, the program does not
calculate BMD values for the regions shown on the histogram.

Figure G-15. Transverse Histogram screen

H Specifications
Appendix H Contents
The information that follows gives technical and functional specifications for all
LUNAR DPX-IQ systems configured with a Dell computer and an HP DeskJet
printer. For computer and printer specifications, refer to the manufacturer's
product literature.
MODEL: DPX-IQ
TYPE: Dual energy X-ray absorptiometry (DEXA).
Appendix H includes the sections that follow:
H.1 Space Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-1

H.2 Component Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-2
H.3 Functional Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-3
H.4 Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-4
H.5 Power Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.6 X-ray Generator Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-5
H.7 Compatible Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H-10
Revised 1/99C
Appendix H:Specifications
H.1 Space Requirements

Room dimensions must be at least 12' x 12' (3.7 m x 3.7 m) for a 240-cm long
DPX-IQ system, and 9' x 9' (2.7 m x 2.7 m) for a 180-cm long DPX-IQ system.
Because of cable lengths, all DPX-IQ components must be in the same room. For
radiation and electrical safety, the console table must be at least 3 feet from the scan
table.
Because of cable length, the maximum distance from the console table to the power
outlet can be no more than 5' (1.52 m). In addition, the distance between the scan table
and console table can be no more than 10' (3.05 m).
DPX-IQ Operator’s Manual Specifications H-1

H.2 Component Specifications
All systems purchased in the United States include a computer and monitor:
• Computer—Refer to section H.7 for compatible computer components and

minimum system requirements.
• Monitor—A 17” (43.2 cm) monitor is standard for DPX-IQ systems.
NOTE: Refer to your product literature for component specifications.
H.2.1 Printer
Your system may include one of the printers that follow. For your printer's
specifications, refer to product literature:
• HP LaserJet 6L
17.5"(H) x 8.2"(W) x 15.3"(D)
(44.3 cm x 20.6 cm x 38.9 cm)
• HP DeskJet 895C
7.2"(H) x 17.56"(W) x 13.8"(D)
(18.5 cm x 44.6 cm x 35.5 cm)
H.2.2 Other Output Devices

The output devices that follow can also be purchased:
• Matrix Instruments Video Imager, CEC

9.5"(H) x 15.5"(W) x 28.5"(L)
(24.1 cm x 39.4 cm x 72.4 cm)
• Mitsubishi Color Video Copy Processor

4.9"(H) x 16.7"(W) x 16.3"(L)
(12.4 cm x 42.4 cm x 41.4 cm)
H-2 Specifications DPX-IQ Operator’s Manual

H.2.3 Scan Table
• DPX-IQ240 (full table)
8.1"(L) x 24.6"(W)* x 52.2"(H)**
(197.5 cm x 62.3 cm x 132.5 cm)
• DPX-IQ 180 (compact table)

2.6"(L) x 21.3"(W)* x 52.2"(H)**
(133 cm x 54.0 cm x 132.5 cm)
*Width is measured from the front edge of the scan table to the back edge of the scan arm.
**Height is measured from the top of the scan arm to the bottom of the scan arm.
The scan table serial number is on a metal strip fixed to the end panel at the foot of
the table.
H.3 Functional Specifications
H.3.1 General Specifications

Focal spot to image receptor distance is 58.4 cm. Attenuation equivalence of patient
support table is 0.7 mm AI.
H.3.2 Maximum Scan Area (Long x Transverse)

NOTE: The maximum scan length and width are limited by the maximum
scan time for the scan. Refer to the appendixes for maximum scan
time information.
• AP Spine Scans
7.87" x 7.09" (20 cm x 18 cm)
167 scan lines x 150 sample points
• Femur Scans
7.87" x 7.09" (20 cm x 18 cm)
• Lateral Spine Scans

7.87" x 7.09" (20 cm x 18 cm)
• Total Body Scans

77.48" x 22.68" (196.8 cm x 57.6 cm)
• Forearm Scans
5.51" x 4.96" (14 cm x 12.6 cm)

• Orthopedic Hip Scans
15.74" x 7.09" (40 cm x 18 cm)
H.3.3 Programs
Depending on the number of options you purchased, not all of the programs listed
below may be included with your software:
• AP spine scan and analysis
• Femur scan and analysis
• Lateral spine scan and analysis (optional)
• Total Body scan and analysis (optional)
• Forearm scan and analysis (optional)
• Hand scan and analysis (optional)
• Orthopedic Hip scan and analysis (optional)
• Quality Assurance
H.4 Environmental Specifications

Adhere to the environmental specifications that follow.
• Ambient Space (Interior Subcomponents): For scanner operation and

servicing, do not block the area around the scan table. Make sure there is a
minimum clearance of 12" (30.5 cm) at the head and foot ends of the scan table,
at least 6" (15.2 cm) for the arm side, and 18" (45.7 cm) for the operator side.
• Ambient Space (Ventilation): Do not block the cooling vents on the computer
and scan table. Make sure there is 6" (15.2 cm) from the console table to the wall
for cable clearance and computer plugs.
• Dust, Fumes and Debris: Install the system in a clean, ventilated area. Dust and
other airborne debris can cause the diskette drive heads and other sensitive
mechanical components to malfunction. LUNAR recommends that you do not
smoke in the scanner room.
• Humidity: Make sure the humidity for the scanner area is 20%–80%,
non-condensing.
• Static Electricity: Install and operate the system in a static-free area. Use anti-
static mats and adhere to minimum humidity requirements to prevent
malfunctions caused by static electricity.

• Shock and Vibration: Make sure the scan table does not receive shock greater
than 1 G for more than 1 millisecond. Make sure the scan table does not receive
vibrations greater than 0.25 G at 5 Hz.
• Temperature: Make sure the temperature during system operation is 65°F–81°F

(18°C–27°C).
NOTE: When the system is turned off, or there is a power failure, you must
turn the system on and let it warm up for one hour. After one hour,
complete a Quality Assurance procedure.
H.5 Power Specifications
H.5.1 Leakage Current

Total System with Isolation Transformer: <100 microamperes.
Scan Table alone: <100 microamperes.
H.5.2 Scan Table

The following are the power specifications for the DPX product line. Check the power
specifications label on your scanner to determine which power specifications apply to
your scanner.
Bertan/Spellman 100 Range: 90-110 VAC 50/60 Hz 10A

P/N 0311 and 0312 115 Range: 103-127 VAC 50/60 Hz 10A
230/240 Range: 207-264 VAC 50/60 Hz 7.5A
H.6 X-ray Generator Specifications
H.6.1 X-ray Generator

Table H-1 contains information about the X-ray generator for DPX-IQ series devices.
Table H-1: X-ray generator technical information.

