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Minonzio JG, Ramiandrisoa D, Schneider J, Kohut E, Streichhahn M, Stervbo U, Wirth R, Westhoff TH, Raum K, Babel N. Bi-Directional Axial Transmission measurements applied in a clinical environment. PLoS One 2022; 17:e0277831. [PMID: 36584002 PMCID: PMC9803229 DOI: 10.1371/journal.pone.0277831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/03/2022] [Indexed: 12/31/2022] Open
Abstract
Accurate measurement of cortical bone parameters may improve fracture risk assessment and help clinicians on the best treatment strategy. Patients at risk of fracture are currently detected using the current X-Ray gold standard DXA (Dual XRay Absorptiometry). Different alternatives, such as 3D X-Rays, Magnetic Resonance Imaging or Quantitative Ultrasound (QUS) devices, have been proposed, the latter having advantages of being portable and sensitive to mechanical and geometrical properties. The objective of this cross-sectional study was to evaluate the performance of a Bi-Directional Axial Transmission (BDAT) device used by trained operators in a clinical environment with older subjects. The device, positioned at one-third distal radius, provides two velocities: VFAS (first arriving signal) and VA0 (first anti-symmetrical guided mode). Moreover, two parameters are obtained from an inverse approach: Ct.Th (cortical thickness) and Ct.Po (cortical porosity), along with their ratio Ct.Po/Ct.Th. The areal bone mineral density (aBMD) was obtained using DXA at the femur and spine. One hundred and six patients (81 women, 25 men) from Marien Hospital and St. Anna Hospital (Herne, Germany) were included in this study. Age ranged from 41 to 95 years, while body mass index (BMI) ranged from 16 to 47 kg.m-2. Three groups were considered: 79 non-fractured patients (NF, 75±13years), 27 with non-traumatic fractures (F, 80±9years) including 14 patients with non-vertebral fractures (NVF, 84±7years). Weak to moderate significant Spearman correlations (R ranging from 0.23 to 0.53, p < 0.05) were found between ultrasound parameters and age, BMI. Using multivariate Partial Least Square discrimination analyses with Leave-One-Out Cross-Validation (PLS-LOOCV), we found the combination of VFAS and the ratio Ct.Po/Ct.Th to be predictive for all non traumatic fractures (F) with the odds ratio (OR) equals to 2.5 [1.6-3.4] and the area under the ROC curve (AUC) equal to 0.63 [0.62-0.65]. For the group NVF, combination of four parameters VA0. Ct.Th, Ct.Po and Ct.Po/Ct.Po, along with age provides a discrimination model with OR and AUC equals to 7.5 [6.0-9.1] and 0.75 [0.73-0.76]. When restricted to a smaller population (87 patients) common to both BDAT and DXA, BDAT ORs and AUCs are comparable or slightly higher to values obtained with DXA. The fracture risk assessment by BDAT method in older patients, in a clinical setting, suggests the benefit of the affordable and transportable device for the routine use.
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Affiliation(s)
- Jean-Gabriel Minonzio
- Sorbonne Université, INSERM UMR S 1146, CNRS UMR 7371, Laboratoire d’Imagerie Biomédicale, Paris, France
- Escuela de Ingeniería Informática, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
- * E-mail:
| | | | - Johannes Schneider
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
| | - Eva Kohut
- Medical Clinic I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Melanie Streichhahn
- Medical Clinic I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Ulrik Stervbo
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Rainer Wirth
- Department for Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | - Timm Henning Westhoff
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
| | - Kay Raum
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
| | - Nina Babel
- Berlin-Brandenburg School for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Germany
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr University, Bochum, Herne, Germany
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Tran TNHT, Le LH, Ta D. Ultrasonic Guided Waves in Bone: A Decade of Advancement in Review. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2875-2895. [PMID: 35930519 DOI: 10.1109/tuffc.2022.3197095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of guided wave ultrasonography as a means to assess cortical bone quality has been a significant practice in bone quantitative ultrasound for more than 20 years. In this article, the key developments within the technology of ultrasonic guided waves (UGW) in long bones during the past decade are documented. The covered topics include data acquisition configurations available for measuring bone guided waveforms, signal processing techniques applied to bone UGW, numerical modeling of ultrasonic wave propagation in cortical long bones, formulation of inverse approaches to extract bone properties from observed ultrasonic signals, and clinical studies to establish the technology's application and efficacy. The review concludes by highlighting specific challenging problems and future research directions. In general, the primary purpose of this work is to provide a comprehensive overview of bone guided-wave ultrasound, especially for newcomers to this scientific field.
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Estimation of Thickness and Speed of Sound for Transverse Cortical Bone Imaging Using Phase Aberration Correction Methods: An In Silico and Ex Vivo Validation Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Delay-and-sum (DAS) beamforming of backscattered echoes is used for conventional ultrasound imaging. Although DAS beamforming is well suited for imaging in soft tissues, refraction, scattering, and absorption, porous mineralized tissues cause phase aberrations of reflected echoes and subsequent image degradation. The recently developed refraction corrected multi-focus technique uses subsequent focusing of waves at variable depths, the tracking of travel times of waves reflected from outer and inner cortical bone interfaces, the estimation of the shift needed to focus from one interface to another to determine cortical thickness (Ct.Th), and the speed of sound propagating in a radial bone direction (Ct.ν11). The method was validated previously in silico and ex vivo on plate shaped samples. The aim of this study was to correct phase aberration caused by bone geometry (i.e., curvature and tilt with respect to the transducer array) and intracortical pores for the multi-focus approach. The phase aberration correction methods are based on time delay estimation via bone geometry differences to flat bone plates and via the autocorrelation and cross correlation of the reflected ultrasound waves from the endosteal bone interface. We evaluate the multi-focus approach by incorporating the phase aberration correction methods by numerical simulation and one experiment on a human tibia bone, and analyze the precision and accuracy of measuring Ct.Th and Ct.ν11. Site-matched reference values of the cortical thickness of the human tibia bone were obtained from high-resolution peripheral computed tomography. The phase aberration correction methods resulted in a more precise (coefficient of variation of 5.7%) and accurate (root mean square error of 6.3%) estimation of Ct.Th, and a more precise (9.8%) and accurate (3.4%) Ct.ν11 estimation, than without any phase aberration correction. The developed multi-focus method including phase aberration corrections provides local estimations of both cortical thickness and sound velocity and is proposed as a biomarker of cortical bone quality with high clinical potential for the prevention of osteoporotic fractures.
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Bochud N, Laugier P. Axial Transmission: Techniques, Devices and Clinical Results. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1364:55-94. [DOI: 10.1007/978-3-030-91979-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Michimoto I, Miyashita K, Suzuyama H, Yano K, Kobayashi Y, Saito K, Matsukawa M. Simulation study on the effects of cancellous bone structure in the skull on ultrasonic wave propagation. Sci Rep 2021; 11:17592. [PMID: 34475422 PMCID: PMC8413454 DOI: 10.1038/s41598-021-96502-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 08/11/2021] [Indexed: 12/15/2022] Open
Abstract
The transcranial Doppler method (TCD) enables the measurement of cerebral blood flow velocity and detection of emboli by applying an ultrasound probe to the temporal bone window, or the orbital or greater occipital foramina. TCD is widely used for evaluation of cerebral vasospasm after subarachnoid hemorrhage, early detection of patients with arterial stenosis, and the assessment of brain death. However, measurements often become difficult in older women. Among various factors contributing to this problem, we focused on the effect of the diploe in the skull bone on the penetration of ultrasound into the brain. In particular, the effect of the cancellous bone structure in the diploe was investigated. Using a 2D digital bone model, wave propagation through the skull bone was investigated using the finite-difference time-domain (FDTD) method. We fabricated digital bone models with similar structure but different BV/TV (bone volume/total volume) values in the diploe. At a BV/TV of approximately 50–60% (similar to that of older women), the minimum ultrasound amplitude was observed as a result of scattering and multiple reflections in the cancellous diploe. These results suggest that structural changes such as osteoporosis may be one factor hampering TCD measurements.
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Peralta L, Maeztu Redin JD, Fan F, Cai X, Laugier P, Schneider J, Raum K, Grimal Q. Bulk Wave Velocities in Cortical Bone Reflect Porosity and Compression Strength. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:799-808. [PMID: 33341302 DOI: 10.1016/j.ultrasmedbio.2020.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 06/12/2023]
Abstract
The goal of this study was to evaluate whether ultrasonic velocities in cortical bone can be considered as a proxy for mechanical quality of cortical bone tissue reflected by porosity and compression strength. Micro-computed tomography, compression mechanical testing and resonant ultrasound spectroscopy were used to assess, respectively, porosity, strength and velocity of bulk waves of both shear and longitudinal polarisations propagating along and perpendicular to osteons, in 92 cortical bone specimens from tibia and femur of elderly human donors. All velocities were significantly associated with strength (r = 0.65-0.83) and porosity (r = -0.64 to -0.77). Roughly, according to linear regression models, a decrease in velocity of 100 m/s corresponded to a loss of 20 MPa in strength (which is approximately 10% of the largest strength value) and to an increase in porosity of 5%. These results provide a rationale for the in vivo measurement of one or several velocities for the diagnosis of bone fragility.
