Abstract
Measurements of broadband ultrasonic attenuation (BUA) represent an established means of skeletal status assessment in osteoporosis. Today, the skeletal site that is the most widely used clinically is the calcaneus (heel bone). However, we hypothesized that fracture risk predictions could be improved if ultrasound measurements were performed directly at the main site of fracture, e.g., the proximal femur. The goal of this paper is to demonstrate in vitro the feasibility of quantitative ultra sound (QUS) imaging at the upper part of fee femur, and to investigate the relationships of BUA to bone mineral density (BMD). Forty-four excise human femurs were measured in transmission with a pair of focused 0.5-MHz central frequency transducers. Two-dimensional scans were performed, and the radio frequency (rf) signals were recorded at each measurement point. A data acceptance criterion for region of interest (ROI) selection was established based on the linearity of the frequency-dependent attenuation. Five measurements with repositioning were performed on each sample to determine the reproducibility. Dual energy x-ray absorptiometry (DXA) scans have been performed on the samples for BMD measurements: Three ROIs were selected in the specimens: greater, trochanter intertrochanteric, and femoral neck regions. Coefficient of variations were in the range 1.6% to 2.5 %. The determination coefficients (r2) between BUA and BMD in site-matched ROIs were 0.81, 0.78, and 0.73, respectively, for the greater trochanteric, intertrochanteric, and femoral neck regions. Our results are consistent with data previously shown at the calcaneus and demonstrate the feasibility of QUS measurements at the femur in vitro, with reasonable reproducibility.
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References
RJ Norris (1992) ArticleTitleMedical costs of osteoporosis Bone 13 S11–16 Occurrence Handle1627408
TM Link S Majumdar JC Lin D Newitt P Augat X Ouyang A Mathur HK Genant (1998) ArticleTitleA comparative study of trabecular bone properties in the spine and femur using high resolution MRI and CT J Bone Miner Res 13 122–132 Occurrence Handle1:STN:280:DyaK1c7gsVSgtw%3D%3D Occurrence Handle9443798
S Majumdar M Kothari P Augat DC Newitt TM Link JC Lin T Lang Y Lu HK Genant (1998) ArticleTitleHigh-resolution magnetic resonance imaging: three-dimensional trabecular bone architecture and biomechanical properties Bone 22 445–454 Occurrence Handle10.1016/S8756-3282(98)00030-1 Occurrence Handle1:STN:280:DyaK1c3mtFCjtg%3D%3D Occurrence Handle9600777
TM Link V Vieth C Stehling A Lotter A Beer D Newitt S Majumdar (2003) ArticleTitleHigh-resolution MRI vs multislice spiral CT: which technique depicts the trabecular bone structure best? Eur Radiol 13 663–671 Occurrence Handle12664101
P Laugier P Giat G Berger (1994) ArticleTitleBroadband ultrasonic attenuation imaging: A new imaging technique of the os calcis Calcif Tissue Int 54 83–86 Occurrence Handle1:STN:280:ByuB1c3msFE%3D Occurrence Handle8012875
CM Langton SB Palmer SW Porter (1984) ArticleTitleThe measurement of broadband ultrasonic attenuation in cancellous bone Engineering Med 13 89–91 Occurrence Handle1:STN:280:BiuB283hsFI%3D
R Barkmann E Kantorovich C Singal D Hans H Genant M Heller C Gluer (2000) ArticleTitleA new method for quantitative ultrasound measurements at multiple skeletal sites J Clin Densitom 3 1–7 Occurrence Handle10.1385/JCD:3:1:001 Occurrence Handle1:STN:280:DC%2BD3c3htFyksA%3D%3D Occurrence Handle10745297
E Bossy M Talmant P Laugier (2003) ArticleTitleBi-directional axial transmission can improve accuracy and precision of ultrasonic velocity measurement in cortical bone: a validation on test material JEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control Under Press . .
