Credentials of Technologists Performing REMS Echolight Scans

You should always ask about the education and training of the technician performing your REMS Echolight scan. I recently had an online chat with a bot at Precision Bone Imaging, which performs scans at OsteoStrong facilities and other locations in Arizona, California, and Colorado.

I asked: 

What are the credentials of techs performing REMS scans?

The bot answered: 

Our technicians who administer REMS scans at our locations are trained ultrasound technicians. They not only have a background in ultrasound technology but also receive specialized training specific to REMS scanning. This additional training ensures they can perform accurate scans and guide patients smoothly through the process. 

Precision Bone Imaging, 3301 E Indian School Rd, Suite 101, Phoenix, AZ 85018, 

phone (888) 415-7377

https://www.precisionboneimaging.com/

https://app.acuityscheduling.com/schedule.php?owner=32710610

To become an ultrasound technician, you'll need to:

Complete high school

• You'll need a high school diploma or GED to enroll in a college or university program. 

  
  

  Earn an associate's or bachelor's degree
• You can earn an associate's degree in Diagnostic Medical Sonography from an accredited college or university. You can also earn a bachelor's degree in sonography. 

  
  

  Complete a certificate program
• You can complete a one-year certificate program in sonography at a college or hospital. 

  
  

  Complete clinical education
• You'll need to complete clinical education, where you'll apply your formal education in a hands-on setting. 

  
  

  Pass licensing exams
• You'll need to pass the proper licensing exams to become a licensed ultrasound technician.

  
  

  Become certified
• You can become certified through the American Registry for Diagnostic Medical Sonographers (ARDMS) or the American Registry of Radiologic Technologists (ARRT).

  
  

  Some courses you might take in an ultrasound technician program include:

Anatomy and physiology, Medical terminology, Applied sciences, General physics, Pharmacology, and Echocardiography pathology.

Many employers also require candidates to complete basic life support training. 

Echolight & NASA

 News release from Echolight Medical:

NASA NOW EQUIPPED WITH ECHOLIGHT DEVICES FOR BONE HEALTH MONITORING IN SPACEFLIGHT SIMULATIONS

 

HOUSTON, Oct. 21, 2024 /PRNewswire/ — Echolight, a global innovator in bone densitometry, announced that NASA is using its proprietary REMS (Radiofrequency Echographic Multi Spectrometry) technology to monitor bone changes in a human bedrest study and to assess the effects of unloading on bone mass given the paramount importance of Bone Health in space too.

Through a simple ultrasound scan of axial anatomical sites such as the spine and femur, the REMS innovative technology measures bone density and microarchitecture without using the radiation of traditional x-ray scans. This radiation-free technology allows scientists to perform repeated scans for monitoring bone health over time. In addition, the ability to automatically exclude artifacts commonly present with other densitometry procedures yields a highly reliable diagnostic assessment.

“Echolight is pleased with this additional milestone in the US adoption of REMS devices, where the diagnostic system for the unique, personalized and patient-centered assessment of bone health has registered a very high interest among the US medical community sharing the intent to reduce fragility fractures,” explained Sergio Casciaro, Echolight S.p.A. CEO and founder.

Prof. Aenor Sawyer, director of UCSF Skeletal Health Service and of UC Space Health, reported “Echolight technology provides a number of potential benefits for possible use during spaceflight missions including its portability (the unit is the size of a small suitcase), fast scan time of under 10 minutes, edge analytics, and the ability to scan frequently with no harmful radiation effects. NASA is currently unable to assess the bone loss of each astronaut occurring in spaceflight and make real-intime adjustments to their countermeasures. This will be increasingly important on longer missions such as those to the Moon and Mars, and REMS could potentially provide this critical in-mission information.”

Echolight was established in Italy with head office in Lecce, and in 2020 opened its offices in the United States. Since then, its sales network has grown to more than 40 distributors and several hundreds of satisfied customers across the world who have adopted the innovative R.E.M.S. technology for assessing the bone condition of their patients.

Created as a spin-off of the Italian National Research Council, Echolight is at the forefront of medical innovation, introducing new cutting-edge solutions to contribute to human wellbeing. It has been awarded all the standard certificates: UNI CEI EN ISO 13485: 2016, Quality Management System UNI EN ISO 9001: 2015, CE mark, FDA clearance, and other major certificates worldwide for innovative solutions considered as the best practice in bone health for personalized medicine.

Dexa Bone Density Axial Skeleton with TBS on 18 November 2024

Below are the results of my latest DXA scan and my first TBS. I am so excited about my TBS showing normal bone microarchitecture! 

The only value that was slightly worse than my previous scan of 18 August 2022, was my left femoral neck BMD of 0.728 g/cm2 and a T-score of -1.1 (osteopenia) in 2024, compared to left femoral neck BMD of 0.741 g/cm2 and a T-score of -1.0 (normal density) in 2022. 

For almost a year and a half (3/5/2023 through 8/17/2024), I reduced my daily dosage of strontium citrate from 682 mg of strontium per day to 341 mg 4X per week and 682 mg 3X per week. I resumed the full dosage on 8/18/2024. 

Impression

Based on BMD criteria, the patient has osteopenia. 

Based on the lumbar spine TBS data, the patient has a normal bone microarchitecture compared to the reference population. 

The patient's associated BMD and TBS values suggest a moderate resilience to fracture. 