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Affiliation(s)
- Laura Peralta
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France; Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, Kings College London, London, United Kingdom.
| | - Juan Deyo Maeztu Redin
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France
| | - Fan Fan
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France; Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiran Cai
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France
| | - Pascal Laugier
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France
| | - Johannes Schneider
- Berlin-Brandenburg School for Regenerative Therapies, Charit-Universittsmedizin Berlin, Berlin, Germany
| | - Kay Raum
- Berlin-Brandenburg School for Regenerative Therapies, Charit-Universittsmedizin Berlin, Berlin, Germany
| | - Quentin Grimal
- Sorbonne Universite, INSERM, CNRS, Laboratoire d'lmagerie Biomedicale, LIB, F-75006 Paris, France
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Fu Y, Li C, Luo W, Chen Z, Liu Z, Ding Y. Fragility fracture discriminative ability of radius quantitative ultrasound: a systematic review and meta-analysis. Osteoporos Int 2021; 32:23-38. [PMID: 32728897 PMCID: PMC7755656 DOI: 10.1007/s00198-020-05559-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/21/2020] [Indexed: 01/11/2023]
Abstract
The fragility fracture discriminative ability of radius quantitative ultrasound (QUS) was evaluated in a systematic review of 13 studies, including 16,681 individuals and 1296 fractures. The radial speed of sound (SOS) per standard deviation (SD) decrease contributed to an increased risk of total and hip fracture by 32% and 66% in women. Osteoporotic fracture, as a devastating consequence of osteoporosis, brings severe socio-economic burden. The availability of dual-energy X-ray absorptiometry (DXA), as the gold standard of diagnosis, was quite limited in remote areas. Radius QUS measured by SOS shows potential in fracture discriminative ability where DXA equipment is not available. This study aimed to provide a comprehensive evaluation of the association between radius QUS and fracture risk. A detailed article search was carried out on PubMed, EMBASE, Cochrane Libraries, CNKI, Wan-Fang database, VIP, and SinoMed for studies published between January 1980 and February 2020. We determined the estimated relative risk (RR) for fracture per each radial SOS SD decrease. A meta-analysis of studies was performed under the random-effects model. A total of 16,681 individuals were included in this review. Among the participants, 5892 were male and 10,789 were female. A total of 1296 cases of fragility fracture were included. With each SD decrease in radial SOS, the risk of overall fragility fracture and hip fracture was increased by 21% and 55%, respectively. Particularly, the risk was increased by 32% and 66% for women. The association was even stronger for postmenopausal women. Radius QUS showed great potential as an effective tool for fracture risk evaluation, especially for women.
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Affiliation(s)
- Y Fu
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - C Li
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - W Luo
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Z Chen
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Z Liu
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y Ding
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou, China.
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Nguyen Minh H, Du J, Raum K. Estimation of Thickness and Speed of Sound in Cortical Bone Using Multifocus Pulse-Echo Ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:568-579. [PMID: 31647428 DOI: 10.1109/tuffc.2019.2948896] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Most bone loss during the development of osteoporosis occurs in cortical bone at the peripheral skeleton. Decreased cortical thickness (Ct.Th) and the prevalence of large pores at the tibia are associated with reduced bone strength at the hip. Ct.Th and cortical sound velocity, i.e., a surrogate marker for changes of cortical porosity (Ct.Po), are key biomarkers for the identification of patients at high fracture risk. In this study, we have developed a method using a conventional ultrasound array transducer to determine thickness (Ct.Th) and the compressional sound velocity propagating in the radial bone direction (Ct. ν11 ) using a refraction-corrected multifocus imaging approach. The method was validated in-silico on porous bone plate models using a 2-D finite-difference time-domain method and ex vivo on plate-shaped plastic reference materials and on plate-shaped cortical bovine tibia samples. Plane-wave pulse-echo measurements provided reference values to assess precision and accuracy of our method. In-silico results revealed the necessity to account for inclination-dependent transmission losses at the bone surface. Moreover, the dependence of Ct. ν11 on both porosity and pore density was observed. Ct.Th and Ct. ν11 obtained ex vivo showed a high correlation ) with reference values. The ex-vivo accuracy and precision for Ct. ν11 were 29.9 m/s and 0.94%, respectively, and those for Ct.Th were 0.04 mm and 1.09%, respectively. In conclusion, this numerical and experimental study demonstrates an accurate and precise estimation of Ct.Th and Ct. ν11 . The developed multifocus technique may have high clinical potential to improve fracture risk prediction using noninvasive and nonionizing conventional ultrasound technology with image guidance.
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Raimann A, Mehany SN, Feil P, Weber M, Pietschmann P, Boni-Mikats A, Klepochova R, Krššák M, Häusler G, Schneider J, Patsch JM, Raum K. Decreased Compressional Sound Velocity Is an Indicator for Compromised Bone Stiffness in X-Linked Hypophosphatemic Rickets (XLH). Front Endocrinol (Lausanne) 2020; 11:355. [PMID: 32582030 PMCID: PMC7296046 DOI: 10.3389/fendo.2020.00355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/06/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives: To assess the diagnostic potential of bidirectional axial transmission (BDAT) ultrasound, and high-resolution peripheral quantitative computed tomography (HR-pQCT) in X-linked hypophosphatemia (XLH, OMIM #307800), a rare genetic disorder of phosphate metabolism caused by mutations in the PHEX gene. Methods: BDAT bone ultrasound was performed at the non-dominant distal radius (33% relative to distal head) and the central left tibia (50%) in eight XLH patients aged between 4.2 and 20.8 years and compared to twenty-nine healthy controls aged between 5.8 and 22.4 years. In eighteen controls, only radius measurements were performed. Four patients and four controls opted to participate in HR-pQCT scanning of the ultradistal radius and tibia. Results: Bone ultrasound was feasible in patients and controls as young as 4 years of age. The velocity of the first arriving signal (νFAS) in BDAT ultrasound was significantly lower in XLH patients compared to healthy controls: In the radius, mean νFAS of XLH patients and controls was 3599 ± 106 and 3866 ± 142 m/s, respectively (-6.9%; p < 0.001). In the tibia, it was 3578 ± 129 and 3762 ± 124 m/s, respectively (-4.9%; p = 0.006). HR-pQCT showed a higher trabecular thickness in the tibia of XLH patients (+16.7%; p = 0.021). Conclusions: Quantitative bone ultrasound revealed significant differences in cortical bone quality of young XLH patients as compared to controls. Regular monitoring of XLH patients by a radiation-free technology such as BDAT might provide valuable information on bone quality and contribute to the optimization of treatment. Further studies are needed to establish this affordable and time efficient method in the XLH patients.
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Affiliation(s)
- Adalbert Raimann
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Sarah N. Mehany
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Patricia Feil
- Division of Pediatric Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Michael Weber
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Peter Pietschmann
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Andrea Boni-Mikats
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Radka Klepochova
- Department of Biomedical Imaging and Image-guided Therapy, The High Field MR Centre, Vienna, Austria
| | - Martin Krššák
- Department of Biomedical Imaging and Image-guided Therapy, The High Field MR Centre, Vienna, Austria
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging—MOLIMA, Vienna, Austria
| | - Gabriele Häusler
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Johannes Schneider
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Janina M. Patsch
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- *Correspondence: Janina M. Patsch
| | - Kay Raum
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
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Minonzio JG, Bochud N, Vallet Q, Ramiandrisoa D, Etcheto A, Briot K, Kolta S, Roux C, Laugier P. Ultrasound-Based Estimates of Cortical Bone Thickness and Porosity Are Associated With Nontraumatic Fractures in Postmenopausal Women: A Pilot Study. J Bone Miner Res 2019; 34:1585-1596. [PMID: 30913320 DOI: 10.1002/jbmr.3733] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/21/2019] [Accepted: 03/10/2019] [Indexed: 01/02/2023]
Abstract
Recent ultrasound (US) axial transmission techniques exploit the multimode waveguide response of long bones to yield estimates of cortical bone structure characteristics. This pilot cross-sectional study aimed to evaluate the performance at the one-third distal radius of a bidirectional axial transmission technique (BDAT) to discriminate between fractured and nonfractured postmenopausal women. Cortical thickness (Ct.Th) and porosity (Ct.Po) estimates were obtained for 201 postmenopausal women: 109 were nonfractured (62.6 ± 7.8 years), 92 with one or more nontraumatic fractures (68.8 ± 9.2 years), 17 with hip fractures (66.1 ± 10.3 years), 32 with vertebral fractures (72.4 ± 7.9 years), and 17 with wrist fractures (67.8 ± 9.6 years). The areal bone mineral density (aBMD) was obtained using DXA at the femur and spine. Femoral aBMD correlated weakly, but significantly with Ct.Th (R = 0.23, p < 0.001) and Ct.Po (R = -0.15, p < 0.05). Femoral aBMD and both US parameters were significantly different between the subgroup of all nontraumatic fractures combined and the control group (p < 0.05). The main findings were that (1) Ct.Po was discriminant for all nontraumatic fractures combined (OR = 1.39; area under the receiver operating characteristic curve [AUC] equal to 0.71), for vertebral (OR = 1.96; AUC = 0.84) and wrist fractures (OR = 1.80; AUC = 0.71), whereas Ct.Th was discriminant for hip fractures only (OR = 2.01; AUC = 0.72); there was a significant association (2) between increased Ct.Po and vertebral and wrist fractures when these fractures were not associated with any measured aBMD variables; (3) between increased Ct.Po and all nontraumatic fractures combined independently of aBMD neck; and (4) between decreased Ct.Th and hip fractures independently of aBMD femur. BDAT variables showed comparable performance to that of aBMD neck with all types of fractures (OR = 1.48; AUC = 0.72) and that of aBMD femur with hip fractures (OR = 2.21; AUC = 0.70). If these results are confirmed in prospective studies, cortical BDAT measurements may be considered useful for assessing fracture risk in postmenopausal women. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- J-G Minonzio
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
| | - N Bochud
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
| | - Q Vallet
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
| | - D Ramiandrisoa
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
| | - A Etcheto
- Department of Rheumatology, Cochin Hospital, Epidemiology and Biostatistics Sorbonne Paris Cité, Research Center, INSERM U1153, Paris Descartes University, Paris, France
| | - K Briot