Classification Class I Equipment IEC 601-2-7 5.1
Degree of protection against electrical shock Type B equipment IEC 601-2-7 5.2
Protection against ingress of liquids Ordinary medical electrical equipment IEC 601-2-7 5.3
Connection to supply mains Detachable power cord IEC 601-2-7 6.1g)
Mode of operation Continuous IEC 601-2-7 6.1m)
Maximum X-ray tube voltage 76 Kv IEC 601-2-7 6.1m)
Maximum X-ray tube current 5 mA IEC 601-2-7 6.1m)
Rated mains voltage 100/115/230/240 volts IEC 601-2-7 6.1j)1
Number of phases in mains 1 IEC 601-2-7 6.1j)2

Table H-1: X-ray generator technical information. (continued)
Mains frequency 50/60 Hertz IEC 601-2-7 6.1j)3
Maximum apparent resistance of supply mains 0.8 Ohms IEC 601-2-7 6.1j)4
Required over-current releases 15 Amp dedicated service IEC 601-2-7 6.1j)5
X-ray tube dissipates 305W max. into
surrounding air through forced air
Heat dissipative components IEC 601-2-7 6.1t)
convection. Flow rate: 36 m3/h (approx.)
Temp. rise of air stream 25º C (approx.)
Spellman X2112/X2113/ rev. K and higher.
IEC 601-2-7 6.8.1
Allowable high voltage supplies Bertran 2411P and 2411N rev. A and
and 50.2.101-102
higher. LUNAR p/n 0311 and 0312.
IEC 601-2-7 6.8.1
Allowable tube head assemblies LUNAR model 2288 or equivalent
and 50.2.101-102
Original language of accompanying documents English IEC 601-2-7 6.8.1
Maximum contiuous kV, mA at nominal rated kV 76 kV, 4 mA IEC 601-2-7 6.8.2 1)
Maximum intermittent kV, mA at maximum kV 76 kV, 5 mA IEC 601-2-7 6.8.2 1)
Maximum continuous kV, mA at maximum mA 61 kV, 5 mA IEC 601-2-7 6.8.2 2)
Maximum intermittent kV, mA at maximum mA 76 kV, 5 mA IEC 601-2-7 6.8.2 2)
Continuous kV, mA for maximum electric output
76 kV, 4 mA IEC 601-2-7 6.8.2 3)
power
Intermittent kV, mA for maximum electric output
76 kV, 5 mA IEC 601-2-7 6.8.2 3)
power
Nominal electric power 0.4 kW IEC 601-2-7 6.8.2 4)
7.89 mAs. Parameters: 76 kV, 2.63 mA,
Reference current time product IEC 601-2-7 6.8.2 5)
3 seconds.
Nominal shortest irradiation times 3 seconds. IEC 601-2-7 6.8.2 8)
No specific wait period was imposed.
IEC 601-2-7
Repetition rate for loading during tests Time between tests was approximately
50.104.4
20 seconds.
Voltage divider in high voltage power IEC 601-2-7
Method of X-ray tube voltage measurement
supply. 50.106.1
Shunt resistor in high voltage supply IEC 601-2-7
Method of X-ray tube current measurement
return line. 50.106.2
Line normal to the tube port, centered on IEC 601-2-7 6.1j)5)
X-ray tube assembly reference axis
tube port as shown in figure H-1. 50.107.1
Reference loading conditions 1.09 x 106 Joules, 4 mA, 76 kV for 1 hour. IEC 601-1-3
Leakage radiation was measured at the following
750mA, 76 kV for 1 hour. IEC 601-1-3
loading factors.
Focal spot to Image Receptor distance 58.1 cm IEC 601-1-3
Attenuation equivalence of patient support table. 0.7 mm Al IEC 601-1-3

Figure H-1. Reference axis and target angles for
tube head assembly
H.6.2 LUNAR 8022 X-ray Tube

Table H-2 gives LUNAR 8022 X-ray tube information.
Table H-2: LUNAR 8022 X-ray tube technical information.

361 Watts for an equivalent
Nominal anode input power IEC 613/1989
Anode input power of 361 W
Maximum anode heat content 6000 Joules IEC 613/1989
Anode heating and cooling curves Refer to figure H-2. IEC 613/1989
Anode target material Tungsten IEC 601-2-28
Reference axis Refer to figure H-3. IEC 601-2-28
Target angle 78° (reference to normal) IEC 601-2-28
Nominal focal spot values 0.5 IEC 336/1982
Maximum useful voltage 95 kVp Not Applicable
Maximum filament current 2.2 Amperes Not Applicable
Figure H-2. Anode heating/cooling curves

Figure H-3. X-ray tube and reference axis
H.6.3 LUNAR 2288 X-ray Tube Head Assembly

Beam filtration is permanently fixed at 3.2 mm Aluminum-equivalent. Refer to table
H-3 for 2288 X-ray tube head assembly technical information.
Table H-3: LUNAR 2288 X-ray tube assembly technical information.

Quality equivalent filtration 41 mm AL/76 kV IEC 522/1976
Filament characteristics Refer to figure H-4. IEC 613/1989
76 kV - Anode to Cathode
Nominal X-ray tube voltage 38 kV - Anode to Earth IEC 613/1989
38 kV - Cathode to Earth
361 W (4.75 mA, 76 kV) for
Single load rating IEC 613/1989
up to 4 min., 59 sec.
361 W (4.75 mA, 76 kV) for up to 4
Serial load rating min., 59 sec. with a 10 min. cool IEC 613/1989
down time between scans.
Maximum X-ray tube assembly
260 kJoules IEC 613/1989
heat content
X-ray tube assembly heating and
Refer to figure H-5. IEC 613/1989
cooling curves
Maximum continuous heat dissipation 361 Watts IEC 613/1989
Maximum symmetrical radiation field Diameter = 10 mm IEC 806/1984
Dimensions 17 cm x 19.4 cm x 11 cm IEC 601-2-28
Weight 8.6 kg IEC 601-2-28

Figure H-4. Cathode emission characteristics
Figure H-5. X-ray tube assembly heating/cooling curves
H.6.4 Laser Specifications

Table H-4 gives the specifications for the LUNAR laser.
Table H-4: Laser specifications.

Output Power <1mW
Wavelength 670nm
Frequency Drift 0.25nm/C
Laser Structure Gain Guided
Laser Composition In GaAIP
Spatial Mode Single
Longitudinal Mode Multiple
Beam Dimensions 3.3/0.8mm
Aspect Ratio 4.0 to 1
Divergence 0.2mrad

Table H-4: Laser specifications. (continued)
Astigmatism 11 microns
Laser Lifetime 50,000 hours
Optimal Spot 500 microns
Bore Sighting 2mrad
Current Draw 105 mA
Voltage Input 4-6 VDC
Safety Rating Class II
H.7 Compatible Components

In accordance with US government requirements, LUNAR certifies certain computers
as compatible with the DPX series bone densitometer. These models are currently
designated as “Model XRC1” by LUNAR, and use of these computers is therefore
compliant with US regulations and is required for US installations. These computers
contain identification labels identifying this model number. Please contact LUNAR
for more information.
For customers located internationally, make sure the computer is certified to local
requirements such as IEC 950. The computer must meet the requirements that follow:
• 100 MHz Pentium
• 16 MB RAM
• 500 MB Hard Disk
• 8X CD ROM
• 1 MB Video RAM
• 14” SVGA Monitor
Table H-5 gives components certified to the FDA for use with DPX-IQ scanners and
is updated periodically. Contact LUNAR for a current listing of compatible
components.