R Barkmann S Lusse B Stampa S Sakata M Heller CC Gluer (2000) ArticleTitleAssessment of the geometry of human ringer phalanges using quantitative ultrasound in vivo Osteoporos Int 11 745–755 Occurrence Handle10.1007/s001980070053 Occurrence Handle1:STN:280:DC%2BD3M7hs1aqsQ%3D%3D Occurrence Handle11148802
RB Ashman JY Rho (1988) ArticleTitleElastic modulus of trabecular bone material J Biomech 21 177–181 Occurrence Handle10.1016/0021-9290(88)90167-4 Occurrence Handle1:STN:280:BieB2czosFU%3D Occurrence Handle3379077
CF Njeh CW Kuo CM Langton HI Atrah CM Boivin (1997) ArticleTitlePrediction of human femoral bone strength using ultrasound velocity and BMD: an in vitro study Osteoporosis Int 7 471–477 Occurrence Handle10.1007/s001980050035 Occurrence Handle1:STN:280:DyaK1c%2Fos1KnsQ%3D%3D
ML Bouxsein SE Radloff (1997) ArticleTitleQuantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone J Bone Miner Re 12 839–846 Occurrence Handle1:STN:280:ByiB1cbksVI%3D
PH Nicholson R Muller G Lowet XG Cheng T Hildebrand P Ruegsegger G Perre Particlevan der J Dequeker S Boonen (1998) ArticleTitleDo quantitative ultrasound measurements reflect structure independently of density in human vertebral cancellous bone? Bone 23 425–431 Occurrence Handle10.1016/S8756-3282(98)00128-8 Occurrence Handle1:STN:280:DyaK1M%2FktVOrsA%3D%3D Occurrence Handle9823448
S Chaffaï F Peyrin S Nuzzo R Porcher G Berger P Laugier (2002) ArticleTitleUltrasonic characterization of human cancellous bone using transmission and backscatter measurements: relationships to density and microstructure Bone 30 229–237 Occurrence Handle10.1016/S8756-3282(01)00650-0 Occurrence Handle11792590
F Jenson F Padilla P Laugier (2003) ArticleTitlePrediction of frequency-dependent ultrasonic backscatter in cancellous bone using statistical weak scattering model Ultrasound Med Biol 29 455–464 Occurrence Handle10.1016/S0301-5629(02)00742-1 Occurrence Handle12706197
CF Njeh D Hans T Fuerst C Gluer HK Genant (1999) Quantitative ultrasound: assessment of osteoporosis and bone status Martin Dunitz Ltd London
CC Gluer SR Cummings DC Bauer K Stone A Pressman A Mathur HK Genant (1996) ArticleTitleOsteoporosis: association of recent fractures with quantitative US findings Radiology 199 725–732 Occurrence Handle8637996
D Hans P Dargent-Moline AM Schott JL Sebert C Cormier PO Kotski PD Delmas JM Pouilles G Breart PJ Meunier (1996) ArticleTitleUltrasonographic heel measurements to predict hip fracture in elderly women: the Epidos prospective study Lancet 348 511–514 Occurrence Handle10.1016/S0140-6736(95)11456-4 Occurrence Handle1:STN:280:BymA2cjnvVU%3D Occurrence Handle8757153
DC Bauer CC Gluer JA Cauley TM Vogt KE Ensrud HK Genant DM Black (1997) ArticleTitleBroadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women Arch Intern Med 157 629–634 Occurrence Handle10.1001/archinte.157.6.629 Occurrence Handle1:STN:280:ByiB3srpvFw%3D Occurrence Handle9080917
P Thompson J Taylor A Fisher R Oliver (1998) ArticleTitleQuantitative heel ultrasound in 3180 women between 45 and 75 years of age: compliance, normal ranges and relationship to fracture history Osteoporos Int 8 211–214 Occurrence Handle10.1007/s001980050056 Occurrence Handle1:STN:280:DyaK1M%2FhsVKgug%3D%3D Occurrence Handle9797904
C Huang PD Ross AJ Yates RE Walker K Imose K Emi RD Wasnich (1998) ArticleTitlePrediction of fracture risk by radiographic absorptiometry and quantitative ultrasound: a prospective study Calcif Tissue Int 63 380–384 Occurrence Handle10.1007/s002239900544 Occurrence Handle1:CAS:528:DyaK1cXntV2ltr4%3D Occurrence Handle9799821