- Department of Rheumatology, Cochin Hospital, Epidemiology and Biostatistics Sorbonne Paris Cité, Research Center, INSERM U1153, Paris Descartes University, Paris, France
| | - S Kolta
- Department of Rheumatology, Cochin Hospital, Epidemiology and Biostatistics Sorbonne Paris Cité, Research Center, INSERM U1153, Paris Descartes University, Paris, France
| | - C Roux
- Department of Rheumatology, Cochin Hospital, Epidemiology and Biostatistics Sorbonne Paris Cité, Research Center, INSERM U1153, Paris Descartes University, Paris, France
| | - P Laugier
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
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Soto Martinez ME, Love JC, Pinto DC, Wiersema JM, Derrick SM, Bachim A, Greeley C, Donaruma‐Kwoh M, Truong VTT, Gao S, Crowder CM. The Infant Injury Database: A Tool for the Study of Injury Patterns in Medicolegal Investigations of Child Abuse. J Forensic Sci 2019; 64:1622-1632. [DOI: 10.1111/1556-4029.14120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/06/2019] [Accepted: 06/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jennifer C. Love
- Office of the Chief Medical Examiner401 E Street SW Washington DC20024
| | - Deborrah C. Pinto
- Harris County Institute of Forensic Sciences 1861 Old Spanish Trail Houston TX77054
| | - Jason M. Wiersema
- Harris County Institute of Forensic Sciences 1861 Old Spanish Trail Houston TX77054
| | - Sharon M. Derrick
- Department of Life Sciences Texas A&M University – Corpus Christi 6300 Ocean Drive, Unit 5800 Corpus Christi TX 78412
| | - Angela Bachim
- Department of Pediatrics Baylor College of Medicine 6621 Fannin St Houston TX77030
| | - Christopher Greeley
- Department of Pediatrics Baylor College of Medicine 6621 Fannin St Houston TX77030
| | | | - Van Thi Thanh Truong
- Center for Clinical Research and Evidence‐Based Medicine McGovern Medical School The University of Texas Health Science Center at Houston 6431 Fannin St Houston TX 77030
| | - Si Gao
- Harris County Institute of Forensic Sciences 1861 Old Spanish Trail Houston TX77054
| | - Christian M. Crowder
- Dallas County Medical Examiner Office Southwestern Institute of Forensic Sciences 2355 N Stemmons Fwy Dallas TX75207
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Schneider J, Ramiandrisoa D, Armbrecht G, Ritter Z, Felsenberg D, Raum K, Minonzio JG. In Vivo Measurements of Cortical Thickness and Porosity at the Proximal Third of the Tibia Using Guided Waves: Comparison with Site-Matched Peripheral Quantitative Computed Tomography and Distal High-Resolution Peripheral Quantitative Computed Tomography. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1234-1242. [PMID: 30777311 DOI: 10.1016/j.ultrasmedbio.2019.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 05/09/2023]
Abstract
The aim of this study was to estimate cortical porosity (Ct.Po) and cortical thickness (Ct.Th) using 500-kHz bi-directional axial transmission (AT). Ct.ThAT and Ct.PoAT were obtained at the tibia in 15 patients from a 2-D transverse isotropic free plate model fitted to measured guided wave dispersion curves. The velocities of the first arriving signal (υFAS) and A0 mode (υA0) were also determined. Site-matched peripheral quantitative computed tomography (pQCT) provided volumetric cortical bone mineral density (Ct.vBMDpQCT) and Ct.ThpQCT. Good agreement was found between Ct.ThAT and Ct.ThpQCT (R2 = 0.62, root mean square error [RMSE] = 0.39 mm). Ct.vBMDpQCT correlated with Ct.PoAT (R2 = 0.57), υFAS (R2 = 0.43) and υA0 (R2 = 0.28). Furthermore, a significant correlation was found between AT and distal high-resolution pQCT. The measurement ofcortical parameters at the tibia using guided waves might improve the prediction of bone fractures in a cost-effective and radiation-free manner.
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Affiliation(s)
- Johannes Schneider
- Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Donatien Ramiandrisoa
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne University, CNRS, INSERM, Paris, France; BleuSolid, Pomponne, France
| | - Gabriele Armbrecht
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Zully Ritter
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Dieter Felsenberg
- Center for Muscle and Bone Research (ZMK), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kay Raum
- Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Jean-Gabriel Minonzio
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne University, CNRS, INSERM, Paris, France; Escuela de Ingeniería Civil en Informática, Universidad de Valparaíso, Valparaíso, Chile
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Vogl F, Friesenbichler B, Hüsken L, Kramers-de Quervain IA, Taylor WR. Can low-frequency guided waves at the tibia paired with machine learning differentiate between healthy and osteopenic/osteoporotic subjects? A pilot study. ULTRASONICS 2019; 94:109-116. [PMID: 30660337 DOI: 10.1016/j.ultras.2018.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/04/2018] [Accepted: 11/29/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Axial transmission quantitative acoustics (ax-QA) has shown to be a promising tool for assessing bone health and properties in a safe, inexpensive, and portable manner. This study investigated the efficacy of low-frequency ax-QA measured at the tibia, paired with a support vector machine (SVM) approach for combining multiple acoustic indicators, to diagnose osteoporosis as defined by bone mineral density. METHODS This pilot study measured 41 female subjects using ax-QA (flexural mode, 3 kHz) at the tibia and using dual X-ray absorptiometry (DXA) at the lumbar spine, femoral neck, and distal radius. For each location, a threshold classifier and SVM were trained to differentiate between healthy and non-healthy subjects based on the phase velocity at different frequencies. Receiver Operating Characteristics and area under curve values (AUC) were used to assess the classifiers' performances for various thresholds and class-weights. RESULTS The SVM outperformed the threshold classifier for all three bone locations at low false positive rates. While differentiation between healthy and non-healthy bone states was poor for the spine (AUC: 0.56 ± 0.04), good to moderate performances were observed for the radius (AUC: 0.83 ± 0.03) and hip (AUC: 0.71 ± 0.04). CONCLUSIONS Low-frequency ax-QA has demonstrated potential for complementing DXA in screening for osteoporosis at the radius and hip. Through further addition of acoustic indicators ax-QA could provide a diagnostic alternative in third-world countries, and bring bone health screening and monitoring into the hands of clinicians and general health practitioners everywhere.
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Affiliation(s)
- Florian Vogl
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland.
| | | | - Laura Hüsken
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
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Ex vivo cortical porosity and thickness predictions at the tibia using full-spectrum ultrasonic guided-wave analysis. Arch Osteoporos 2019; 14:21. [PMID: 30783777 PMCID: PMC6394459 DOI: 10.1007/s11657-019-0578-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/31/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The estimation of cortical thickness (Ct.Th) and porosity (Ct.Po) at the tibia using axial transmission ultrasound was successfully validated ex vivo against site-matched micro-computed tomography. The assessment of cortical parameters based on full-spectrum guided-wave analysis might improve the prediction of bone fractures in a cost-effective and radiation-free manner. PURPOSE Cortical thickness (Ct.Th) and porosity (Ct.Po) are key parameters for the identification of patients with fragile bones. The main objective of this ex vivo study was to validate the measurement of Ct.Po and Ct.Th at the tibia using a non-ionizing, low-cost, and portable 500-kHz ultrasound axial transmission system. Additional ultrasonic velocities and site-matched reference parameters were included in the study to broaden the analysis. METHODS Guided waves were successfully measured ex vivo in 17 human tibiae using a novel 500-kHz bi-directional axial transmission probe. Theoretical dispersion curves of a transverse isotropic free plate model with invariant matrix stiffness were fitted to the experimental dispersion curves in order to estimate Ct.Th and Ct.Po. In addition, the velocities of the first arriving signal (υFAS) and A0 mode (υA0) were measured. Reference Ct.Po, Ct.Th, and vBMD were obtained from site-matched micro-computed tomography. Scanning acoustic microscopy (SAM) provided the acoustic impedance of the axial cortical bone matrix. RESULTS The best predictions of Ct.Po (R2 = 0.83, RMSE = 2.2%) and Ct.Th (R2 = 0.92, RMSE = 0.2 mm, one outlier excluded) were obtained from the plate model. The second best predictors of Ct.Po and Ct.Th were vBMD (R2 = 0.77, RMSE = 2.6%) and υA0 (R2 = 0.28, RMSE = 0.67 mm), respectively. CONCLUSIONS Ct.Th and Ct.Po were accurately predicted at the human tibia ex vivo using a transverse isotropic free plate model with invariant matrix stiffness. The model-based predictions were not further enhanced when we accounted for variations in axial tissue stiffness as reflected by the acoustic impedance from SAM.
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Minonzio JG, Bochud N, Vallet Q, Bala Y, Ramiandrisoa D, Follet H, Mitton D, Laugier P. Bone cortical thickness and porosity assessment using ultrasound guided waves: An ex vivo validation study. Bone 2018; 116:111-119. [PMID: 30056165 DOI: 10.1016/j.bone.2018.07.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/13/2018] [Accepted: 07/23/2018] [Indexed: 11/21/2022]
Abstract
Several studies showed the ability of the cortex of long bones such as the radius and tibia to guide mechanical waves. Such experimental evidence has given rise to the emergence of a category of quantitative ultrasound techniques, referred to as the axial transmission, specifically developed to measure the propagation of ultrasound guided waves in the cortical shell along the axis of long bones. An ultrasound axial transmission technique, with an automated approach to quantify cortical thickness and porosity is described. The guided modes propagating in the cortex are recorded with a 1-MHz custom made linear transducer array. Measurement of the dispersion curves is achieved using a two-dimensional spatio-temporal Fourier transform combined with singular value decomposition. Automatic parameters identification is obtained through the solution of an inverse problem in which the dispersion curves are predicted with a two-dimensional transverse isotropic free plate model. Thirty-one radii and fifteen tibiae harvested from human cadavers underwent axial transmission measurements. Estimates of cortical thickness and porosity were obtained on 40 samples out of 46. The reproducibility, given by the root mean square error of the standard deviation of estimates, was 0.11 mm for thickness and 1.9% for porosity. To assess accuracy, site-matched micro-computed tomography images of the bone specimens imaged at 9 μm voxel size served as the gold standard. Agreement between micro-computed tomography and axial transmission for quantification of thickness and porosity at the radius and tibia ranged from R2=0.63 for porosity (root mean square error RMSE=1.8%) to 0.89 for thickness (RMSE=0.3 mm). Despite an overall good agreement for porosity, the method performs less well for porosities lower than 10%. The heterogeneity and general complexity of cortical bone structure, which are not fully accounted for by our model, are suspected to weaken the model approximation. This study presents the first validation study for assessing cortical thickness and porosity using the axial transmission technique. The automatic signal processing minimizes operator-dependent errors for parameters determination. Recovering the waveguide characteristics, that is to say cortical thickness and porosity, could provide reliable information about skeletal status and future fracture risk.