Table H-5: FDA certified compatible components.
LUNAR
COMPONENT DESCRIPTION
PART #
Controller–DPX-IQ Dell1 Computer Models
575GM: 5GB-16MB 4085
590XM: 1GB-32MB 17456
5120/GM: 1GB-16MB 4075
5120/XM: Pentium-1GB-8MB-120MHz 3828
5133/GM:
—1GB-8MB 4398
—1GB-16MB 4415
—2GB-16MB-133MHz 4579
—2GB-32MB 4647
5200GXM:
—2GB-32MB with 10/100 ether card 4634
—2GB-32MB 4724
5200GXiM: 2GB-32MB 4756
P133GSM:
—2GB-32MB 4846
—2GB-16MB w/Windows '95 4769
P166GsM: 2GB-32MB-166MHZ 4838
P5MMX200/GXiM: 2GB-32MB 5473
P5MMX166/GsM: 2GB, 32MB 5475
P6266/GXA: 3.2GB, 32MB, 233MHz w/Windows ‘95 5579
2
Controller–DPX-IQ ACER America Computer Models
2021: 2GB-16MB-166MHz 4761
2181: 6.4GB-32MB-233MHz 5524
2341:
—8MB RAM 4115
—16 MB RAM 4013
—1.6GB-32MB-133MHz (black) 4491
2731: 2GB-16MB-166MHz 4928
2831: 1.6GB-16MB-133MHz 4713
3
Controller–DPX-IQ CITUS Computer Models
3.1GB-32MB-200MHz (black) 4777
1.2GB-16MB-100MHz (white) 4781
2.1GB-32MB-166MHz-Internal jaz4 drive (black) 4957
4
2.1GB-32MB-166MHz-Internal zip drive (black) 4967
2.1GB-32MB-200MHz-Internal jaz drive (black) 4953
2.1GB-32MB-200MHz-Internal jaz drive (beige) 4969
3.2GB-32MB-266MHz-Pentium-Internal zip drive (white) 5646
3.2GB-32MB-266MHz-Internal jaz drive (black) 5575

Table H-5: FDA certified compatible components. (continued)
LUNAR
COMPONENT DESCRIPTION
PART #
3.2GB-32MB-266MHz-Pentium-Internal jaz drive (black) 5575
3.2GB-32MB-233MHz-Pentium-Internal zip drive (white) 5806
Spellman5 Models:
High Voltage 0311
—PTV40N200X2113
Power Supplies 0312
—PTV40P200X2112
Bertan6 Models:
—2411AP 0312
—2411AN 0311
Tube Head Assembly LUNAR X-Ray Tube Head Assembly 2288
1
Dell Computer Corporation, Austin, TX
2
ACER America Corporation, San Jose, CA
3
CITUS (Granite Microsystems), Mequon, WI
4
Iomega Corporation, Roy, Utah
5
Spellman High Voltage Electronics Corporation Hauppauge, NY
6
Bertan Associates, 121 New South Road, Hicksville, NY

Comparison to
I Reference Population
Appendix I Contents
I.1 Reference Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-1
I.2 Reference Population Database. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-2
I.3 Age Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-7
I.4 Weight Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-8
I.5 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-9
Use of the reference population comparisons is fully at the discretion of the

clinician.
Revised 1/99C
Appendix I:Comparison to Reference Population
I.1 Reference Data

The reference data for the LUNAR DPX were based on ambulatory subjects from the
general population who were free from chronic diseases affecting bone and who were
not taking medications which influence bone (such as corticosteroids, anticonvulsants
and thyroxine). Subjects were from the US and Northern Europe (UK, Scandinavia).
As additional data becomes available, the reference database will be increased and the
tabular materials updated to reflect these changes.
In the past, reference values obtained with a different instrument (LUNAR DP3) have
been shown to be virtually identical in different white populations (US, Australia, UK,
Spain, Brazil, Argentina).1–6 Variations within normal limits of nutrition and physical
activity have not been demonstrated to have a significant influence on reference
values, but body weight does have some influence.1,7 Race can have an influence, as
bone mineral density (BMD) in black subjects is about 8-12% more dense than in
whites.8-14 Hispanics have a somewhat higher BMD (2–4%) than whites.13 People of
Asian descent may be a few percent lower, but this difference appears to be associated
with a smaller body size.12,15,16 Also, the inclusion of subjects with skeletal fractures in
an elderly reference group could influence such data by lowering the average BMD
since patients with fractures are usually 1 SD below age-matched controls without
fractures. Consequently, all patients with fractures were excluded from our
reference group.
DPX-IQ Operator’s Manual Comparison to Reference Population I-1

I.2 Reference Population Database
The comparison values used in DPX software are supported by a large database from
studies of the reference population (tables I-1 thru I-5). Research was conducted at
university medical centers and clinics in the US, England, and Northern Europe. The
variation of mean BMD values among geographical sites contributing normal data
was about 1.3% (SD/mean). All data from these studies were acquired with LUNAR
DPX instrumentation. Table I-1 lists the number of subjects in the reference
population for each measurement site.
Table I-1: Number of male and female subjects in the reference population for each
measurement site.
Site Male Female

AP Spine32–34,36,47-49 1460 8905
35,37
Lateral Spine 392 1318
32-36,48,50
Proximal Femur 1611 7524
Total Body7,14,32,39,40,41 655 2154
14,38,39
Radius Shaft 987 1685
Tables I-2 and I-3 list the mean BMD values used as DPX’s AP spine reference data.
BMD values are presented in grams per centimeter squared (g/cm2) in ten-year
intervals. The regions of interest are AP spine L2-L4 and lateral spine L2+L3.
Table I-2: Mean BMD values for AP spine L2-L4 (SD = 0.12 g/cm2) BMD values are
listed for US/Europe populations.32–34,36,48-50
Female Male
Age n Mean n Mean
20–29 672 1.200 131 1.241
30–39 916 1.214 164 1.215
40–49 1630 1.180 185 1.180
50–59 2472 1.096 250 1.145
60–69 1942 1.016 400 1.157
70–79 1273 0.988 330 1.173
Total 8905 1460
I-2 Comparison to Reference Population DPX-IQ Operator’s Manual

Table I-3: Mean BMD values for lateral spine L2+L3 (SD = 0.12 g/cm2). BMD values
are listed for US/Europe populations.35,37
Female Male
Age n Mean n Mean
20–29 236 0.790 44 0.919
30–39 202 0.764 61 0.938
40–49 312 0.718 113 0.892
50–59 277 0.628 93 0.813
60–69 184 0.522 50 0.726
70–79 107 0.502 31 0.721
Total 1318 392
Table I-4: Mean female BMD values for femur regions for the US/Europe populations
(SD in g/cm2 for each site is listed below site names, in parentheses).32-36,49
Age n Neck Ward’s Trochanter Total

(0.12) (0.13) (0.11) (0.12)
20–29 739 0.998 0.945 0.796 1.007
30–39 1067 0.973 0.888 0.782 0.998
40–49 1746 0.946 0.839 0.782 0.979
50–59 1799 0.881 0.753 0.758 0.932
60–69 1433 0.818 0.674 0.724 0.874
70–79 1027 0.767 0.622 0.689 0.815
Total 7811
Table I-5: Mean male BMD values for femur regions for the US/Europe populations
(SD in g/cm2 for each site is listed below site names, in parentheses).32,48,50
Age n Neck Ward’s Trochanter Total

(0.13) (0.13) (0.11) (0.13)
20–29 139 1.098 1.038 0.950 1.105
30–39 225 1.045 0.937 0.908 1.071
40–49 279 0.984 0.853 0.892 1.042
50–59 319 0.956 0.803 0.902 1.029
60–69 428 0.909 0.744 0.873 1.000
70–79 344 0.876 0.706 0.845 0.961
Total 1734

