Training requirements for DXA technologists in the United States

The purposes of this study were to determine, by state, the requirements for dual-energy X-ray absorptiometry (DXA) operators' training, knowledge of these state requirements, and factors that predicted state and International Society of Clinical Densitometry (ISCD) certification of DXA technologists. Seventeen states required registered technologist (RT) certification or authorized/licensed limited certification for DXA operators, 16 had no certification requirements, 12 required RT certification, and 5 had state-specific requirements. There were 9745 surveys mailed to DXA users including 50% Hologic Inc., 50% GE Lunar, and 100% Norland; 3148 surveys are included in this analysis. Among responders who indicated that their state did not have any certification requirements (n = 1673), 1095 (65.5%) were incorrect; there were requirements. Possession of state and ISCD certification was significantly correlated with the number of patients scanned per week (p ≤ 0.05), the number of technologists employed within a center (p < 0.01), and the subspecialty of the practitioner (p ≤ 0.02). Our study uncovered a lack of uniformity among states with respect to central DXA operator training requirements. Additionally, in those states with requirements, DXA operators were often unaware of these requirements. Uniform national training requirements for central DXA operators to ensure adequate DXA scan quality are urgently needed.