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Affiliation(s)
- J-G Minonzio
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale LIB, Paris F-75006, France
| | - N Bochud
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale LIB, Paris F-75006, France.
| | - Q Vallet
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale LIB, Paris F-75006, France
| | - Y Bala
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM Unit UMR1033, F-69622 Lyon, France
| | - D Ramiandrisoa
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale LIB, Paris F-75006, France
| | - H Follet
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM Unit UMR1033, F-69622 Lyon, France
| | - D Mitton
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR T9406, Lyon F-69622, France
| | - P Laugier
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale LIB, Paris F-75006, France
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Andronowski JM, Crowder C, Soto Martinez M. Recent advancements in the analysis of bone microstructure: New dimensions in forensic anthropology. Forensic Sci Res 2018; 3:278-293. [PMID: 30788447 PMCID: PMC6374927 DOI: 10.1080/20961790.2018.1483294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 05/30/2018] [Indexed: 10/29/2022] Open
Abstract
Bone is a mechanically active, three-dimensionally (3D) complex, and dynamic tissue that changes in structure over the human lifespan. Bone tissue exists and remodels in 3D and changes over time, introducing a fourth dimension. The products of the remodelling process, secondary and fragmentary osteons, have been studied substantially using traditional two-dimensional (2D) techniques. As a result, much has been learned regarding the biological information encrypted in the histomorphology of bone, yielding a wealth of information relating to skeletal structure and function. Three-dimensional imaging modalities, however, hold the potential to provide a much more comprehensive understanding of bone microarchitecture. The visualization and analysis of bone using high-resolution 3D imaging will improve current understandings of bone biology and have numerous applications in both biological anthropology and biomedicine. Through recent technological advancements, we can hone current anthropological applications of the analysis of bone microstructure and accelerate research into the third and fourth dimensional realms. This review will explore the methodological approaches used historically by anthropologists to assess cortical bone microstructure, spanning from histology to current ex vivo imaging modalities, discuss the growing capabilities of in vivo imaging, and conclude with an introduction of novel non-histological modalities for investigating bone quality.
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Renaud G, Kruizinga P, Cassereau D, Laugier P. In vivo ultrasound imaging of the bone cortex. ACTA ACUST UNITED AC 2018; 63:125010. [DOI: 10.1088/1361-6560/aac784] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Kassou K, Remram Y, Laugier P, Minonzio JG. Dispersion characteristics of the flexural wave assessed using low frequency (50-150kHz) point-contact transducers: A feasibility study on bone-mimicking phantoms. ULTRASONICS 2017; 81:1-9. [PMID: 28570855 DOI: 10.1016/j.ultras.2017.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/11/2017] [Accepted: 05/14/2017] [Indexed: 06/07/2023]
Abstract
Guided waves-based techniques are currently under development for quantitative cortical bone assessment. However, the signal interpretation is challenging due to multiple mode overlapping. To overcome this limitation, dry point-contact transducers have been used at low frequencies for a selective excitation of the zeroth order anti-symmetric Lamb A0 mode, a mode whose dispersion characteristics can be used to infer the thickness of the waveguide. In this paper, our purpose was to extend the technique by combining a dry point-contact transducers approach to the SVD-enhanced 2-D Fourier transform in order to measure the dispersion characteristics of the flexural mode. The robustness of our approach is assessed on bone-mimicking phantoms covered or not with soft tissue-mimicking layer. Experiments were also performed on a bovine bone. Dispersion characteristics of measured modes were extracted using a SVD-based signal processing technique. The thickness was obtained by fitting a free plate model to experimental data. The results show that, in all studied cases, the estimated thickness values are in good agreement with the actual thickness values. From the results, we speculate that in vivo cortical thickness assessment by measuring the flexural wave using point-contact transducers is feasible. However, this assumption has to be confirmed by further in vivo studies.
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Affiliation(s)
- Koussila Kassou
- Laboratory of Instrumentation (LINS), USTHB, P.O. BOX 32, 16111 Bab-Ezzouar, Algiers, Algeria.
| | - Youcef Remram
- Laboratory of Instrumentation (LINS), USTHB, P.O. BOX 32, 16111 Bab-Ezzouar, Algiers, Algeria
| | - Pascal Laugier
- Sorbonne Universités, UPMC Univ. Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), F-75006 Paris, France
| | - Jean-Gabriel Minonzio
- Sorbonne Universités, UPMC Univ. Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), F-75006 Paris, France
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Vogl F, Bernet B, Bolognesi D, Taylor WR. Towards assessing cortical bone porosity using low-frequency quantitative acoustics: A phantom-based study. PLoS One 2017; 12:e0182617. [PMID: 28880868 PMCID: PMC5589096 DOI: 10.1371/journal.pone.0182617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 07/22/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Cortical porosity is a key characteristic governing the structural properties and mechanical behaviour of bone, and its quantification is therefore critical for understanding and monitoring the development of various bone pathologies such as osteoporosis. Axial transmission quantitative acoustics has shown to be a promising technique for assessing bone health in a fast, non-invasive, and radiation-free manner. One major hurdle in bringing this approach to clinical application is the entanglement of the effects of individual characteristics (e.g. geometry, porosity, anisotropy etc.) on the measured wave propagation. In order to address this entanglement problem, we therefore propose a systematic bottom-up approach, in which only one bone property is varied, before addressing interaction effects. This work therefore investigated the sensitivity of low-frequency quantitative acoustics to changes in porosity as well as individual pore characteristics using specifically designed cortical bone phantoms. MATERIALS AND METHODS 14 bone phantoms were designed with varying pore size, axial-, and radial pore number, resulting in porosities (bone volume fraction) between 0% and 15%, similar to porosity values found in human cortical bone. All phantoms were manufactured using laser sintering, measured using axial-transmission acoustics and analysed using a full-wave approach. Experimental results were compared to theoretical predictions based on a modified Timoshenko theory. RESULTS A clear dependence of phase velocity on frequency and porosity produced by increasing pore size or radial pore number was demonstrated, with the velocity decreasing by between 2-5 m/s per percent of additional porosity, which corresponds to -0.5% to -1.0% of wave speed. While the change in phase velocity due to axial pore number was consistent with the results due to pore size and radial pore number, the relative uncertainties for the estimates were too high to draw any conclusions for this parameter. CONCLUSIONS This work has shown the capability of low-frequency quantitative acoustics to reflect changes in porosity and individual pore characteristics and demonstrated that additive manufacturing is an appropriate method that allows the influence of individual bone properties on the wave propagation to be systematically assessed. The results of this work opens perspectives for the efficient development of a multi-frequency, multi-mode approach to screen, diagnose, and monitor bone pathologies in individuals.
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Affiliation(s)
- Florian Vogl
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
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Gräsel M, Glüer CC, Barkmann R. Characterization of a new ultrasound device designed for measuring cortical porosity at the human tibia: A phantom study. ULTRASONICS 2017; 76:183-191. [PMID: 28107676 DOI: 10.1016/j.ultras.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/30/2016] [Accepted: 01/02/2017] [Indexed: 06/06/2023]
Abstract
Quantitative ultrasound (QUS) measurements of trabecular bone are a useful tool for the assessment of osteoporotic fracture risk. However, cortical bone properties (e.g. porosity) have an impact on bone strength as well and thus current research is focused on QUS assessment of cortical bone properties. Simulation studies of ultrasound propagation through cortical bone indicate that anisotropy, calculated from the ratio of the velocities in axial and tangential directions, is correlated with porosity. However, this relationship is affected by error sources, specifically bone surface curvature and variability of probe positioning. With the aim of in vivo estimation of cortical porosity a new ultrasound device was developed, which sequentially measures velocities in 3 different directions (axial=0° and ±37.5°) using the axial transmission method. Measurements on planar porosity phantoms (0-25%) were performed to confirm the results of the afore mentioned simulation studies. Additionally, measurements on cylindrical phantoms without pores (min. radius=34mm for strongest curvature) were performed to estimate the influence of surface curvature on velocity measurements (the tibia bone surface is fairly flat but may show surface curvature in some patients). The velocities in the axial and ±37.5° directions were used to calculate an anisotropy index. The velocities measured on the porosity phantoms showed a decrease by -6.3±0.2m/s and -10.1±0.2m/s per percent increase in porosity in axial and ±37.5° directions, respectively. Surface curvature had an effect on the velocities measured in ±37.5° directions which could be minimized by a correction algorithm resulting in an error of 5m/s. The anisotropy index could be used to estimate porosity with an accuracy error of 1.5%. These results indicate that an estimation of porosity using velocity measurements in different directions might be feasible, even in bones with curved surface. These results obtained on phantom material indicate that the approach tested may be suited for porosity measurements on human tibia bone.
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Affiliation(s)
- M Gräsel
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
| | - C-C Glüer
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
| | - R Barkmann
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
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Bochud N, Vallet Q, Minonzio JG, Laugier P. Predicting bone strength with ultrasonic guided waves. Sci Rep 2017; 7:43628. [PMID: 28256568 PMCID: PMC5335564 DOI: 10.1038/srep43628] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/26/2017] [Indexed: 11/30/2022] Open
Abstract
Recent bone quantitative ultrasound approaches exploit the multimode waveguide response of long bones for assessing properties such as cortical thickness and stiffness. Clinical applications remain, however, challenging, as the impact of soft tissue on guided waves characteristics is not fully understood yet. In particular, it must be clarified whether soft tissue must be incorporated in waveguide models needed to infer reliable cortical bone properties. We hypothesize that an inverse procedure using a free plate model can be applied to retrieve the thickness and stiffness of cortical bone from experimental data. This approach is first validated on a series of laboratory-controlled measurements performed on assemblies of bone- and soft tissue mimicking phantoms and then on in vivo measurements. The accuracy of the estimates is evaluated by comparison with reference values. To further support our hypothesis, these estimates are subsequently inserted into a bilayer model to test its accuracy. Our results show that the free plate model allows retrieving reliable waveguide properties, despite the presence of soft tissue. They also suggest that the more sophisticated bilayer model, although it is more precise to predict experimental data in the forward problem, could turn out to be hardly manageable for solving the inverse problem.