The DPX reference values for femur BMD correspond closely to the large sample of
white males (n=1676) and females (n=1541) collected by the third National Health
and Nutrition Examination Survey (NHANES III) and published by Looker et al.13
The NHANES values were converted to DPX-equivalent BMD using the regression
equations established for subjects in vivo at UCSF52 (figures I-1 through I-4).
1.2 1.2
Female Female
1.1 1.1
Femur Neck BMD (g/cm )
2
Femur Total BMD (g/cm )

2
1.0 1.0
0.9 0.9
0.8 0.8
0.7 0.7
DPX
DPX
NHANES
NHANES
0.6 0.6
20 30 40 50 60 70 80
20 30 40 50 60 70 80
Age (years)
Age (years)
Figure I-1. Figure I-2.
1.2 1.2
Male Male
1.1 1.1
Total Femur BMD (g/cm )
Femur Neck BMD (g/cm )
2
2
1.0 1.0
0.9 0.9
0.8 0.8
0.7 0.7
DPX DPX
NHANES NHANES
0.6 0.6
20 30 40 50 60 70 80 20 30 40 50 60 70 80
Age (years) Age (years)
Figure I-3. Figure I-4.
Figures I-1 through I-4. Comparison of DPX reference values for femur neck
and total femur with NHANES Values13 converted to DPX-equivalent BMD52
Table I-6 lists the mean BMD used in LUNAR’s total body reference data for females.
Table I-7 lists the mean BMD used in LUNAR’s total body reference data for males.
BMD values are given for the total body and five subregions: arms, legs, trunk, pelvis,
and spine. Table I-8 lists the mean BMD used in LUNAR’s radius shaft
reference data.

Table I-6: Mean female BMD values for total body sites (SD in g/cm2 for each site is
listed below site name, in parenthesis).7,14,32,39,40
Total
Age n Arms Legs Trunk Pelvis Spine
Body
(0.08) (0.08) (0.09) (0.07) (0.10) (0.14)
20–29 179 1.120 0.825 1.155 0.905 1.078 1.157
30–39 192 1.141 0.839 1.159 0.927 1.115 1.191
40–49 259 1.123 0.822 1.136 0.911 1.100 1.137
50–59 408 1.086 0.789 1.107 0.875 1.057 1.060
60–69 640 1.030 0.740 1.040 0.841 1.015 1.025
70–79 476 0.998 0.742 0.967 0.801 0.942 0.958
Total 2154
Table I-7: Mean male BMD values for total body sites (SD in g/cm2 for each site is
listed below site name, in parenthesis).32
Total
Body
(0.08) (0.08) (0.09) (0.07) (0.10) (0.14)
20–29 35 1.234 0.976 1.401 1.002 1.218 1.160
30–39 64 1.215 0.984 1.345 0.986 1.204 1.146
40–49 83 1.210 0.995 1.339 0.990 1.196 1.166
50–59 86 1.232 1.000 1.351 1.001 1.196 1.179
60–69 236 1.203 0.977 1.332 0.996 1.164 1.203
70–79 151 1.177 0.937 1.306 0.974 1.126 1.182
Total 655
Table I-8: Male and female BMD for radius shaft (SD=0.07 g/cm2).14,38,39,50
Age Female Male

n BMD n BMD
20–29 235 0.700 117 0.790
30–39 277 0.710 133 0.820
40–49 140 0.700 138 0.820
50–59 237 0.660 111 0.780
60–69 308 0.580 177 0.770
70–79 382 0.530 221 0.740
80–89 106 0.490 90 0.730
Total 1685 987

Table I-9: Mean male BMD values for total body sites (SD in g/cm2 for each site is
listed below site name, in parenthesis).32
Total
Body
(0.08) (0.08) (0.09) (0.07) (0.10) (0.14)
20–29 35 1.234 0.976 1.401 1.002 1.218 1.160
30–39 64 1.215 0.984 1.345 0.986 1.204 1.146
40–49 83 1.210 0.995 1.339 0.990 1.196 1.166
50–59 86 1.232 1.000 1.351 1.001 1.196 1.179
60–69 236 1.203 0.977 1.332 0.996 1.164 1.203
70–79 151 1.177 0.937 1.306 0.974 1.126 1.182
Total 655
Table I-10: Male and female BMD for radius shaft (SD=0.07 g/cm2).14,38,39,50
Age Female Male

n BMD n BMD
20–29 235 0.700 117 0.790
30–39 277 0.710 133 0.820
40–49 140 0.700 138 0.820
50–59 237 0.660 111 0.780
60–69 308 0.580 177 0.770
70–79 382 0.530 221 0.740
80–89 106 0.490 90 0.730
Total 1685 987

I.3 Age Adjustment
All Age-Matched comparisons use age regressions to calculate an expected BMD.
The subject’s BMD is compared with the expected BMD for a person of the same age
and gender in the reference population. Age regressions were determined from
subsets of the reference data of table I-3. The expected BMD values are based on the
studies of white reference females (table I-9).
Table I-11: Age regression for AP spine, lateral spine, femur and total body BMD in
white reference females.
SEE
Age n ROI BMD r
(g/cm2)
20–45 334 Ap Spine = 1.20-(0.0002 X Age) 0.00 0.139
45–65 665 Ap Spine = 1.71-(0.0113 X Age) 0.32 0.174
65+ 166 Ap Spine = 1.16-(0.0026 X Age) 0.20 0.170
20–45 171 Lateral Spine = 0.895-(0.0047 X Age) 0.25 0.118

45–65 125 Lateral Spine = 1.190-(0.0104 X Age) 0.46 0.118
65+ 86 Lateral Spine = 0.774-(0.0036 X Age) 0.00 0.155
Femur
20–45 345 Neck = 1.04-(0.0023 X Age) 0.13 0.121
45–65 370 Neck = 1.32-(0.0083 X Age) 0.34 0.127
65+ 109 Neck = 0.94-(0.0022 X Age) 0.08 0.127
Femur
20–45 345 Ward’s = 1.05-(0.0045 X Age) 0.21 0.144
40–65 370 Ward’s = 1.27-(0.0098 X Age) 0.36 0.145
65+ 109 Ward’s = 0.60-(0.0003 X Age) 0.00 0.147
Femur
20–45 345 Troch = 0.763+(0.0003 X Age) 0.00 0.108
45–65 370 Troch = 1.010-(0.0053 X Age) 0.24 0.117
65+ 109 Troch = 0.838-(0.0023 X Age) 0.08 0.126
20–45 146 Total Body= 1.13+(0.0005 X Age) 0.00 0.088

45–65 93 Total Body= 1.40-(0.0053 X Age) 0.33 0.084
65+ 54 Total Body= 1.06-(0.0003 X Age) 0.00 0.073

I.4 Weight Adjustment
The Age-Matched comparison can be adjusted for body weight by selecting the
appropriate default in the program. Increased weight is associated with higher BMD
values (table I-12). Conversely, decreased weight is associated with lower BMD
values. A weight adjustment is applied for subjects who weigh more or less than the
mean weight. The mean weights are 65 kg for women and 78 kg for men in the US/
Europe database.
Adjustments are applied for weight between 25 and 100 kg.
Table I-12: BMD weight regression for reference females.
Site Regression r See (g/cm2)

AP Spine BMD = 0.845 + (0.004 x Weight) 0.14 0.184
Lateral Spine BMD = 0.464 + (0.003 x Weight) 0.21 0.159
Neck BMD = 0.670 + (0.003 x Weight) 0.28 0.134
Ward’s BMD = 0.574 + (0.003 x Weight) 0.21 0.173
Trochanter BMD = 0.460 + (0.003 x Weight) 0.40 0.111
Total Body BMD = 0.886 + (0.004 x Weight) 0.47 0.083
I.4.1 %Young Adult

The %Young Adult value compares a patient’s BMD with the expected peak bone
mass for a subject of the same sex and nationality. The Young Adult age ranges for
each scan site are as follows:
Male Female
Site
(years) (years)
Femur 20–45 20–45
AP Spine 20–45 20–45
Forearm 20–50 20–50
Lateral Spine 20–40 20–40
Total Body* 20–55 20–45
* For total body region only.

