The Science Behind REMS

SonoHealth CA uses REMS (Radiofrequency Echographic Multi-Spectrometry)—an advanced, radiation-freeultrasound-based technology that evaluates bone status by analyzing raw ultrasound radiofrequency signals. REMS has been studied in peer-reviewed research, including comparisons with DXA and studies evaluating fracture-risk prediction.

What the evidence is designed to answer

Most people want to know three things:

  1. Does REMS agree with the current reference standard (DXA) for BMD assessment?

  2. Is REMS reliable and reproducible when performed correctly?

  3. Do REMS-derived results relate to what matters most—fracture risk?

The published literature addresses these questions through diagnostic accuracy studies, multicenter evaluations, and prospective follow-up studies.

What peer-reviewed studies generally show

Diagnostic agreement with DEXA
Studies comparing REMS with DEXA report good accuracy and precision for lumbar spine and femoral neck assessment, with an important note: proper acquisition and operator training matter.

Multicenter performance in real-world clinical settings
A large European multicenter evaluation assessed REMS diagnostic accuracy against DEXA across multiple sites and populations, supporting REMS performance beyond a single-center setting.

Fracture-risk prediction
Prospective research supports REMS-derived measures as predictors of incident fragility fractures in studied populations—an outcome that is more clinically meaningful than a number in isolation.

Why DEXA results can sometimes be misleading

DEXA is widely used and clinically valuable, but lumbar spine measurements can be influenced by artifacts. Degenerative changes (including osteophytes) and calcifications can contribute to falsely elevated spine BMD estimates, which may reduce sensitivity for detecting osteoporosis in some individuals.

This is not an argument against DEXA. It is a reason many patients and clinicians seek additional clarity—especially when results do not match the clinical picture.

FDA clearance

The EchoS Family device (Echolight) has an FDA 510(k) clearance listing in the United States under the classification “Bone Sonometer.”
Additional EchoS-related submissions exist for associated modules/software.

IMPORTANT LIMITATIONS

What responsible providers acknowledge

Operator technique matters
Published research notes that operator training and correct acquisition are important to minimize erroneous acquisitions and support full clinical practicability.

No single test diagnoses your entire future
Bone health decisions should incorporate clinical history, risk factors, and (when appropriate) physician guidance. REMS provides valuable assessment data; it does not replace medical care.

OUR APPROACH AT SONOHEALTH CA

Evidence-based, client-first

SonoHealth CA’s process is designed to support scan quality and understanding:

  • Consistent intake and identity verification to support accurate reporting
  • Guided acquisition performed with a precision-first standard
  • Clear review of results in plain English
  • Practical next-step guidance you can take to your physician or use for your plan

Selected peer-reviewed references

Links are provided for transparency so you can review the evidence directly.

  • REMS diagnostic accuracy vs DXA (lumbar spine & femoral neck)

    Di Paola et al. (PubMed)

  • European multicenter diagnostic accuracy evaluation (REMS vs DXA)

    Cortet et al. (PubMed)

  • Prospective fracture prediction using REMS T-score (5-year follow-up)

    Adami et al. (PubMed)

  • Fragility Score (REMS-based) prediction of incident fragility fractures (5 years)

    Pisani et al. (PubMed / Full text)

  • DXA lumbar spine artifact: degenerative changes can mislead BMD interpretation

    Tenne et al. (PubMed)

  • DXA lumbar spine artifact: vascular/aortic calcification can elevate BMD

    Gupta et al. (PubMed / Full text)

  • FDA 510(k) clearance listing — EchoS Family (Echolight)

    K202514 (FDA) • Decision Summary (PDF)

FDA 510(k) listing (EchoS Family): https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?id=K202514 FDA 510(k) PDF (K202514): https://www.accessdata.fda.gov/cdrh_docs/pdf20/K202514.pdf PubMed (Di Paola et al., REMS vs DXA): https://pubmed.ncbi.nlm.nih.gov/30178159/ REMS fracture prediction (Adami et al., 2020, ScienceDirect): https://www.sciencedirect.com/science/article/pii/S8756328220300776 REMS European multicenter context (Cortet et al., 2021, ScienceDirect): https://www.sciencedirect.com/science/article/pii/S8756328220305743 REMS literature review (PMC 2023): https://pmc.ncbi.nlm.nih.gov/articles/PMC10217295/