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Affiliation(s)
- Nicolas Bochud
- Sorbonne Universités, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMR S1146, Laboratoire d'imagerie biomédicale, 15 rue de l'école de médecine, F-75006, Paris, France
| | - Quentin Vallet
- Sorbonne Universités, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMR S1146, Laboratoire d'imagerie biomédicale, 15 rue de l'école de médecine, F-75006, Paris, France
| | - Jean-Gabriel Minonzio
- Sorbonne Universités, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMR S1146, Laboratoire d'imagerie biomédicale, 15 rue de l'école de médecine, F-75006, Paris, France
| | - Pascal Laugier
- Sorbonne Universités, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMR S1146, Laboratoire d'imagerie biomédicale, 15 rue de l'école de médecine, F-75006, Paris, France
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Bochud N, Vallet Q, Bala Y, Follet H, Minonzio JG, Laugier P. Genetic algorithms-based inversion of multimode guided waves for cortical bone characterization. Phys Med Biol 2016; 61:6953-6974. [DOI: 10.1088/0031-9155/61/19/6953] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vallet Q, Bochud N, Chappard C, Laugier P, Minonzio JG. In Vivo Characterization of Cortical Bone Using Guided Waves Measured by Axial Transmission. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:1361-1371. [PMID: 27392349 DOI: 10.1109/tuffc.2016.2587079] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cortical bone loss is not fully assessed by the current X-ray methods, and there is an unmet need in identifying women at risk of osteoporotic fracture, who should receive a treatment. The last decade has seen the emergence of the ultrasound (US) axial transmission (AT) techniques to assess a cortical bone. Recent AT techniques exploit the multimode waveguide response of the long bones such as the radius. A recent ex vivo study by our group evidenced that a multimode AT approach can yield simultaneous estimates of cortical thickness (Ct.Th) and stiffness. The aim of this paper is to move one step forward to evaluate the feasibility of measuring multimode guided waves (GW) in vivo and to infer from it cortical thickness. Measurements were taken on the forearm of 14 healthy subjects with the goal to test the accuracy of the estimated thickness using the bidirectional AT method implemented on a dedicated 1-MHz linear US array. This setup allows determining in vivo the dispersion curves of GW transmitted in the cortical layer of the radius. An inverse procedure based on the comparison between the measured and modeled dispersion curves predicted by a 2-D transverse isotropic free plate waveguide model allowed an estimation of cortical thickness, despite the presence of soft tissue. The Ct.Th values were validated by comparison with the site-matched estimates derived from X-ray high-resolution peripheral quantitative computed tomography. Results showed a significant correlation between both measurements ( r2 = 0.7 , , and [Formula: see text] mm). This pilot study demonstrates the potential of bidirectional AT for the in vivo assessment of cortical thickness, a bone strength-related factor.
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Quantitative ultrasound measurement of bone density based on dynamic time window: suitable for the measurement of speed of sound in radius. J Med Ultrason (2001) 2016; 43:347-54. [DOI: 10.1007/s10396-016-0710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/14/2016] [Indexed: 10/21/2022]
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Vogl F, Schnüriger K, Gerber H, Taylor WR. Reliability of Phase Velocity Measurements of Flexural Acoustic Waves in the Human Tibia In-Vivo. PLoS One 2016; 11:e0152417. [PMID: 27015093 PMCID: PMC4807826 DOI: 10.1371/journal.pone.0152417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 03/14/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose Axial-transmission acoustics have shown to be a promising technique to measure individual bone properties and detect bone pathologies. With the ultimate goal being the in-vivo application of such systems, quantification of the key aspects governing the reliability is crucial to bring this method towards clinical use. Materials and Methods This work presents a systematic reliability study quantifying the sources of variability and their magnitudes of in-vivo measurements using axial-transmission acoustics. 42 healthy subjects were measured by an experienced operator twice per week, over a four-month period, resulting in over 150000 wave measurements. In a complementary study to assess the influence of different operators performing the measurements, 10 novice operators were trained, and each measured 5 subjects on a single occasion, using the same measurement protocol as in the first part of the study. Results The estimated standard error for the measurement protocol used to collect the study data was ∼ 17 m/s (∼ 4% of the grand mean) and the index of dependability, as a measure of reliability, was Φ = 0.81. It was shown that the method is suitable for multi-operator use and that the reliability can be improved efficiently by additional measurements with device repositioning, while additional measurements without repositioning cannot improve the reliability substantially. Phase velocity values were found to be significantly higher in males than in females (p < 10−5) and an intra-class correlation coefficient of r = 0.70 was found between the legs of each subject. Conclusions The high reliability of this non-invasive approach and its intrinsic sensitivity to mechanical properties opens perspectives for the rapid and inexpensive clinical assessment of bone pathologies, as well as for monitoring programmes without any radiation exposure for the patient.
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Affiliation(s)
- Florian Vogl
- Institute for Biomechanics, Department of Health Sciences and Technology, Swiss Federal Institute for Technology in Zurich, Zurich, Switzerland
| | - Karin Schnüriger
- Institute for Biomechanics, Department of Health Sciences and Technology, Swiss Federal Institute for Technology in Zurich, Zurich, Switzerland
| | - Hans Gerber
- Institute for Biomechanics, Department of Health Sciences and Technology, Swiss Federal Institute for Technology in Zurich, Zurich, Switzerland
| | - William R. Taylor
- Institute for Biomechanics, Department of Health Sciences and Technology, Swiss Federal Institute for Technology in Zurich, Zurich, Switzerland
- * E-mail:
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Minonzio JG, Foiret J, Moilanen P, Pirhonen J, Zhao Z, Talmant M, Timonen J, Laugier P. A free plate model can predict guided modes propagating in tubular bone-mimicking phantoms. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 137:EL98-EL104. [PMID: 25618107 PMCID: PMC4277555 DOI: 10.1121/1.4903920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 11/12/2014] [Accepted: 11/20/2014] [Indexed: 06/04/2023]
Abstract
The goal of this work was to show that a non-absorbing free plate model can predict with a reasonable accuracy guided modes measured in bone-mimicking phantoms that have circular cross-section. Experiments were carried out on uncoated and coated phantoms using a clinical axial transmission setup. Adjustment of the plate model to the experimental data yielded estimates for the waveguide characteristics (thickness, bulk wave velocities). Fair agreement was achieved over a frequency range of 0.4 to 1.6 MHz. A lower accuracy observed for the thinnest bone-mimicking phantoms was caused by limitations in the wave number measurements rather than by the model itself.
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Affiliation(s)
- Jean-Gabriel Minonzio
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC University of Paris 06, INSERM, CNRS, F-75006, Paris, France ,
| | - Josquin Foiret
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC University of Paris 06, INSERM, CNRS, F-75006, Paris, France ,
| | - Petro Moilanen
- Department of Physics, University of Jyväskylä, FI-40014, Jyväskylä, Finland ,
| | - Jalmari Pirhonen
- Department of Physics, University of Jyväskylä, FI-40014, Jyväskylä, Finland ,
| | - Zuomin Zhao
- Department of Electrical Engineering, University of Oulu, FI-90014, Oulu, Finland
| | - Maryline Talmant
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC University of Paris 06, INSERM, CNRS, F-75006, Paris, France
| | - Jussi Timonen
- Department of Physics, University of Jyväskylä, FI-40014, Jyväskylä, Finland
| | - Pascal Laugier
- Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC University of Paris 06, INSERM, CNRS, F-75006, Paris, France
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Berteau JP, Baron C, Pithioux M, Launay F, Chabrand P, Lasaygues P. In vitro ultrasonic and mechanic characterization of the modulus of elasticity of children cortical bone. ULTRASONICS 2014; 54:1270-1276. [PMID: 24112598 DOI: 10.1016/j.ultras.2013.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 08/30/2013] [Accepted: 09/10/2013] [Indexed: 06/02/2023]
Abstract
The assessment of elastic properties in children's cortical bone is a major challenge for biomechanical engineering community, more widely for health care professionals. Even with classical clinical modalities such as X-ray tomography, MRI, and/or echography, inappropriate diagnosis can result from the lack of reference values for children bone. This study provides values for elastic properties of cortical bone in children using ultrasonic and mechanical measurements, and compares them with adult values. 18 fibula samples from 8 children (5-16 years old, mean age 10.6 years old ±4.4) were compared to 16 fibula samples from 3 elderly adults (more than 65 years old). First, the dynamic modulus of elasticity (Edyn) and Poisson's ratio (ν) are evaluated via an ultrasonic method. Second, the static modulus of elasticity (Esta) is estimated from a 3-point microbending test. The mean values of longitudinal and transverse wave velocities measured at 10 MHz for the children's samples are respectively 3.2mm/μs (±0.5) and 1.8mm/μs (±0.1); for the elderly adults' samples, velocities are respectively 3.5mm/μs (±0.2) and 1.9 mm/μs (±0.09). The mean Edyn and the mean Esta for the children's samples are respectively 15.5 GPa (±3.4) and 9.1 GPa (±3.5); for the elderly adults' samples, they are respectively 16.7 GPa (±1.9) and 5.8 GPa (±2.1). Edyn, ν and Esta are in the same range for children's and elderly adults' bone without any parametric statistical difference; a ranking correlation between Edyn and Esta is shown for the first time.
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Affiliation(s)
- Jean-Philippe Berteau
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France.
| | - Cécile Baron
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Franck Launay
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Patrick Chabrand
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
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Chen J, Su Z. On ultrasound waves guided by bones with coupled soft tissues: a mechanism study and in vitro calibration. ULTRASONICS 2014; 54:1186-96. [PMID: 24008173 DOI: 10.1016/j.ultras.2013.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 08/05/2013] [Accepted: 08/06/2013] [Indexed: 05/10/2023]
Abstract
The influence of soft tissues coupled with cortical bones on precision of quantitative ultrasound (QUS) has been an issue in the clinical bone assessment in conjunction with the use of ultrasound. In this study, the effect arising from soft tissues on propagation characteristics of guided ultrasound waves in bones was investigated using tubular Sawbones phantoms covered with a layer of mimicked soft tissue of different thicknesses and elastic moduli, and an in vitro porcine femur in terms of the axial transmission measurement. Results revealed that presence of soft tissues can exert significant influence on the propagation of ultrasound waves in bones, leading to reduced propagation velocities and attenuated wave magnitudes compared with the counterparts in a free bone in the absence of soft tissues. However such an effect is not phenomenally dependent on the variations in thickness and elastic modulus of the coupled soft tissues, making it possible to compensate for the coupling effect regardless of the difference in properties of the soft tissues. Based on an in vitro calibration, this study proposed quantitative compensation for the effect of soft tissues on ultrasound waves in bones, facilitating development of high-precision QUS.
