Calcified Tissue International

, Volume 55, Issue 1, pp 46–52 | Cite as

Three quantitative ultrasound parameters reflect bone structure

  • C. C. Gluer
  • C. Y. Wu
  • M. Jergas
  • S. A. Goldstein
  • H. K. Genant
Laboratory Investigations


We investigated whether quantitative ultrasound (QUS) parameters are associated with bone structure. In an in vitro study on 20 cubes of trabecular bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters—ultrasound velocity through bone (UVB) and ultrasound attenuation in bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and bone structure was assessed by microcomputed tomography (μCT) with approximately 80 μm spatial resolution. We found all three QUS parameters to be significantly associated with bone structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with bone structure parameters showed squared correlation coefficients of r2=0.70–0.85 for UVB, r2=0.27–0.56 for UAB, and r2=0.30–0.68 for BUA compared with r2=0.18–0.58 for UVB, r2<0.26 for UAB and r2<0.13 for BUA for models including BMD alone. QUS thus reflects bone structure, and a combined analysis of QUS and BMD will allow for a more comprehensive assessment of skeletal status than either method alone.

Key words

Osteoporosis Ultrasound Bone densitometry Bone structure 


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  1. 1.
    Genant HK, Faulkner KG, Glüer CC (1991) Measurement of bone mineral density: current status. Am J Med 91 (suppl 5B): 49–53Google Scholar
  2. 2.
    Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Hulley SB, Palermo L, Scott J, Vogt TM (1993) Bone density at various sites for prediction of hip fractures: the study of osteoporotic fractures. Lancet 341:72–75Google Scholar
  3. 3.
    Wasnich RD, Ross PD, Heilbrun LK, Vogel JM (1987) Selection of the optimal site for fracture risk prediction Clin Orthop 216: 262–268Google Scholar
  4. 4.
    Gärdsell P, Johnell O, Nilsson BE (1989) Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int 44:235–242Google Scholar
  5. 5.
    Hui SL, Slemenda CW, Johnston CC (1989) Baseline measurement of bone mass predicts fracture in white women. Ann Intern Med 111:355–361Google Scholar
  6. 6.
    Lotz JC, Gerhart TN, Hayes WC (1990) Mechanical properties of trabecular bone from the proximal femur: a quantitative CT study. J Comput Assist Tomogr 14:107–114Google Scholar
  7. 7.
    Mosekilde L, Bentzen SM, rtoft G, Jørgensen J (1989) The predictive value of quantitative computed tomography for vertebral body compressive strength and ash density. Bone 10:465–470Google Scholar
  8. 8.
    Lang SM, Moyle DD, Berg EW, Detorie N, Gilpin AT, Pappan Jr NJ, Reynolds JC, Tkacik M, Waldron RL (1988) Correlation of mechanical properties of vertebral trabecular bone with equivalent mineral density as measured by computed tomography. J Bone Joint Surg 70-A:1531–1538Google Scholar
  9. 9.
    Hayes WC, Piazza SJ, Zysset PK (1991) Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography. Radiol Clin North Am 29:1–18Google Scholar
  10. 10.
    Goulet RW, Goldstein SA, Ciarelli MJ, Kuhn JL, Brown MB, Feldkamp LA (in press) Relationship between the structural and orthogonal compressive properties of trabecular bone. J BiomechanicsGoogle Scholar
  11. 11.
    Ciarelli MJ, Goldstein SA, Kuhn JL, Cody DD, Brown MB (1991) Evaluation of orthogonal mechanical properties and density of human trabecular bone from the major metaphyseal regions with materials testing and computed tomography. J Orthop Res 9:674–682Google Scholar
  12. 12.
    Goldstein SA, Goulet R, McCubbrey D (1993) Measurement and significance of three-dimensional architecture in the mechanical integrity of trabecular bone. Calcif Tissue Int 53(S.1): S127–133Google Scholar
  13. 13.
    Riggs BL, Hodgson SF, O'Fallon WM, Chao EYS, Wahner HW, Muhs JM, Cedel SL, Melton LJ (1990) Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med 322:802–809Google Scholar
  14. 14.
    Ross PD, Genant HK, Davis JW, P.D. M., Wasnich RD (1993) Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporosis Int 3:120–126Google Scholar
  15. 15.
    Heaney RP, Avioli LV, Chestnut CH, Lappe J, Recker RR, Brandburger GH (1989) Osteoporotic bone fragility: detection by ultrasound transmission velocity. JAMA 261:2986–2990Google Scholar
  16. 16.
    Baran DT, Kelly AM, Karellas A, Gionet M, Price M, Leahy D, Steuterman S, McSherry B, Roche J (1988) Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif Tissue Int 43:138–142Google Scholar
  17. 17.