I.5 References
1. Mazess RB, Barden HS, Johnston C, Dawson-Hughes B, Baran D, Powell M,
Notelovitz M (1987) Spine and femur density using dual-photon absorptiometry in
normal U.S. white women. Bone Miner 2:211-219.
2. Pocock NA, Eberl S, Eisman JA, Yeates MG, Sambrook PN, Duncan A (1987)
Dual-photon bone densitometry in normal Australian women: a cross-sectional study.
Med J Aust 146:293-297.
3. Stevenson JC, Lees B, Devenport M, Cust MP, Ganger KF (1989) Determinants of

bone density in normal women: risk factors for future osteoporosis? Br Med J
298:924-928.
4. Marone M, Lewin S, Bianco A, Correa P (1989) Diagnostico de osteoporose atraves

da densitometria de dois fotons. Rev Ass Med Brasil 35:57-62.
5. Mautalen C, Tau C, Casco C, Fromm G (1984) Contenido mineral oseo en la

poblacion normal de Buenos Aires. Medicina (Buenos Aires) 44:356-360.
6. Hui SL, Slemenda CW, Johnston CC, Appledorn CR (1987) Effects of age and
menopause on vertebral bone density. Bone Miner 2:141-146.
7. Teegarden D, Proulx WR, Martin BR, Zhao J, Mccabe GP, Lyle RM, Peacock M,
Slemenda C, Johnston CC, Weaver CM (1995) Peak bone mass in young women. J
Bone Miner Res 10:711-715.
8. Bell NH, Gordon L, Stevens J, Shary JR (1995) Demonstration that bone mineral
density of the lumbar spine, trochanter, and femoral neck is higher in black than in
white young men. Calcif Tissue Int 56:11-13.
9. Liel Y, Edwards J, Shary J, Spicer KM, Gordon L, Bell NH (1988) The effects of race
and body habitus on bone mineral density of the radius, hip, and spine in
premenopausal women. J Clin Endocrinol Metab 66:1247-1250.
10. Luckey MM, Meier DE, Mandeli JP, DaCosta MC, Hummard ML, Goldsmith SJ
(1989) Radial and vertebral bone density in white and black women: Evidence for
racial differences in premenopausal bone homeostasis. J Clin Endocrinol Metab
69:762-770.
11. Luckey MM, Wallenstein S, Lapinski R, Meier DE (1996) A prospective study of

bone loss in African-American and white women - A clinical research center study. J
Clin Endocrinol Metab 81:2948-2956.
12. Tobias JH, Cook DG, Chambers TJ, Dalzell N (1994) A comparison of bone mineral
density between Caucasian, Asian, and Afro-Caribbean women. Clin Sci 87:587-591.
13. Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr,
Lindsay RL, (1995) Proximal femur bone mineral levels of US adults. Osteoporosis
Int 5:389-409.

14. Harris SS, Wood MJ, Dawson-Hughes B (1995) Bone mineral density of the total
body and forearm in premenopausal black and white women. Bone 16(Suppl):311S-
315S.
15. Kin K, Lee JHE, Kushida K, Sartoris DJ, Ohmura A, Clopton P, Inoue T (1993) Bone
density and body composition on the pacific rim: a comparison between Japan-born
and U.S.-born Japanese-American women. Bone Miner 8:861-869.
16. Ross PD, He YF, Yates AJ, Coupland C, Ravn P, McClung M, Thompson D, Wasnich
RD (1996) Body size accounts for most differences in bone density between Asian
and Caucasian women. Calcif Tissue Int 59:339-343.
17. Newton-John HF, Morgan DB (1970) The loss of bone with age, osteoporosis and
fractures. Clin Orthop 71:229-252.
18. Mazess RB (1982) On aging bone loss. Clin Orthop 162:239-252.
19. Nilas L, Christiansen C (1987) Bone mass and its relationship to age and the
menopause. J Clin Endocrinol Metab 65(4):697-702.
20. Gallagher JC, Goldgar D, Moy A (1987) Total bone calcium in normal women: effect
of age and menopause status. J Bone Miner Res 2:491-496.
21. Johnston CC, Hui SL, Christian JC (1984) Some determinants of peak bone mass and
subsequent rates of bone loss. In: Osteoporosis I Christiansen C, Arnaud CD, Nordin
BEC, Parfitt AM, Peck WA, Riggs BL (eds), Proceedings of the Copenhagen
International Symposium on Osteoporosis. pp. 263-268.
22. Johnston CC, Jr, Norton JA, Jr, Khairi RA, Longcope C (1979) Age-related
bone loss. In: Osteoporosis II, Barzel US (ed), New York: Grune & Stratton,
pp. 91-100.
23. Falch JA, Sandvik L (1990) Perimenopausal appendicular bone loss: A 10-year
prospective study. Bone 11:425-428.
24. Gambacciani M, Spinetti A, de Simone L, Cappagli B, Maffei A, Taponeco F, Fioretti

P (1993) The relative contributions of menopause and aging to postmenopausal
vertebral osteopenia. J Clin Endocrinol Metab 77:1148-1151.
25. Hansen MA, Overgaard K, Christiansen C (1995) Spontaneous postmenopausal bone

loss in different skeletal areas - followed up for 15 years. J Bone Miner Res 10:205-
210.
26. Dawson-Hughes B, Shipp C, Sadowski L, Dallal G (1987) Bone density of the radius,
spine, and hip in relation to percent of ideal body weight in postmenopausal women.
Calcif Tissue Int 40-:310-314.
27. Pouilles JM, Tremollieres F, Ribot C (1995) Effect of menopause on femoral and
vertebra bone loss. J Bone Miner Res 10:1531-1536.
28. Hui SL, Slemenda CW, Johnston CC Jr (1990) The contribution of bone loss to
postmenopausal osteoporosis. Osteoporosis Int 1:30-34.