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Affiliation(s)
- Jiangang Chen
- The Department of Mechanical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Zhongqing Su
- The Department of Mechanical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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Egorov V, Tatarinov A, Sarvazyan N, Wood R, Magidenko L, Amin S, Khosla S, Ruh RJ, Ruh JM, Sarvazyan A. Osteoporosis detection in postmenopausal women using axial transmission multi-frequency bone ultrasonometer: clinical findings. ULTRASONICS 2014; 54:1170-7. [PMID: 24070826 PMCID: PMC3951708 DOI: 10.1016/j.ultras.2013.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 08/22/2013] [Accepted: 08/30/2013] [Indexed: 05/07/2023]
Abstract
The objective of this study was to evaluate if the Bone UltraSonic Scanner (BUSS) can detect osteoporosis in postmenopausal women. BUSS is an axial transmission multi-frequency ultrasonometer for acquisition of wave propagation profiles along the proximal anterior tibia. We derived 10 diagnostically significant BUSS parameters that were then compared with the DXA spine T-score, which was used in this study as the "gold standard" for the assessment of osteoporosis (T-score<-2.5). BUSS wave parameters were studied in 331 postmenopausal women examined by 9 trained operators at 3 clinical sites with use of 3 devices. The efficiency of each BUSS parameter in osteoporosis detection was assessed using a receiver operating characteristic curve analysis. Area under the curve (AUC) for each of 10 parameters ranged from 58.1% to 70.2%. Using these parameters a linear classifier was derived which provided at its output 83.0% AUC, 87.7% sensitivity and 63.2% specificity to DXA-identified osteoporosis. The results of this study confirm BUSS's capability to detect osteoporosis in postmenopausal women.
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Affiliation(s)
| | | | | | | | | | | | | | - Richard J Ruh
- Catholic Health, Sisters of Charity Hospital, Buffalo, NY 14214, USA
| | - Jennifer M Ruh
- Catholic Health, Sisters of Charity Hospital, Buffalo, NY 14214, USA
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Zhang Z, Liu D, Deng M, Ta D, Wang W. Experimental observation of cumulative second-harmonic generation of lamb waves propagating in long bones. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1660-1670. [PMID: 24726796 DOI: 10.1016/j.ultrasmedbio.2014.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/26/2013] [Accepted: 01/06/2014] [Indexed: 06/03/2023]
Abstract
The experimental observation of cumulative second-harmonic generation of fundamental Lamb waves in long bones is reported. Based on the modal expansion approach to waveguide excitation and the dispersion characteristics of Lamb waves in long bones, the mechanism underlying the generation and accumulation of second harmonics by propagation of the fundamental Lamb waves was investigated. An experimental setup was established to detect the second-harmonic signals of Lamb wave propagation in long bones in vitro. Through analysis of the group velocities of the received signals, the appropriate fundamental Lamb wave modes and the duration of the second-harmonic signals could be identified. The integrated amplitude of the time-domain second-harmonic signal was introduced and used to characterize the efficiency of second-harmonic generation by fundamental Lamb wave propagation. The results indicate that the second-harmonic signal generated by fundamental Lamb waves propagating in long bones can be observed clearly, and the effect was cumulative with propagation distance when the fundamental Lamb wave mode and the double-frequency Lamb wave mode had the same phase velocities. The present results may be important in the development of a new method to evaluate the status of long bones using the cumulative second harmonic of ultrasonic Lamb waves.
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Affiliation(s)
- Zhenggang Zhang
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Dan Liu
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Mingxi Deng
- Department of Physics, Logistics Engineering University, Chongqing, China.
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, China; Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Shanghai, China.
| | - Weiqi Wang
- Department of Electronic Engineering, Fudan University, Shanghai, China
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Määttä M, Moilanen P, Timonen J, Pulkkinen P, Korpelainen R, Jämsä T. Association between low-frequency ultrasound and hip fractures -- comparison with DXA-based BMD. BMC Musculoskelet Disord 2014; 15:208. [PMID: 24934318 PMCID: PMC4067525 DOI: 10.1186/1471-2474-15-208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 06/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women. METHODS The study population consisted of 490 community-dwelling women (78-82 years). Ultrasound velocity (V(LF)) at mid-tibia was measured in 2006 using a low-frequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997. RESULTS During the total follow-up period (1997-2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low V(LF) (the lowest quartile) was associated with increased hip fracture risk when compared with V(LF) in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, V(LF) was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0). CONCLUSION Low V(LF) was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors. Further development of the method is needed to improve the measurement precision and to confirm the results.
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Affiliation(s)
- Mikko Määttä
- Department of Medical Technology, University of Oulu, Institute of Biomedicine, PO Box 5000, FI-90014 Oulu, Finland.
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Abstract
Bone quality is determined by a variety of compositional, micro- and ultrastructural properties of the mineralized tissue matrix. In contrast to X-ray-based methods, the interaction of acoustic waves with bone tissue carries information about elastic and structural properties of the tissue. Quantitative ultrasound (QUS) methods represent powerful alternatives to ionizing x-ray based assessment of fracture risk. New in vivo applicable methods permit measurements of fracture-relevant properties, [eg, cortical thickness and stiffness at fragile anatomic regions (eg, the distal radius and the proximal femur)]. Experimentally, resonance ultrasound spectroscopy and acoustic microscopy can be used to assess the mesoscale stiffness tensor and elastic maps of the tissue matrix at microscale resolution, respectively. QUS methods, thus, currently represent the most promising approach for noninvasive assessment of components of fragility beyond bone mass and bone microstructure providing prospects for improved assessment of fracture risk.
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Affiliation(s)
- Kay Raum
- Julius Wolff Institute & Berlin-Brandenburg School for Regenerative Therapies, Augustenburger Platz 1, 13353, Berlin, Germany,
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Non-destructive assessment of human ribs mechanical properties using quantitative ultrasound. J Biomech 2014; 47:1548-53. [DOI: 10.1016/j.jbiomech.2014.01.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 01/24/2014] [Accepted: 01/25/2014] [Indexed: 11/18/2022]
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Rohde K, Rohrbach D, Glüer CC, Laugier P, Grimal Q, Raum K, Barkmann R. Influence of porosity, pore size, and cortical thickness on the propagation of ultrasonic waves guided through the femoral neck cortex: a simulation study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2014; 61:302-313. [PMID: 24474136 DOI: 10.1109/tuffc.2014.6722615] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The femoral neck is a common fracture site in elderly people. The cortical shell is thought to be the major contributor to the mechanical competence of the femoral neck, but its microstructural parameters are not sufficiently accessible under in vivo conditions with current X-ray-based methods. To systematically investigate the influences of pore size, porosity, and thickness of the femoral neck cortex on the propagation of ultrasound, we developed 96 different bone models (combining 6 different pore sizes with 4 different porosities and 4 different thicknesses) and simulated the ultrasound propagation using a finite-difference time-domain algorithm. The simulated single-element emitter and receiver array consisting of 16 elements (8 inferior and 8 superior) were placed at anterior and posterior sides of the bone, respectively (transverse transmission). From each simulation, we analyzed the waveform collected by each of the inferior receiver elements for the one with the shortest time of flight. The first arriving signal of this waveform, which is associated with the wave traveling through the cortical shell, was then evaluated for its three different waveform characteristics (TOF: time point of the first point of inflection of the received signal, Δt: difference between the time point at which the signal first crosses the zero baseline and TOF, and A: amplitude of the first extreme of the first arriving signal). From the analyses of these waveform characteristics, we were able to develop multivariate models to predict pore size, porosity, and cortical thickness, corresponding to the 96 different bone models, with remaining errors in the range of 50 μm for pore size, 1.5% for porosity, and 0.17 mm for cortical thickness.
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Daugschies M, Rohde K, Glüer CC, Barkmann R. The preliminary evaluation of a 1 MHz ultrasound probe for measuring the elastic anisotropy of human cortical bone. ULTRASONICS 2014; 54:4-10. [PMID: 23896622 DOI: 10.1016/j.ultras.2013.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 07/04/2013] [Accepted: 07/04/2013] [Indexed: 06/02/2023]
Abstract
Our objective is to evaluate an ultrasound probe for measurements of velocity and anisotropy in human cortical bone (tibia). The anisotropy of cortical bone is a known and mechanically relevant property in the context of osteoporotic fracture risk. Current in vivo quantitative ultrasound devices measuring the velocity of ultrasound in long bones can only be applied in the axial direction. For anisotropy measurements a second direction for velocity measurements preferably perpendicular to the axial direction is necessary. We developed a new ultrasound probe which permits axial transmission measurements with a simultaneous second perpendicular direction (tangential). Anisotropy measurements were performed on isotropic and anisotropic phantoms and two excised human female tibiae (age 63 and 82). Anisotropy ratios (AI; ratio of squared ultrasound velocities in the two directions) were for the isotropic phantom 1.06 ± 0.01 and for the anisotropic phantom 1.14 ± 0.03 (mean ± standard deviation). AI was 1.83 ± 0.29 in the tibia from the older donor and 1.37 ± 0.18 in the tibia from the younger donor. The AIs were in the expected range and differed significantly (p<0.05, t-test) between the tibiae. Measured sound velocities were reproducible (mean standard deviation of short time precision of both channels for phantom measurements 31 m/s) and in agreement with reported velocities of the phantom material. Our results document the feasibility of anisotropy measurements at long bones using a single probe. Further improvements in the design of the probe and tests in vivo are warranted. If this approach can be evaluated in vivo an additional tool for assessing the bone status is available for clinical use.
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Affiliation(s)
- M Daugschies
- Sektion Biomedizinische Bildgebung, Klinik für Radiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Am Botanischen Garten 14, 24118 Kiel, Germany.
