Ultrasonic assessment of cortical bone thickness in vitro and in vivo

In osteoporosis, total bone mass decreases and the thickness of the cortical layer diminishes in the shafts of the long bones. In this study, a simple ultrasonic in vivo method for determining the thickness of the cortical bone layer was applied, and the suitability of two different signal analysis techniques, i.e., envelope and cepstral methods, for measuring cortical thickness was compared. The values of cortical thickness, as determined with both techniques, showed high linear correlations (r ≥ 0.95) with the thickness values obtained from in vitro measurements with a caliper or in vivo measurements by peripheral quantitative CT (pQCT). No systematic errors that could be related to the cortical thickness were found. The in vivo accuracy of the measurements was 6.6% and 7.0% for the envelope and cepstral methods, respectively. Further, the in vivo precision for the envelope and cepstral methods was 0.26 mm and 0.28 mm, respectively. Although the results are similar for both of the techniques, the simplicity of the envelope method makes it more attractive for clinical applications. In conclusion, a simple ultrasound measurement provides an accurate estimate of the cortical bone thickness. The techniques investigated may have clinical potential for osteoporosis screening and therefore warrant more extensive clinical investigations with healthy and osteoporotic individuals

Linear acoustics of trabecular bone

During the two recent decades, quantitative ultrasound (QUS) methods have been developed for in vivo diagnostics of trabecular bone. Mostly, trabecular bone QUS measurements are conducted in through-transmission and pulse-echo geometry. Since the first in vivo QUS measurements at the heel, the research efforts have also been focused on enabling QUS measurements at important fracture sites, such as proximal femur or lumbar vertebra. This chapter introduces the experimental QUS methods and reviews the recent developments in in vitro and in vivo measurement methods and results on linear acoustic properties of trabecular bone. Specifically, ultrasound parameters determined in through-transmission and pulse-echo measurements are introduced and their frequency dependency as well as feasibility for characterization of bone density, structure, composition and mechanical properties is reviewed. Finally, potential of QUS for clinical diagnostics of osteoporosis and prediction of bone fracture risk are discussed, with some suggestions

Ultrasound Backscatter Imaging Provides Frequency-Dependent Information on Structure, Composition and Mechanical Properties of Human Trabecular Bone

The strength as well as the acoustic properties of trabecular bone are determined by its structure and composition. Consequently, tissue structure and compositional properties also affect the ultrasound propagation in bone. The diagnostic potential of ultrasound has not been fully exploited in clinical quantitative ultrasound devices. The aim of this study was to investigate the ability of quantitative ultrasound pulse-echo imaging, conducted over a broad range of frequencies (1 to 5 MHz), to predict the mechanics, composition and microstructure of trabecular bone. Ultrasound reflection and backscatter parameters correlated significantly with the ultimate strength of the trabecular bone and the bone volume fraction (r = 0.76-0.90, n = 20, p < 0.01). Ultrasound backscatter associated significantly (independently of bone structure or mineral content) with the collagen content of the bone matrix (r = 0.75, r = 0.66, p < 0.01). Interestingly, the applied ultrasound frequency seemed to relate the sensitivity of ultrasound backscatter to different properties of trabecular bone. At frequencies ranging from 1 to 3.5 MHz, the ultrasound backscatter associated significantly with the tissue mechanical and structural parameters. At 5 MHz, the composition of the bone matrix was a more significant determinant of the measured backscatter. This study provides useful information for optimizing the use of pulse-echo measurements, and thereby further emphasizes the diagnostic potential of the ultrasound backscatter measurements of trabecular bone

Numerical Analysis of Uncertainties in Dual Frequency Bone Ultrasound Technique

Quantitative ultrasound (QUS) measurements are used in the diagnostics of osteoporosis. However, the variation in the thickness and composition of the overlying soft tissue causes significant errors to the bone QUS parameters and diminishes the reliability of the technique in vivo. Recently, the dual frequency ultrasound (DFUS) technique was introduced to minimize the errors related to soft tissue effects. In this study, the significance of soft tissue induced errors and their elimination with the DFUS technique were simulated using the finite difference time domain technique. Furthermore, we investigated the potential of the DFUS corrected integrated reflection coefficient (IRC) of bone to detect changes in the cortical bone density. The effects of alterations in the thickness of fat and lean tissue layers and the inclination between the soft-tissues and between the soft tissue-bone layers were simulated. When the angle of the soft tissue interface was zero, i.e., perpendicular to the incident ultrasound beam, the DFUS-calculated soft tissue composition correlated highly linearly with the true soft tissue composition. The inclination between the soft tissue-bone layers was found to be critical. Even a 2-degree inclination between the soft tissue and the bone surface induced an almost 18% relative error in the corrected IRC. Increasing the inclination between the soft tissue layers increased the error in the DFUS-calculated lean and fat tissue thickness. This error was especially significant at inclination angles greater than 20 degrees. The significant soft tissue induced errors in IRC values (>300 %) could be effectively minimized