Osteoporosis Assessment 

(DXA) Industry: Review of 

Proposed Accessibility 

Standards

U.S. Access Board

May 8, 2012

Atlanta, Georgia

Glenn Nygard, Dir. Engineering R&D

Skeletal Health Division of Hologic, Inc.
Diagnostic Equipment - DXA

Current State

• Osteoporosis assessment measures bone mineral density using 

Dual-energy X-ray Absorptiometry (DXA) technology.

• Manufacturers are committed to give all patients access to DXA 

technology; for treating osteoporosis and other conditions.

• DXA’s diagnostic quality and the safety of easy, dignified patient 

scans are part of the ongoing commitment of all device makers.

• Other DXA applications include body composition analysis and 

discovering aortic calcification.

• DXA accessibility standards don’t exist today. Standards for structural 

strength, material choice & known hazards are consistently applied.
Diagnostic Equipment – DXA

Current State

Note large X-ray source, beam forming and motion sub-systems under the 

patient on the left.

Also, the table must pass X-rays and must be a single uniform piece.
Diagnostic Equipment – DXA

Current State

Patient Access to Current Equipment

• Table heights of 25”, or more may require transfer assistance 

• The “C-arm” may be moved to the table-end for transfer.

• A patient who can’t get on the table may get a forearm scan.
Diagnostic Equipment - DXA

Question 2. What other barriers that affect the 

accessibility and usability of medical diagnostic 

equipment should be addressed in future updates to 

the standards?

• The DXA exam room can limit patient access. Today, the floor space to 

accommodate a ramp is not a requirement.
Diagnostic Equipment - DXA

Question 8: To what extent does diagnostic equipment 

currently incorporate features that conform to the technical 

criteria proposed in Chapter M3?

Some features, such as transfer surface size now comply, additional 

assessment of proposed table-height requirements in the context of 

DXA is needed. 
Diagnostic Equipment - DXA

Question 9. If diagnostic equipment does not currently incorporate features 

that conform to all the technical criteria proposed in Chapter M3, which 

technical criteria can be easily incorporated into the design or redesign and 

manufacture of equipment with little difficulty or expense? 

• Reducing table height a few inches might be done with little difficulty.

• A ramp to reduce table-height could be sold as an accessory. 

Which technical criteria would have the greatest incremental costs on the 

design or redesign and manufacture of equipment? 

• Table height to transfer surface appears to be adjustable & 17” min.

Include estimates of the incremental costs, where possible. 

• The adjustable lifts employed in some systems cost several thousand 

dollars for the material, alone.
Diagnostic Equipment - DXA

Question10. How often is diagnostic equipment redesigned?

DXA equipment system-level design changes are multi-year projects

Would incorporating features that conform to the technical criteria 

proposed in Chapter M3 in the planned redesign of equipment lessen 

the economic and technical impacts?

A planned redesign to meet proposed technical criteria lessens the 

cost & project risk when compared to an unplanned redesign.
Moving Forward

• DXA manufacturers are committed to providing medical 

device access for all patients and are thankful for the 

opportunity to participate in standards development with 

the United States Access Board.

Thank You