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Moreau L, Minonzio JG, Foiret J, Bossy E, Talmant M, Laugier P. Accurate measurement of guided modes in a plate using a bidirectional approach. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2014; 135:EL15-EL21. [PMID: 24437851 DOI: 10.1121/1.4832335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Measuring guided wave propagation in long bones is of interest to the medical community. When an inclination exists between the probe and the tested specimen surface, a bias is introduced on the guided mode wavenumbers. The aim of this study was to generalize the bidirectional axial transmission technique initially developed for the first arriving signal. Validation tests were performed on academic materials such a bone-mimicking plate covered with either a silicon or fat-mimicking layer. For any inclination, the wavenumbers measured with the probe parallel to the waveguide surface can be obtained by averaging the wavenumbers measured in two opposite directions.
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Affiliation(s)
- Ludovic Moreau
- UPMC University Paris 06, Unité Mixte de Recherche 7623, LIP, F-75005, Paris, France , ,
| | - Jean-Gabriel Minonzio
- UPMC University Paris 06, Unité Mixte de Recherche 7623, LIP, F-75005, Paris, France , ,
| | - Josquin Foiret
- UPMC University Paris 06, Unité Mixte de Recherche 7623, LIP, F-75005, Paris, France , ,
| | - Emmanuel Bossy
- Institut Langevin ESPCI ParisTech, CNRS Unité Mixte de Recherche 7587, Institut National de la Santé et de la Recherche Médicale ERL U979, 1 rue Jussieu F-75005 Paris France
| | - Maryline Talmant
- UPMC University Paris 06, Unité Mixte de Recherche 7623, LIP, F-75005, Paris, France ,
| | - Pascal Laugier
- UPMC University Paris 06, Unité Mixte de Recherche 7623, LIP, F-75005, Paris, France ,
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Kilappa V, Xu K, Moilanen P, Heikkola E, Ta D, Timonen J. Assessment of the fundamental flexural guided wave in cortical bone by an ultrasonic axial-transmission array transducer. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1223-1232. [PMID: 23643059 DOI: 10.1016/j.ultrasmedbio.2013.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 01/09/2013] [Accepted: 02/03/2013] [Indexed: 06/02/2023]
Abstract
The fundamental flexural guided wave (FFGW), as modeled, for example, by the A0 Lamb mode, is a clinically useful indicator of cortical bone thickness. In the work described in this article, we tested so-called multiridge-based analysis, based on the crazy climber algorithm and short-time Fourier transform, for assessment of the FFGW component recorded by a clinical array transducer featuring a limited number of elements. Methods included numerical finite-element simulations and experiments in bone phantoms and human radius specimens (n = 41). The proposed approach enabled extraction of the FFGW component and determination of its group velocity. This group velocity was in good agreement with theoretical predictions and possessed reasonable sensitivity to cortical width (r(2) = 0.51, p < 0.001) in the in vitro experiments. It is expected that the proposed approach enables related clinical application. Further work is still needed to analyze in more detail the challenges related to the impact of the overlying soft tissue.
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Affiliation(s)
- Vantte Kilappa
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland.
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Certon D, Ternifi R, Boulme A, Legros M, Minonzio JG, Talmant M, Patat F, Remenieras JP. Low frequency cMUT technology: Application to measurement of brain movement and assessment of bone quality. Ing Rech Biomed 2013. [DOI: 10.1016/j.irbm.2013.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Stein EM, Rosete F, Young P, Kamanda-Kosseh M, McMahon DJ, Luo G, Kaufman JJ, Shane E, Siffert RS. Clinical assessment of the 1/3 radius using a new desktop ultrasonic bone densitometer. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:388-95. [PMID: 23312957 PMCID: PMC3570600 DOI: 10.1016/j.ultrasmedbio.2012.09.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 09/20/2012] [Accepted: 09/27/2012] [Indexed: 05/23/2023]
Abstract
The objectives of this study were to evaluate the capability of a novel ultrasound device to clinically estimate bone mineral density (BMD) at the 1/3 radius. The device rests on a desktop and is portable, and permits real-time evaluation of the radial BMD. The device measures two net time delay (NTD) parameters, NTD(DW) and NTD(CW). NTD(DW) is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue, cortex and medullary cavity, and the transit time through soft tissue only of equal overall distance. NTD(CW) is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue and cortex only, and the transit time through soft tissue only again of equal overall distance. The square root of the product of these two parameters is a measure of the radial BMD at the 1/3 location as measured by dual-energy X-ray absorptiometry (DXA). A clinical IRB-approved study measured ultrasonically 60 adults at the 1/3 radius. BMD was also measured at the same anatomic site and time using DXA. A linear regression using NTD produced a linear correlation coefficient of 0.93 (p < 0.001). These results are consistent with previously reported simulation and in vitro studies. In conclusion, although X-ray methods are effective in bone mass assessment, osteoporosis remains one of the largest undiagnosed and under-diagnosed diseases in the world today. The research described here should enable significant expansion of diagnosis and monitoring of osteoporosis through a desktop device that ultrasonically assesses bone mass at the 1/3 radius.
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Affiliation(s)
- Emily M Stein
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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40
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Moilanen P, Määttä M, Kilappa V, Xu L, Nicholson PHF, Alén M, Timonen J, Jämsä T, Cheng S. Discrimination of fractures by low-frequency axial transmission ultrasound in postmenopausal females. Osteoporos Int 2013; 24:723-30. [PMID: 22638711 DOI: 10.1007/s00198-012-2022-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
Abstract
SUMMARY In this cross-sectional study, 95 postmenopausal women, with and without fracture history, were measured by low-frequency axial transmission ultrasound. The measured ultrasound velocity discriminated the fractured subjects from the nonfractured ones equally or better than peripheral quantitative computed tomography (pQCT) and dual energy x-ray absorptiometry (DXA). These results suggest that low-frequency ultrasound is suitable for bone fragility assessment. INTRODUCTION Quantitative low-frequency axial transmission ultrasound is a promising modality for assessing mineral density and geometrical properties of long bones such as radius and tibia. The aim of the current study was to evaluate the ability of low-frequency axial transmission ultrasound to discriminate fractures retrospectively in postmenopausal women. METHODS A cross-sectional study involved 95 female subjects aged 45-88 years, whose fracture information was gathered retrospectively. The fracture group was defined as subjects with one or more low-/moderate-energy fractures. The radius and tibial shaft were measured with a custom-made ultrasonometer to assess the velocity of the low-frequency first-arriving signal (V (LF)). Site-matched pQCT was used to measure volumetric cortical and subcortical bone mineral density (sBMD), and cortical thickness (CTh). Areal BMD (aBMD) was measured using DXA for the whole body (WB), lumbar spine, and hip. RESULTS The majority (19/32; 59 %) of the fractures were in the upper limb. V (LF) in the radius, but not in the tibia, discriminated fractures with an age- and BMI-adjusted odds ratio (OR) of 2.06 (95 % CI 1.21-3.50, p < 0.01). In the radius, CTh and cortical BMD (CBMD) significantly discriminated fractures, as did the total, cortical, and sBMD in the tibia (adjusted OR 1.35-2.15, p < 0.05). Sensitivity and specificity were similar among all the measurements (area under the receiver operating characteristic curve 0.74-0.81, p < 0.001). CONCLUSIONS Low-frequency axial transmission ultrasound in the radius was able to discriminate fractured subjects from the nonfractured ones. This suggests that low-frequency axial transmission ultrasound has the potential to assess bone fragility in postmenopausal women.
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Affiliation(s)
- P Moilanen
- Department of Physics, University of Jyväskylä, P.O. Box 35, Jyväskylä, FI-40014, Finland.
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Foiret J, Grimal Q, Talmant M, Longo R, Laugier P. Probing heterogeneity of cortical bone with ultrasound axial transmission. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2013; 60:187-193. [PMID: 23405434 DOI: 10.1109/tuffc.2013.2549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In clinical examination of long cortical bones based on ultrasound axial transmission, the parameter currently used as indicator of bone fragility is the velocity of the first arriving signal (VFAS). VFAS is inherently related to the material properties of the bone site. However, experimental uncertainties may hide the true sensitivity of VFAS to elastic characteristics of bone. Measurements are performed with a multi-element compact array placed in contact with the bone. Therefore, VFAS measurements may be biased by variability imposed by geometrical irregularities of the sample below the probe and/or by probe misalignment. In this paper, we test the assumption that despite experimental errors, VFAS variations resulting from material properties can be measured. The methodology was to compare VFAS and velocities of compression bulk waves (VBWs) on carefully matched sites around the circumference of a test sample (bovine femur). VBW was mapped on bone cross-sections using a through-transmission technique. VBW and VFAS were highly correlated [R² = 0.80, root mean square error = 23 m·s⁻¹, p < 10⁻⁵] and the slope of the linear regression was close to 1 except in a part of the circumference with a pronounced curvature. In measurements performed with the same protocol as for clinical measurements, regions with different material properties (reflected by VBW) could be identified. This work demonstrates that within-specimen variations of material properties can be assessed with a technique available for in vivo measurements.
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Affiliation(s)
- Josquin Foiret
- Laboratoire d’Imagerie Parametrique, UMR 7623, Universite Pierre et Marie Curie-Paris VI, Paris, France.