29. Harris S, Dawson-Hughes B (1992) Rates of change in bone mineral density of the
spine, heel, femoral neck and radius in healthy postmenopausal women. Bone Miner
17:87-95.
30. Kin K, Kushida K, Yamazaki K, Okamoto S, Inoue T (1991) Bone mineral density of
the spine in normal Japanese subjects using dual-energy x-ray absorptiometry: effect
of obesity and menopausal status. Calcif Tissue Int 49:101-106.
31. Ribot C, Tremollieres F, Pouilles JM, Louvet JP, Guiraud R (1988) Influence of the
menopause and aging on spinal density in French women. Bone Min 5:89-97.
32. Karlsson MK, Gardsell P, Johnell O, Nilsson BE, Akesson K, Obrant KJ (1993) Bone
mineral normative data in Malmo, Sweden - Comparison with reference hip data and
hip fracture incidence in other ethnic groups. Acta Orthop Scand 64:168-172.
33. Kröger H, Heikkinen J, Laitinin K, Kotaniemi A (1992) Dual-energy x-ray

absorptiometry in normal women: a cross-sectional study of 717 Finnish volunteers.
Osteoporosis Int 2:135-140.
34. Laitinen K, Valmaki M, Keto P (1991) Bone mineral density measured by dual-energy
X-ray absorptiometry in healthy Finnish women. Calcif Tissue Int
48:224-231.
35. Lilley J, Eyre S, Walters B, Heath DA, Mountford PJ (1994) An investigation of

spinal bone mineral density measured laterally: a normal range for UK women. Br J
Radiol 67:157-161.
36. Truscott JG, Simpson D, Fordham JN. Compilation of national bone densitometry
reference data. in: Ring EFS, Elvins DM, Ghalla AK, eds. Current Research in
Osteoporosis and Bone Mineral Measurement IV: 1996, London: The British Institute
of Radiology, 1996:77-78.
37. Mazess RB, Barden HS, Eberle RW, Denton MD (1995) Age changes of spine density
in posterior-anterior and lateral projections in normal women. Calcif Tissue Int
56:201-205.
38. Ringe JD, Rehpenning W, Steinhagen-Thiessen E (1985) Increasing skeletal

involution in the elderly? Mech Aging Dev 29:83-88.
39. Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, Andon MB, Smith
KT, Heaney RP (1994) Timing of peak bone mass in Caucasian females and its
implication for the prevention of osteoporosis. J Clin Invest 93:799-808.
40. Nuti R, Martini G, Gennari C (1993) Total body, spine, and femur dual x-ray
absorptiometry in spinal osteoporosis. Calcif Tissue Int 53:388-393.
41. Krall E, Dawson-Hughes B, Hirst K, Gallagher J.C., Sherman SS, Dalsky G (1997)
Bone mineral density and biochemical markers of bone turnover in healthy elderly
men and women. J Gerontal 52A:m61-m67.
42. Lu PW, Briody JN, Ogle GD, Morley K, Humphries IRJ, Allen J, Howman-Giles R,
Sillence D, Cowell CT (1994) Bone mineral density of total body, spine, and femoral
neck in children and young adults: a cross-sectional and longitudinal study. J Bone
Miner Res 9:1451-1458.

43. Harris S, Dallal GE, Dawson-Hughes B, (1992) Influence of body weight on rates of
change in bone density of the spine, hip, and radius in postmenopausal women. Calcif
Tissue Int 50:19-23.
44. Truscott JG, Oldroyd B, Simpson M, Stewart S, Westmacott CF, Milner R, Horsman
A, Smith MA (1993) Variation in lumbar spine and femoral neck bone mineral density
measured by dual energy x-ray absorption: a study of 329 normal women. Br J Radiol
66:514-521.
45. Young R, May H, Murphy S, Grey C, Compston JE (1996) Rates of bone loss in peri-
and postmenopausal women: a 4-year, prospective, population-based study. Clin Sci
91:307-312.
46. Pouilles A, Tremollieres F, Ribot C (1996) Variability of vertebral and femoral

postmenopausal bone loss: a longitudinal study. Osteoporosis Int 6: 320-324.
47. Gardsell P, Johnell O, Nilsson BE, (1991) The predictive value of bone loss for
fragility fractures in women: a longitudinal study over 15 years. Calcif Tissue
Int 49:90-94.
48. Kröger H, Laitinen K (1992) Bone mineral density measured by dual-energy x-ray
absorptiometry in normal men. Eur J Clin Nutr 22:454-460.
49. Wetzel R, Pfandl S, Bodenburg R, Puhl W (1996) Bone mineral density – reference
values of healthy German females – examinations of the lumbar spine using LUNAR
DPX. Osteologie 5:71-81.
50. Burger H, van Daele PLA, Algra D, van den Onweland FA, Grobbee DE, Hofman A,
van Kujik C, Schütte HE, Birkenhäger JC, Pols HAP (1994) The association between
age and bone mineral density in men and women aged 55 years and over. The
Rotterdam study. J Bone Miner Res 25:1-13.
51. Runge H, Fengler F, Franke J, Koall W (1980) Ermittlung des peripheren

Knochenmineralgehaltes bei Normalpersonen und Patienten mit verschiedenen
Knochenerkrankungen, bestimmt mit Hilfe der Photonenabsorptionstechnik am
Radius. Radiologe 20:505-514.
52. Genant HK, Grampp S, Gluer CC, Faulkner KG, Jergas M, Engelke K, Hagiwara S,
Van Kujik C (1994) Universal standardization for dual x-ray absorptiometry: patient
and phantom cross-calibration results. J Bone Miner Res 9:1503-1514.

J Precision and Accuracy
Appendix J Contents
J.1 Precision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-1
J.2 Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-3
J.3 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-5
Revised 1/99C
Appendix J:Precision and Accuracy
J.1 Precision
Precision is the ability of a methodology to repeatedly obtain the same value. Your
system, using DEXA, has been tested in the factory to ensure reliable measurements
(precision error <0.01 g/cm2). For comparison, a series of measurements over time
with conventional DPA typically shows a slightly higher variability of .02 to .03 g/
cm2. The measurements used a Gd153 radionuclide source on a phantom simulating a
spine or femur.
The DPX has shown a better precision than Gd153 based DPA (about .01 g/cm2 error on
spine and femur phantoms). (Refer to tables J-1 and J-2.) Measurements with the
DPX system were repeated on a spine phantom and a femur phantom to assess
precision. AP spine measurements were made 40 times on 6 subjects over 1 week and
50 times in 1 subject over 1 month. The standard deviation (SD) was about .01 g/cm2
for L2–L4, which corresponds to about 1% at an average density of 1 g/cm2. Femur
measurements were made 75 times on 15 subjects (5/case) over 1 week and 50 times
on 1 subject over 1 month. The precision error was about .015 g/cm2 for the neck
region, or about 1.5% at a typical density of 1 g/cm2. These precision results were
summarized by Mazess et al (1989).1
DPX-IQ Operator’s Manual Precision and Accuracy J-1

Table J-1. Short-term (5 days) precision of DPX.
Observations Cases Obs/Case SD (g/cm2)
Spine (L2-L4)
Spine Phantom (in vitro) 195 1 195 .005
Young Subjects 40 6 6.7 .011
Young Male 50 1 50 .013
Femur (neck)
Femur Phantom (in vitro) 22 1 22 .015
Young Subjects 75 15 5 .015
Young Male 50 1 50 .015
Table J-2. Short-term (5 days) precision of DPX for regions of total body scans.
Intrascanner (n=34) and interscanner (n=37) results for single skeletons
in vitro, and results for young subjects in vivo (n=60; 12 subjects with 5
scans per case).
Intrascanner Interscanner In Vivo

(N=34) (N=37) (N=60)
Mean SD Mean SD Mean SD
Head 1.164 .007 1.459 .026 2.326 .039
Arms 0.499 .006 0.499 .011 0.839 .013
Legs 0.801 .005 0.672 .009 1.281 .010
Trunk 0.587 .004 0.619 .008 0.940 .010
Spine 0.497 .007 0.575 .010 1.034 .020
Total 0.772 .003 0.731 .007 1.168 .007
J-2 Precision and Accuracy DPX-IQ Operator’s Manual

