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Steven M. Petak, MD, MACE, JD, FCLM
Director of the Osteoporosis Center and Bone Densitometry Unit
Clinical Assistant Professor
University of Texas Medical School at Houston

Equipment Requirements
PC: Win7/Win8, Pentium processor or faster, at least 2GB RAM, Internet Explorer version 10/11, Mozilla FireFox version 33.0.

MAC: OS version 10.8/10.9, Intel processor, at least 2GB RAM, Safari version 6.2, FireFox 33.0

DXA and Body Composition
Emerging Clinical Applications

Recording of a live webinar presented on February 15, 2012

Format: Archived Webinar
Credit:  1.0 AMA PRA Category 1

Credit:  1.0 ARRT Category A
Fee for Credit Certificate: $0


A certified one-hour educational activity for radiologists, radiologic technologists, geriatricians, bariatricians, primary care physicians, and healthcare professionals who work with obese and elderly patients.

To enroll in this activity, click the ENROLL NOW icon to the left.

DXA and Body Composition
Emerging Clinical Applications

Course Overview
Dual-emission x-ray absorptiometry (DXA) was primarily developed for the diagnosis of osteoporosis and is widely utilized in clinical practice. In research applications, DXA is the recognized gold standard for assessing body composition as it is highly precise, accessible, and requires a short scanning time. However, DXA is underutilized in clinical practice for body composition analysis because many clinicians are unaware of this emerging clinical application.[1]

Consider the following:

  • Overweight and obesity-conditions affect an estimated 97 million Americans and are the second leading cause of preventable death in the United States [2,3]. Physician supervision is necessary to detect and treat weight-related medical conditions.[4]
  • According to a report from the U.S. Census Bureau, by 2050, the number of people 90 and older may reach 9 million. Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty, and increased health care costs. Data support a research approach on preventive and treatment strategies for osteoporosis and sarcopenia targeting both bone and muscle tissues.[5]

While imprecise, most non-DXA body composition analysis techniques are adequate for treating and managing the general patient population. However, many of the routine methods currently in clinical use are not precise enough to differentiate the percentage of fat, lean muscle, and bone necessary for treating and managing certain diseases and patient cohorts, eg, bariatric patients, some pediatric and geriatric patients, and those patients with wasting diseases, eating disorders, and digestive disorders.[3,6]

[1] Blue Cross of Idaho website. Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition. Available at: Accessed December 2, 2011.

[2] Endocrine Today.  DXA more accurately predicts obesity compared with BMI. American Association of Clinical Endocrinologists 19th Annual Meeting.  Available at: Accessed October 25, 2011.

[3] International Society of Clinical Densitometry website.  DXA Body Composition Analysis Course.  Available at: Accessed November 15, 2011.

[4] American Society of Bariatric Physicians.  Better than a BMI? New obesity scale proposed. Available at: Accessed November 17, 2011.

[5]  Di Monaco M, Vallero F, Di Monaco R, Tappero R.  Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture.  Arch Gerontol Geriatr. 2011 Jan-Feb;52(1):71-74.  Epub 2010 Mar 5.

[6] Exercise and Physical Fitness Page.  Georgia State University.  Available at: Accessed November 15, 2011.

Educational Objectives
At the conclusion of this activity, participants should be better able to:

  • Assess the role of dual-energy x-ray absorptiometry (DXA) in the evaluation of body composition
  • Describe the pitfalls and challenges in using DXA for identifying at-risk patients
  • Compare DXA to other methods of body composition analysis used in the clinical setting
  • Identify the patient populations that would best benefit from body composition analysis

Accreditation & Credit
This enduring material has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and the International Center for Postgraduate Medical Education (ICPME). PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

SA-CME: This activity meets the criteria for self-assessment toward the purpose of fulfilling requirements in the American Board of Radiology (ABR) Maintenance of Certification Program.

The European Accreditation Council for CME (EACCME®)
The UEMS-EACCME® has mutual recognition agreements with the American Medical Association (AMA) for live events and e-learning materials. For more information go to

Radiologic Technologists
This program has been approved by the American Society of Radiologic Technologists (ASRT) for 1.0 hour of ARRT Category A continuing education credit.

How to Participate

There are no fees to participate in this activity. Each participant will need a computer with internet access.

  • Click the blue link. Complete the precourse evaluation and click SUBMIT.
  • Once the precourse evaluation is submitted, click on the blue link again to view the course.
  • Click on PLAYBACK. To view the streaming video, you may have to download the WebEx Player or Java.

How to Recieve Credit

  • View the entire one-hour session. The question-and-answer period at the end of the lecture is not required to receive credit.
  • At the conclusion of the lecture, close the WebEx Player window. You will be redirected to the ICPME website.
  • From the COURSE HOME page, click the buttons for POSTTEST and for EVALUATION.
  • A passing grade of at least 75% is required to receive credit.  You may take the test up to three times.
  • Upon receipt of a passing grade, you will be able to print a credit certificate from your account on

Faculty Biography

Steven M. Petak, MD, MACE, JD, FCLM
Director of the Osteoporosis Center and Bone Densitometry Unit
Clinical Assistant Professor
University of Texas Medical School at Houston

Dr. Petak graduated from the University of Illinois Abraham Lincoln School of Medicine in 1979. He completed his internship and residency training in Internal Medicine at the University of Texas Medical School at Houston, serving as Chief Medical Resident and Instructor in Medicine. In 1984 he was a Fellow in Endocrinology and the recipient of a five-year physician-scientist award by the National Institutes of Health. In 1985 he became Assistant Professor in the Department of Internal Medicine, Division of Endocrinology and Department of Pharmacology at the University of Texas Medical School at Houston. He obtained his law degree at the University of Houston Law Center in 1996 magna cum laude. He is master of the American College of Endocrinology (MACE) and fellow of the American College of Legal Medicine (FCLM).

Dr. Petak is a past president of the American College of Endocrinology (2009-2010). Dr. Petak is also past President of the International Society of Clinical Densitometry and past President of the American Association of Clinical Endocrinologists.  He has authored or coauthored publications, reviews, and abstracts in the fields of osteoporosis, reproductive medicine, and general endocrinology. He chaired the Hypogonadism Task Force for the American Association of Clinical Endocrinologists, authored the guidelines on the Diagnosis and Management of the Hypogonadal Adult Male, and was a member of the guidelines writing group for post-menopausal osteoporosis. Dr. Petak has also served as Chairman of the Osteoporosis Advisory Committee of the Texas Department of Health. He is a bone densitometry and endocrinology consultant to NASA-JSC.

Disclosure of Conflicts of Interest

The Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty has reported NO financial relationship or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Steven M. Petak, MD, MACE, JD, FCLM

The following planners and managers have reported NO financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Trace Hutchison, PharmD               
Samantha Mattiucci, PharmD
Linda McLean, MS     
Victoria Phoenix, BS
Lisa Schleelein, MEd
Patricia Staples, MSN, NP-C, CCRN

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, ICPME and Hologic, Inc., do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, ICPME and Hologic, Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

For questions regarding this program, please contact ICPME:
Phone: 607-257-5860 x10

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This activity is supported by an independent grant from