Follow up with DEXA and TBS: 2 years 

WHO CRITERIA FOR T-SCORES: 

< or = -2.5 = osteoporosis 

< -1.0 and -2.5 = osteopenia

> or = -1.0 = normal density 

TBS scores: 

>1.31: normal bone microarchitecture

<1.31 and >1.23: partially degraded microarchitecture 

<1.23: degraded microarchitecture 

Narrative

EXAM: DXA AXIAL 

INDICATION: Postmenopausal. Risk factors for osteoporosis include [advanced age 

COMPARISON: 8/18/2022 

FINDINGS: 

Spine: Total BMD of the spine L1-4 is 1.129 g/cm2, with a T-score of 0.7 and a Z-score of 3.2. The lumbar spine trabecular bone score (TBS) is 1.521.

Left Femoral Neck: BMD is 0.728 g/cm2, with a T-score of -1.1 and a Z-score of 1.1. 

Left Total Hip: BMD is 0.842 g/cm2, with a T-score of -0.8 and a Z-score of 1.1. 

Right Femoral Neck: BMD is 0.754 g/cm2, with a T-score of -0.9 and a Z-score of 1.3. 

Right Total Hip: BMD is 0.900 g/cm2, with a T-score of -0.3 and a Z-score of 1.5. 

Diffuse increased 10% in the lumbar spine 

FRAX (adjusted for TBS if available) evaluation calculates 10-year probability of fracture: 

Major Osteoporotic: 8.7% 

Hip: 1.7%

Strontium, Osteoarthritis, and Reduced Dose of Strontium Citrate

Some research has suggested that strontium may boost the formation of collagen and cartilage in joints. In clinical studies, strontium ranelate seemed to reduce the progression of osteoarthritis (OA).

A year and a half ago, I reduced my daily dosage of strontium citrate from 682 mg strontium to 341 mg 4X per week and 682 mg 3X per week. Since then, I have developed the following:

1. A myxoid cyst, or digital mucus cyst, on my left thumb: A mucus cyst is a small, noncancerous bump usually found near a joint at the end of a finger. Such cysts are often found on the fingers of people with OA. Hot compresses may help shrink these cysts. 

2. Temporomendibular joint disorder (TMD): I have had a few, mild, temporary flare-ups of TMD in years past, but this flare-up is quite painful and not easing up after a couple of weeks. I may have brought it on by eating dry papaya slices, which were tough and chewy. I may be clenching my jaws at night due to stress. The pain is worse just after I wake up in the morning. Most likely, my TMJ disorder is due to progressing OA. 

Because of these two physical changes, I am resuming strontium citrate (SrC) at the full dose of 682 mg elemental strontium per day. Also, there was no reason to cut back the dosage in the first place because I was not having any adverse events from the strontium, and osteoporosis is a chronic condition--as is osteoarthritis. I didn't realize I have OA until I reduced my SrC, which was probably keeping the disease in check. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040865/

https://academic.oup.com/mr/article-abstract/24/6/881/6302017?redirectedFrom=fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791090/

How to Prepare for an Echolight REMS Scan

1. Wear loose fitting shorts. During cold weather, you can bring shorts with you.

2. Avoid eating a meal or drinking 2-3 hours before your scan.

3. Use the bathroom before the scan. 

Instructions courtesy of Ray Hinish, Pharm.D., Echolight Maryland at OsteoCoach

Sometimes Less Is More

I take several supplements. Recently, I have reduced the dosage or eliminated some of them.

AOR Strontium Support II, 341 mg strontium (from citrate)/capsule

Reduced from two capsules (682 mg Sr)/day to one capsule/day for four days/week and two capsules/day for three days/week

Reason: My DXA scan of August 18, 2022 showed "normal" bone density. Due to the bone strontium effect, my BMD is more likely at the osteopenia stage. Sure beats osteoporosis! 

Magnesium glycinate 

For about a year and a half, I took one capsule per day of Innate Vitality Magnesium Glycinate, 500 mg/capsule. The label does not give the amount of elemental magnesium, which would be 70.5 mg (14.1% of 500 mg magnesium glycinate). I think it is misleading to not provide the amount of Mg. I switched to Doctor's Best High Absorption Magnesium Glycinate Lysinate, which has 100 mg of Mg from 1000 mg magnesium lysinate glycinate chelate per tablet.  

Eliminated magnesium glycinate 

Reason: I was having multiple bowel movements with Doctor's Best, although not with Innate Vitality. There is Mg in my calcium supplement and my multivitamin. I also eat magnesium-rich foods. My husband is still taking Doctor's Best magnesium.

Horbaach Sublingual Methylcobalamin (Vitamin B-12), 5000 mcg/tablet

I was taking 5000 mcg/day, which is a huge amount. I knew it was a huge amount, but my husband needs that amount of B-12 to keep from getting canker sores. He got recurrent sores until he found out about B-12 for canker sores from a scientific article. More recently, I read that, in some people, B-12 can worsen acne because Propionibacterium acnes (P. acnes) need B-12. I have always had acne-prone skin. 

Reduced from one tablet/day to one tablet/week. My husband still takes it daily.

Reason: Worsening acne flareups, and recommended doses are much lower than I was taking

Probiotic, Various Brands

Eliminated probiotic. 

Reason: Not sure the ones I tried were helping my gas and bloating. For many years, I used Nature's Way Primadophilus Bifidus, which seemed to help my digestion. It had to be mailed overnight with a cold pack, but many vendors, such as Amazon, are not keeping it cold.  

Digestive Enzymes, Various Brands

Eliminated digestive enzymes

Reason: None of the various brands made a noticeable difference for my gas and bloating. I am not lactose intolerant. If I were, I would take Lactaid, or a generic lactase supplement, as my husband does.