Use of Bioimpedance Spectroscopy as a Surrogate for Bone Mineral Content in Oncology Patients: Practical Application of the SOZO Device

Document Type

Conference Proceeding

Publication Date


Publication Title

Cancer Research


Background: Many cancer patients, particularly those with breast or prostate cancer, receive hormonal manipulation therapies that can significantly impact their bone mineral content (BMC), potentially leading to osteoporotic associated life-threatening fractures, particularly given the median age of patients diagnosed with these malignancies. Bioimpedance spectroscopy (BIS) is a non-invasive tool that measures fluid and body composition values including skeletal muscle mass (SMM) and fat free mass (FFM). BIS devices can be used easily and quickly at point-of-care at the time of vital signs, with the patient standing on the device placing their hands and feet on metal electrodes and a reading obtained in less than a minute. Multiple previous studies have shown strong correlation between SMM and BMC, suggesting that a BIS reading can provide a reproducible, simple and quick estimate of BMC. To that end, we present initial findings correlating BIS readings obtained with a SOZO device (ImpediMed) with dual x-ray absorptiometry (DXA) to determine if BIS readings can be applied as an accurate point of care surrogate measure of BMC. Materials and Methods: Concurrent BIS measures and DXA scans, were performed in 75 healthy volunteers and 93 cancer patients (during and after cancer treatment) Group 1: 75 healthy volunteers (32 male, 43 female), mean age 27.4 (18-66 years); Group 2: 44 patients undergoing cancer treatment (11 male, 33 female; 18 breast, 7 lung, 4 endometrial, 4 colorectal, 4 prostate, 7 other), mean age 61.3 (38-79 years); and Group 3: 49 patients participating in a 12-week exercise program after cancer treatment (15 males, 34 females; 22 breast, 6 prostate, 3 colorectal, 3 endometrial, 2 lung, 13 other), mean age 57.8 (19-79 years). The healthy volunteers in Group 1 were further randomized into two subsets. Group A was used to develop a BIS predicted BMC algorithm and Group B was used to validate the algorithm. Results: The Pearson correlation coefficients (R) for DXA BMC and SOZO SMM were strong for all 3 groups (R=0.92, 0.85, and 0.80 for Groups 1, 2, and 3, respectively). Stepwise multiple linear regression for BMC was performed for Group A based on BIS parameters. For Group A, SMM resulted in a multiple correlation coefficient of 0.94 (P< 0.0001). The correlation coefficient between the BIS predicted BMC and DXA BMC of Group B was 0.87 (P< 0.0001, 95%CI 0.78-0.93). For Groups 2 and 3 combined, the correlation coefficient between the BIS predicted BMC and DXA BMC was 0.82 (P< 0.0001, 95%CI 0.73-0.87). Conclusions: Concurrent measures of SMM obtained with BIS using SOZO correlated strongly with DXA BMC, demonstrating that SOZO SMM may be a useful surrogate in the clinic to provide a quick, easy, and reproducible indicator of change in BMC, particularly for those patients undergoing treatments that may affect BMC. Tracking SMM during or after cancer treatment with SOZO may provide an estimate of changes in BMC allowing clinicians to obtain additional diagnostic testing and/or consider treatment modifications.




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2022 San Antonio Breast Cancer Symposium, December 6-10, 2022, San Antonio, TX