    Langton CM, Palmer SB, Porter RW (1984) The measurement of broadband ultrasound attenuation in cancellous bone. Eng Med 13:89–91Google Scholar
  18. 18.
    Antich PP, Anderson JA, Ashman RB, Dowdey JE, Gonzales J, Murry RC, Zerwekh JE, Pak CY (1991) Measurement of mechanical properties of bone material in vitro by ultrasound reflection: methodology and comparison with ultrasound transmission. J Bone Miner Res 6:417–426Google Scholar
  19. 19.
    Zagzebski JA, Rossmann PJ, Mesina C, Mazess RB, Madsen EL (1991) Ultrasound transmission measurements through the os calcis. Calcif Tissue Int 49:107–111Google Scholar
  20. 20.
    Kaufman JJ, Einhorn TA (1993) Perspectives: ultrasound assessment of bone. Osteoporosis Int 8:517–525Google Scholar
  21. 21.
    Hans D, Schott AM, Meunier PJ (1993) Ultrasonic assessment of bone: a review. Eur J Med 2:157–163Google Scholar
  22. 22.
    Smith S, Gautam PC, Porter RW (1992) Bone stiffness in elderly women with hip fracture. Bone 13:281–282Google Scholar
  23. 23.
    Glüer CC, Vahlensieck M, Faulkner KG, Engelke K, Black D, Genant HK (1992) Site-matched calcaneal measurements of broadband ultrasound attenuation and single x-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res 7:1071–1079Google Scholar
  24. 24.
    Waud C, Lew R, DT. B (1992) The relationship between ultrasound and densitometric measurements of bone mass at the calcaneus in women. Calcif Tissue Int 51:415–418Google Scholar
  25. 25.
    Glüer CC, Wu CY, Genant HK (1993) Broadband ultrasound attenuation signals depend on trabecular orientation: an in-vitro study. Osteoporosis Int 3:185–191Google Scholar
  26. 26.
    Miller CG, Herd RJM, Ramalingam T, Fogelman I, Blake GM (1993) Ultrasonic velocity measurements through the calcaneus: which velocity should be measured? Osteoporosis Int 3:31–35Google Scholar
  27. 27.
    Evans JA, Tavakoli MB (1990) Ultrasonic attenuation and velocity in bone. Phys Med Biol 35:1387–1396Google Scholar
  28. 28.
    Kuhn JL, Goldstein SA, Feldkamp LA, Goulet RW, Jesion G (1990) Evaluation of a microcomputed tomography system to study trabecular bone structure. J Orthop Res 8:833–842Google Scholar
  29. 29.
    Parfitt AM, Matthews C, Villanueva A (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. J Clin Invest 72:1396–1409Google Scholar
  30. 30.
    Serra J (1982) Image analysis and mathematical morphology. Academic Press, LondonGoogle Scholar
  31. 31.
    Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4:3–11Google Scholar
  32. 32.
    Harrigan TP, Mann RW (1984) Characterization of microstructural anisotropy in orthotropic materials using a second rank tensor. J Mater Sci 19:761–767Google Scholar
  33. 33.
    Abendschein W, Hyatt GW (1970) Ultrasonics and selected physical properties of bone. Clin Orthop Rel Res 69:294–301Google Scholar
  34. 34.
    Bonfield W, Tully AE (1982) Ultrasonic analysis of the Young's modulus of cortical bone. J Biomed Eng 4:23–27Google Scholar
  35. 35.
    Ashman RB, Cowin SC van Buskirk WC, Rice JC (1984) A continuous wave technique for the measurement of the elastic properties of cortical bone. J Biomechanics 17:349–361Google Scholar
  36. 36.
    Rothman K (1990) No adjustment needed for multiple comparisons. Epidemiology 1:43–46Google Scholar
  37. 37.
    Turner CH, Cowin SC (1988) Errors induced by off-axis measurement of the elastic properties of bone. J Biomech Eng 110: 213–215Google Scholar
  38. 38.
    Turner CH, Cowin SC, Rho JY, Ashman RB, Rice JC (1990) The fabric dependence of the orthotropic elastic constants of cancellous bone. J Biomechanics 23:549–561Google Scholar
  39. 39.
    Grimm MJ, Williams JL (1993) Use of ultrasound attenuation and velocity to estimate Young's modulus in trabecular bone. In: li JKL, Reisman SS (ed) Proc 19th IEEE Annula Northeast Bioengineering Conf, Newark, NJ, IEEE, pp 62–63Google Scholar
  40. 40.
    Bauer DC, Glüer CC, Stone KL, Genant HK, Cummings SR (1993) Quantitative ultrasound and vertebral deformity in post-menopausal women. J Bone Miner Res 8(suppl 1):S-353Google Scholar

Copyright information

© Springer-Verlag New York Inc 1994

Authors and Affiliations

  • C. C. Gluer
    • 1
  • C. Y. Wu
    • 1
  • M. Jergas
    • 1
  • S. A. Goldstein
    • 2
  • H. K. Genant
    • 1
  1. 1.Osteoporosis Research Group, Department of RadiologyUniversity of CaliforniaSan FranciscoUSA
  2. 2.Orthopaedic Research Laboratories at the University of MichiganAnn ArborUSA

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