J.2 Accuracy
The LUNAR DPX-IQ accurately measures BMC and BMD (figures J-1 and J-2). The
BMC and BMD of three standard annuli containing bone equivalent material (made
by Radiation Measurements of Middleton, Wisconsin) were calibrated at the
University of Wisconsin Bone Mineral Laboratory against the ash-weight of known
bone sections. These same three annuli were used for evaluation of the LUNAR DP3
and DP4 scanners using conventional Gd153 sources. The BMC and BMD values
obtained with the DPX were almost identical to the calibrated values. There was a
high degree of linearity (r>0.99) with a regression slope of 1 and a zero intercept.
Accuracy for vertebral area was further validated by comparing the measured areas of
three vertebral bodies (L2-L4) in nine encapsulated spine phantoms using the DPX.
1.1
1.0
Measured BMD
0.9
0.8
0.7
r => 0.99
0.6
0.6 0.7 0.8 0.9 1.0 1.1
Actual BMD
Figure J-1. Actual vs. measured BMD of annuli scanned on DPX
45
40
Measured BMC
35
30
25
r => 0.99
20
20 25 30 35 40 45
Actual BMC
Figure J-2. Actual vs. Measured BMC of Annuli Scanned on DPX
The spine phantoms were radiographed and the projected area of the vertebrae was
measured by image digitization to get an actual area. The area measured with the DPX
correlated highly with the radiographic area (r=0.97) and gave a value that was about
1% higher than the radiographic area. Results for BMD also were closely correlated
(r~0.98) with those obtained on spine and femur phantoms and in vivo using
conventional radionuclide DPA.
DPX-IQ Operator’s Manual J-3 Precision and Accuracy

The accuracy of the DPX total body scans was not directly evaluated on skeletons.
Comparisons were made with conventional Gd153 DPA scans (LUNAR DP4 scanner)
in 11 young subjects. The correlation between results was high (r=0.96, SEE=0.02 g/
cm2). The regression line was congruent with the identity line
(figure J-3).
1.4
1.3
DPX BMD 1.2
1.1
r => 0.99
1.0
1.0 1.1 1.2 1.3 1.4
DP4 BMD
Figure J-3. Comparison of DPA and DEXA results
1.5
1.3
1.1
DPX BMD
0.3%/cm
0.9
0.7 Annulus
Spine
0.5
0 2 4 6 8 10
Distance (cm)
Figure J-4. BMD vs. distance from table top

Conventional DPA scans have been shown to be well correlated to total body calcium
from neutron activation analysis.4 Factors that affect accuracy include tissue thickness
and distance of the object from the table top. Measurements were made on two spine
phantoms at different distances from the table top. There was a change of about
0.3%/cm (figure J-4). Subjects should be repositioned carefully to ensure good long-
term precision. Measurements were made on spine phantoms in a water bath to assess
the effect of tissue thickness on results. There was little effect (<1%) of thickness,
prior to correction for scatter and hardening, in up to 20 cm of water (equivalent to 25-
cm patient thickness). Corrections for scatter and hardening reduce this small
thickness dependence at higher thicknesses (figure J-5).
110
105
Percent BMD
100
95
Spine
Femur
90
0 10 20 30 40
Thickness (cm water)
Figure J-5. Effect of tissue thickness on results
J.3 References
1. Mazess R, Collick B, Trempe J, Barden H, Hanson J (1989) Performance evaluation
of a dual-energy x-ray bone densitometer. Calcified Tissue International 44:228-232.
2. Krolner B (1985) Lumbar spine bone mineral content by photon beam

absorptiometry. Danish Medical Bulletin 32:152-170.
3. Wahner HW, Dunn WL, Mazess RB, et al. (1985) Dual-photon (Gd-153) absorptiometry
of bone. Radiology 156:203-206.
4. Mazess RB, Peppler WW, Chesnut CH, Nelp WB, Cohn SH (1981) Total body bone
mineral and lean body mass by dual-photon absorptiometry. II. Comparison with total
body calcium by neutron activation analysis. Calcified Tissue International
33:361-363.
DPX-IQ Operator’s Manual J-5 Precision and Accuracy


Index
A Total Body, D-3
AP Spine
Accuracy, J-3 Acquisition, A-1
Acquisition Analysis, A-3
Add or select patient, 2-5
Baselines, A-8
AP Spine, A-1
Body ROI, A-10
Basic steps, 2-4
Edge markers, A-9
Continue scan, 2-6
Intervertebral space markers, A-6
DualFemur, B-6
Labels, A-6
End scan, 2-6
Line profile, A-7
Femur, B-1
Scan modes, A-1
Forearm, E-1
Apply Weight Adjustments, 4-7
Hand, F-1
Archive files, 2-11
Lateral Spine, C-1 Change destination and directory, 2-12
Orhopedic Hip, G-1
Patient considerations, 2-3
Start new scan, 2-6 B
Total Body, D-1 Bar 1 and bar 2, 4-7
Active port, 4-2 BMC (Bone Mineral Content)
Age adjustment, I-7 Results defined, 2-8
Age display, 4-5 BMD (Bone Mineral Density)
Age Matched Age adjustment, I-7
Results defined, 2-9 Apply weight adjustment, 4-7
Age matched Results defined, 2-8
Age display, 4-5 Weight adjustment, I-8
Age regression line, 4-7 Body ROI
Apply ethnic origin, 4-7 AP Spine, A-10
BMD comparison, I-7 Lateral Spine, C-7
Analysis Body ROI (B), C-7
Adjust scan image, 2-7
AP Spine, A-3
Basic procedures, 2-6 C
Defined, 2-6 Centering, 2-7
Display line profile, 4-4 Chronological results, 2-10
Femur, B-6 Clothing restrictions, 2-3
Forearm, E-5 Computer
Hand, F-3 ACER, H-11
Lateral Spine, C-4 CITUS, H-11
Orthopedic Hip, G-4 Common keys, 2-2
Results, 2-8 Controllers, H-11
Scan image, 2-8 Dell, H-11
DPX-IQ Operator’s Manual Index 1

DPX-IQ interface, 2-1 5mm ROI, E-11
Minimum requirements, H-10 Acquisition, E-1
Control panel, 1-2 Analysis, E-5
Baseline, E-9
Bone labels, E-8
D Edge markers, E-9
DICOM report, 2-9 Forearm length, E-3
Directory Positioner, E-4
Change archive destination, 2-12
Region lables, E-8
DB_DATA, 2-11
ROI height, E-10
DualFemur Acquisition, B-6
ROI position, E-10
Scan length, E-4
E Total ROI, E-12
Ultradistal ROI, E-10
Edge markers
AP Spine, A-9 Fracture Risk, 4-5, 4-6
Forearm, E-9 Function keys
Analyze scan, 2-1
Lateral Spine, C-9
Change default settings, 2-1
Orthopedic Hip, G-7
Database utilities, 2-1
Electrical safety, 1-10
Exit, 2-2
Emergency stop button
Location, 1-2 Print manager, 2-2
Operate, 1-9 Scan patient, 2-1
Test, 1-13 Select languag, 2-2
Exposure Select reference population, 2-2
Skin entrance, 1-5 Select scan type, 2-2
X-ray, 1-5 System quality assurance, 2-1
F G
Facilities, 1-10 Grey scale, 2-8
Failsafe circuit, 1-9
Femur
Acquisition, B-1 H
Analysis, B-6 Hand
End scan, 2-6 Acquistion, F-1
Insufficient tissue, B-9 Analysis, F-3
Monitor scan, B-5
Neck ROI position, B-9
Rice bags, B-5
I
Scan modes, B-1 IEC 950, 1-10
Filtering, 2-7 Interface, 2-1
Forearm Interpolation, 2-7
10% ROI, E-11 Isodose diagrams, 1-10
33% ROI, E-10
2 Index DPX-IQ Operator’s Manual

