How do you screen (imaging, modality) for bone density changes following oncologic treatment in childhood cancer survivors?

Certain survivors of childhood cancer are at risk for reduced bone mineral density, especially those exposed to extensive corticosteroids or radiation, hypogonadism, growth hormone deficiency, and those who have had reduced weight-bearing/mobility for an extended period of time. It is important to screen for low bone mineral density.

Both the Children's Oncology Group's Long-Term Follow-up Guidelines and the International Guideline Harmonization Group recommend screening using DXA imaging. Specifically, survivors should be screened with DXA of the posterior-anterior spine (L1-L4), total body less head, and total hip.

While QCT screening is a potential alternative modality, it is not recommended at this time due to incomplete data on the cor...