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Chen J, Foiret J, Minonzio JG, Talmant M, Su Z, Cheng L, Laugier P. Measurement of guided mode wavenumbers in soft tissue–bone mimicking phantoms using ultrasonic axial transmission. Phys Med Biol 2012; 57:3025-37. [DOI: 10.1088/0031-9155/57/10/3025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Minonzio JG, Foiret J, Talmant M, Laugier P. Impact of attenuation on guided mode wavenumber measurement in axial transmission on bone mimicking plates. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2011; 130:3574-3582. [PMID: 22225014 DOI: 10.1121/1.3652884] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Robust signal processing methods adapted to clinical measurements of guided modes are required to assess bone properties such as cortical thickness and porosity. Recently, an approach based on the singular value decomposition (SVD) of multidimensional signals recorded with an axial transmission array of emitters and receivers has been proposed for materials with negligible absorption, see Minonzio et al. [J. Acoust. Soc. Am. 127, 2913-2919 (2010)]. In presence of absorption, the ability to extract guided mode degrades. The objective of the present study is to extend the method to the case of absorbing media, considering attenuated plane waves (complex wavenumber). The guided mode wavenumber extraction is enhanced and the order of magnitude of the attenuation of the guided mode is estimated. Experiments have been carried out on 2 mm thick plates in the 0.2-2 MHz bandwidth. Two materials are inspected: polymethylacrylate (PMMA) (isotropic with absorption) and artificial composite bones (Sawbones, Pacific Research Laboratory Inc, Vashon, WA) which is a transverse isotropic absorbing medium. Bulk wave velocities and bulk attenuation have been evaluated from transmission measurements. These values were used to compute theoretical Lamb mode wavenumbers which are consistent with the experimental ones obtained with the SVD-based approach.
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Affiliation(s)
- Jean-Gabriel Minonzio
- CNRS, UPMC Univ Paris 06, UMR 7623, LIP, 15 rue de l'école de médecine F-75006, Paris, France.
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Song X, Ta D, Wang W. Analysis of superimposed ultrasonic guided waves in long bones by the joint approximate diagonalization of eigen-matrices algorithm. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:1704-1713. [PMID: 21924208 DOI: 10.1016/j.ultrasmedbio.2011.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 04/06/2011] [Accepted: 06/29/2011] [Indexed: 05/31/2023]
Abstract
The parameters of ultrasonic guided waves (GWs) are very sensitive to mechanical and structural changes in long cortical bones. However, it is a challenge to obtain the group velocity and other parameters of GWs because of the presence of mixed multiple modes. This paper proposes a blind identification algorithm using the joint approximate diagonalization of eigen-matrices (JADE) and applies it to the separation of superimposed GWs in long bones. For the simulation case, the velocity of the single mode was calculated after separation. A strong agreement was obtained between the estimated velocity and the theoretical expectation. For the experiments in bovine long bones, by using the calculated velocity and a theoretical model, the cortical thickness (CTh) was obtained. For comparison with the JADE approach, an adaptive Gaussian chirplet time-frequency (ACGTF) method was also used to estimate the CTh. The results showed that the mean error of the CTh acquired by the JADE approach was 4.3%, which was smaller than that of the ACGTF method (13.6%). This suggested that the JADE algorithm may be used to separate the superimposed GWs and that the JADE algorithm could potentially be used to evaluate long bones.
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Affiliation(s)
- Xiaojun Song
- Department of Electronic Engineering, Fudan University, Shanghai, China
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Tran D, Bruyere-Garnier K, Didier AL, Minonzio JG, Foiret J, Vilayphiou N, Talmant M, Laugier P, Mitton D. Non-invasive assessment of human ribs mechanical properties. Comput Methods Biomech Biomed Engin 2011. [DOI: 10.1080/10255842.2011.595176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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A two-parameter model of the effective elastic tensor for cortical bone. J Biomech 2011; 44:1621-5. [DOI: 10.1016/j.jbiomech.2011.03.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 03/04/2011] [Accepted: 03/04/2011] [Indexed: 11/24/2022]
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Machado CB, Pereira WCDA, Granke M, Talmant M, Padilla F, Laugier P. Experimental and simulation results on the effect of cortical bone mineralization in ultrasound axial transmission measurements: a model for fracture healing ultrasound monitoring. Bone 2011; 48:1202-9. [PMID: 21376151 DOI: 10.1016/j.bone.2011.02.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 01/27/2011] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
Ultrasound axial transmission (UAT), a technique using propagation of ultrasound waves along the cortex of cortical bones, has been proposed as a diagnostic technique for the evaluation of fracture healing. Quantitative ultrasound parameters have been reported to be sensitive to callus changes during the regeneration process. The aim of this work was to identify the specific effect of cortical bone mineralization on UAT measurements by means of numerical simulations and experiments using a reverse fracture healing approach. A cortical bovine femur sample was used, in which a 3mm fracture gap was drilled. A 3mm thick cortical bone slice, extracted from another location in the bone sample, was submitted to a progressive demineralization process with EDTA during 12 days. UAT measurements and simulations using a 1MHz probe were performed with the demineralized slice placed into the fracture gap to mimic different stages of mineralization during the healing process. The calcium loss of the slice due to the EDTA treatment was recorded everyday, and its temporal evolution could be modeled by an exponential law. A 50MHz scanning acoustic microscopy was also used to assess the mineralization degree of the bone slice at the end of the intervention. These data were used in the numerical simulations to derive a model of the time evolution of bone slice mechanical properties. From both the experiments and the simulations, a significant and progressive increase in the time of flight (TOF; p<0.001) of the propagating waves measured by UAT was observed during the beginning of the demineralization process (first 4 days). Although the simulated TOF values were slightly larger than the experimental ones, they both exhibited a similar time-dependence, validating the simulation approach. Our results suggest that TOF measured in axial transmission is affected by local changes of speed of sound induced by changes in local mineralization. TOF may be an appropriate indicator to monitor callus maturation.
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Kilappa V, Moilanen P, Xu L, Nicholson PHF, Timonen J, Cheng S. Low-frequency axial ultrasound velocity correlates with bone mineral density and cortical thickness in the radius and tibia in pre- and postmenopausal women. Osteoporos Int 2011; 22:1103-13. [PMID: 20577874 DOI: 10.1007/s00198-010-1273-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 04/08/2010] [Indexed: 01/28/2023]
Abstract
UNLABELLED Axial transmission velocity of a low-frequency first arriving signal (V (LF)) was assessed in the radius and tibia of 254 females, and compared to site-matched pQCT measurements. V (LF) best correlated with cortical BMD, but significantly also with subcortical BMD and cortical thickness. Correlations were strongest for the radius in postmenopausal females. INTRODUCTION Ultrasonic low-frequency (LF; 0.2-0.4 MHz) axial transmission, based on the first arriving signal (FAS), provides enhanced sensitivity to thickness and endosteal properties of cortical wall of the radius and tibia compared to using higher frequencies (e.g., 1 MHz). This improved sensitivity of the LF approach has not yet been clearly confirmed by an in vivo study on adult subjects. The aims of the present study were to evaluate the extent to which LF measurements reflect cortical thickness and bone mineral density, and to assess whether an individual LF measurement can provide a useful estimate for these bone properties. METHODS Velocity of the LF FAS (V (LF)) was assessed in the radius and tibia shaft by a new ultrasonometer (CV(RMS) = 0.5%) in a cross-sectional study involving 159 premenopausal (20-58 years) and 95 postmenopausal females (45-88 years). Site-matched volumetric total bone mineral density (BMD), cortical bone mineral density (CBMD), subcortical bone mineral density (ScBMD) and cortical thickness (CTh) were assessed using pQCT. RESULTS For the postmenopausal females, V (LF) correlated best with CBMD in the radius (R = 0.850, p < 0.001), but significantly also with ScBMD and CTh (R = 0.759 and R = 0.761, respectively; p < 0.001). Similar trends but weaker correlations were observed for the tibia and for the premenopausal women. CONCLUSIONS The LF assessment, with an optimal excitation frequency, thus provided good prediction of both cortical thickness and subcortical bone material properties. These results suggest that the LF approach does indeed have enhanced sensitivity for detecting osteoporotic changes that occur deep in the endosteal bone.
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Affiliation(s)
- V Kilappa
- Department of Physics, University of Jyväskylä, PO BOX 35 (YFL), 40014 Jyväskylä, Finland.
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Haïat G, Naili S, Ba Vu M, Desceliers C, Soize C. Equivalent contributing depth investigated by a lateral wave with axial transmission in viscoelastic cortical bone. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2011; 129:EL114-EL120. [PMID: 21476617 DOI: 10.1121/1.3554719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Cortical bone is a viscoelastic heterogeneous medium which may be assessed with axial transmission. This work aims at evaluating the average depth investigated by the lateral wave for radial variations of material properties in relatively thick cortical bone. The equivalent contributing depth (ECD) is derived from the finite element simulation results for spatial variations of a viscoelastic coefficient (η(11)) and of porosity. A value of ECD equal to around 1.6 mm is obtained for a spatial variation of η(11). The method fails to predict accurate values of the ECD for a spatial variation of porosity, because all parameters vary simultaneously.
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Affiliation(s)
- Guillaume Haïat
- CNRS, Université Paris-Est, Laboratoire Modélisation et Simulation Multi Echelle, UMR 8208 CNRS, 94010 Créteil Cedex, France.
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Xu K, Ta D, Wang W. Multiridge-based analysis for separating individual modes from multimodal guided wave signals in long bones. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2010; 57:2480-2490. [PMID: 21041135 DOI: 10.1109/tuffc.2010.1714] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Quantitative ultrasound has great potential for assessing human bone quality. Considered as an elastic waveguide, long bone supports propagation of several guided modes, most of which carry useful information, individually, on different aspects of long bone properties. Therefore, precise knowledge of the behavior of each mode, such as velocity, attenuation, and amplitude, is important for bone quality assessment. However, because of the complicated characteristics of the guided waves, including dispersion and mode conversion, the measured signal often contains multiple wave modes, which yields the problem of mode separation. In this paper, some novel signal processing approaches were introduced to solve this problem. First, a crazy-climber algorithm was used to separate time-frequency ridges of individual modes from time-frequency representations (TFR) of multimodal signals. Next, corresponding time domain signals representing individual modes were reconstructed from the TFR ridges. It was found that the separated TFR ridges were in agreement with the theoretical dispersion, and the reconstructed signals were highly representative of the individual guided modes as well. The validations of this study were analyzed by simulated multimodal signals, with or without noise, and by in vitro experiments. Results of this study suggest that the ridge detection and individual reconstruction method are suitable for separating individual modes from multimodal signals. Such a method can improve the analysis of skeletal guided wave signals by providing accurate assessment of mode-specific ultrasonic parameters, such as group velocity, and indicate different bone quality properties.
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Affiliation(s)
- Kailiang Xu
- Department of Electronic Engineering, Fudan University, Shanghai, PR China
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