L Options screen, 2-1
Orthopedic Hip
Labels, 1-8 Acquisition, G-1
Language, 4-9 Analysis, G-4
Lateral Spine Edge markers, G-7
Acquisition, C-1
Extened Gruen analysis, G-11
Analysis, C-4
Gruen analysis, G-11
Body ROI, C-7, C-10
Gruen Analysis ROI, G-10
Edge markers, C-9
Line profile, G-7
Label body ROI, C-7
Longitudinal Histogram, G-13
Lateral positioner, C-4
Offset value, G-12
Space markers, C-8
Perimeter value, G-12
Leakage radiation, 1-10
Reference point, G-8
Line profile
AP Spine, A-7 Rim value, G-13
Display, 4-4 Scan modes, G-2
Orthopedic Hip, G-7 Standard analysis ROI, G-9
Lunar Standard, 4-6 Transverse Histogram, G-13
M P
Maintenance schedule Patient trending, 2-9
Archive scan files, 1-13 Personnel monitors, 1-3
Emergency stop button, 1-13 Pinch points, 1-4
Quality assurance, 1-14 Position switches, 1-2
Scan table, 1-13 Power supplies
Bertan, H-12
X-ray and Laser, 1-14
Maintenance, 1-3
Mandatory information
Database mini-menus, 4-4 Spellman, H-12
New patient, 2-5 Precision, J-1
Printing
Update, 2-5
Analysis results, 2-8
Middle ROI (M), C-7
Chronological results, 2-10
Delayed print time, 4-2
N Print manager, 4-1
Report defaults, 4-3
Normals Graph Color Bars, 4-5
Select printer and active port, 4-2
Normals Graph Type, 4-5
Fracture Risk, 4-5, 4-6
Lunar Standard, 4-5, 4-6
Q
QA (see Quality Assurance), 3-1
O Quality Assurance
Monitor precision, 3-8
Optional information
Database mini-menus, 4-4 Perform, 3-1
Display country field, 4-4 Spine phantom scan, 3-4
Warning messages, 3-3

R Analyze, 2-8
Scan modes, 1-5
Radiation Scan table, 1-1
Leakage, 1-10 Components, 1-1
Skin entrance exposure, 1-5 Control panel, 1-2
X-ray exposure, 1-5 Position switches, 1-2
Radionuclide agents, 2-3 Power specifications, H-5
Radiopaque agents, 2-3
Scan arm, 1-2
Raditation
Isodose diagrams, 1-10 Screens
Chronological Results, 2-10
Reference data, I-1
Longitudinal Histogram, G-13
Reference population
Database, I-2 Options (main screen), 2-1
Select, 4-9 Print Manager, 4-1
Registration, 1-9 Transverse Histogram, G-13
Reports Shutter, 1-3
Analysis results, 2-8 Source On message, 1-3
Default settings, 4-3 Spine phantom
Display options, 4-5 Analyze, 3-7
Language, 4-9 Scan, 3-4
Print analysis results, 2-8 Standardized BMD
Analysis results, 4-5
Printing, 4-1
Status lights (control panel), 1-2
Tissue quantitation, D-6
Stop scan, 2-6
Results values Symbols, 1-6
Age-Matched, 2-9
Area, 2-9
BMC, 2-8 T
BMD, 2-8
Total Body
Young-Adult, 2-9 Acquisition, D-1
Analysis, D-3
Cuts, D-7
S
Extended research analysis, D-8
Safety Scan modes, D-1
Electrical, 1-10
Standard analysis, D-8
Emergency stop button, 1-9
Tissue Quantitation, D-6
Laser, 1-4
Type, 2-7
Operator, 1-3
Patient, 1-4
Pregnancy restrictions, 2-3 W
Radiation, 1-5
Weight adjustment, I-8
Symbols, 1-6
System, 1-3
Scaling factor, 2-7
Scan image
Adjust, 2-7
4 Index DPX-IQ Operator’s Manual

X
X-ray generator, H-5
X-ray tube
Lunar 2288, H-7, H-8
Lunar 8022, H-7
Y
Young Adult
Results defined, 2-9
Young adult
BMD comparison, I-8
Display on printout, 4-5


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DPX-IQ ™

Software Version: 4.6

LUNAR Corporate Headquarters

LUNAR Europe N.V. LUNAR GmbH

LUNAR France LUNAR Asia/Pacific

Internet Address: http://www.lunarcorp.com

Copyright© 1995, 1996, 1997, 1998, 1999

Software License Agreement

You may not:

IV. Software Limited Warranty

ii DPX-IQ Operator’s Manual

General Product Information

Variables Affecting Scan Results

Scan results can be affected by operator technique and patient variability:

Cautions for DEXA Determinations

DPX-IQ Operator’s Manual iii

• Remain in the room with the patient while a scan is in progress.

• Restrict access to the room to authorized personnel.

• Read chapter 1 of this manual for radiation safety information.

Using the DPX-IQ Operator’s Manual

iv DPX-IQ Operator’s Manual

European Representative: Lunar Europe

Product Description: DPX Series Bone Densitometers

Report Number: E 9713748 E 01

Kenneth D. Buroker Date

vi DPX-IQ Operator’s Manual

Chapter 2: Basic Procedures

DPX-IQ Operator’s Manual Table of Contents vii

Chapter 3: Quality Assurance

Chapter 4: Default Settings

viii Table of Contents DPX-IQ Operator’s Manual

Appendix A: AP Spine Image Acquisition and Analysis

Appendix B: Femur Acquisition and Analysis

Appendix C: Lateral Spine Image Acquisition and Analysis

DPX-IQ Operator’s Manual Table of Contents ix

Appendix D: Total Body Image Acquisition and Analysis

Appendix E: Forearm Image Acquisition and Analysis

Appendix F: Hand Image Acquisition and Analysis

Appendix G: Orthopedic Hip Image Acquisition and Analysis

x Table of Contents DPX-IQ Operator’s Manual

Appendix I: Comparison to Reference Population

Appendix J: Precision and Accuracy

DPX-IQ Operator’s Manual Table of Contents xi

Chapter 1:System Overview

1.1 Scan Table Assembly

Figure 1-1. DPX-IQ scanner assembly

DPX-IQ Operator’s Manual System Overview 1-1

Figure 1-2. Scan arm control panel

Light Status (on)

1-2 System Overview DPX-IQ Operator’s Manual

• Do not put excessive pressure on the scan arm.

1.2.1 Operator Safety

X-ray Power Supply

DPX-IQ Operator’s Manual System Overview 1-3

Figure 1-3. Pinch points

1-4 System Overview DPX-IQ Operator’s Manual

• Scattered Radiation Exposure: The primary source of radiation exposure to

Typical Scan Typical Typical Current Skin

DPX-IQ Operator’s Manual System Overview 1-5

Typical Scan Typical Typical Current Skin

Lateral Spine Medium 76 3.00 12 x 12 270 810 77 1.2 x 1.2

Total Body Screening 76 0.15 54 x 150 290 44 0.1 4.8 x 19.2

Hand Detail 76 0.15 3.8 x 4.3 450 68 1.2 1.2 x 1.4