ML Bouxsein L Palermo C Yeung DM Black (2002) ArticleTitleDigital X-ray radiogrammetry predicts hip, wrist and vertebral fracture risk in elderly women: a prospective analysis from the study of osteoporotic fractures Osteoporos Int 13 358–365 Occurrence Handle10.1007/s001980200040 Occurrence Handle1:STN:280:DC%2BD38zktlantw%3D%3D Occurrence Handle12086345
J Duquette J Lin A Hoffman J Houde S Ahmadi D Baran (1997) ArticleTitleCorrelations among bone mineral density, broadband ultrasound attenuation, mechanical indentation testing, and bone orientation in bovine femoral neck samples Calcif Tissue Int 60 181–186 Occurrence Handle10.1007/s002239900211 Occurrence Handle1:CAS:528:DyaK2sXhtVagu78%3D Occurrence Handle9056168
P Laugier P Droin AM Laval-Jeantet G Berger (1997) ArticleTitle In vitro assessment of the relationship between acoustic properties and bone mass density of the calcaneus by comparison of ultrasound parametric imaging and QCT, Bone 20 157–165 Occurrence Handle10.1016/S8756-3282(96)00347-X Occurrence Handle1:STN:280:ByiC1c%2Fjs1E%3D Occurrence Handle9028541
P Laugier B Fournier G Berger (1996) ArticleTitleUltrasound parametric imaging of the calcaneus: in vivo results with a new device Calcif Tissue Int 58 326–331 Occurrence Handle10.1007/s002239900053 Occurrence Handle1:CAS:528:DyaK28XivVOnsbc%3D Occurrence Handle8661966
WD Evans EA Jones GM Owen (1995) ArticleTitleFactors affecting the in vivo precision of broad-band ultrasonic attenuation Phys Med Biol 40 137–151 Occurrence Handle10.1088/0031-9155/40/1/012 Occurrence Handle1:STN:280:ByqB38vhsVY%3D Occurrence Handle7708836
GM Blake I Fogelman (1998) ArticleTitleApplications of bone densitometry for osteoporosis Endocrinol Metab Clin North Am 27 267–288 Occurrence Handle1:STN:280:DyaK1czjtlOntw%3D%3D Occurrence Handle9669138
D Maggio EV McCloskey L Camilli S Cenci A Cherubini JA Kanis U Senin (1998) ArticleTitleShort-term reproducibility of proximal femur bone mineral density in the elderly Calcif Tissue Int 63 296–299 Occurrence Handle10.1007/s002239900530 Occurrence Handle1:CAS:528:DyaK1cXmsVeht7o%3D Occurrence Handle9744987
CF Njeh D Hans T Fuerst CC Gluer HK Genant (1999) Quantitative Ultrasound assesment of osteoporosis and bone status Martin Dunitz Ltd London
P Laugier G Berger P Giat P Bonnin-Fayet M Laval-Jeantet (1994) ArticleTitleUltrasound attenuation imaging in the os calcis: an improved method Ultrasonic Imaging 16 65–76 Occurrence Handle10.1006/uimg.1994.1004 Occurrence Handle1:STN:280:ByqD28rivVE%3D Occurrence Handle7974909
F Lefebvre G Berger P Laugier (1998) ArticleTitleAutomatic detection of the boundary of the calcaneus from ultrasound parametric images using an active contour model; clinical assessment IEEE Trans Med Imaging 11 45–52 Occurrence Handle10.1109/42.668693
B Fournier C Chappard C Roux G Berger P Laugier (1997) ArticleTitleQuantitative ultrasound imaging at the calcaneus using an automatic region of interest Osteoporos Int 7 363–369 Occurrence Handle1:STN:280:DyaK1c%2FktV2jsQ%3D%3D Occurrence Handle9373572
EM Lochmuller JB Zeller D Kaiser F Eckstein J Landgraf R Putz R Steldinger (1998) ArticleTitleCorrelation of femoral and lumbar DXA and calcaneal ultrasound, measured in situ with intact soft tissues, with the in vitro failure loads of the proximal femur Osteoporos Int 8 591–598 Occurrence Handle10.1007/s001980050104 Occurrence Handle1:STN:280:DyaK1M3lsl2itA%3D%3D Occurrence Handle10326066
ML Bouxsein BS Coan SC Lee (1999) ArticleTitlePrediction of the strength of the elderly proximal femur by bone mineral density and quantitative ultrasound measurements of the heel and tibia Bone 25 49–54 Occurrence Handle10.1016/S8756-3282(99)00093-9 Occurrence Handle1:STN:280:DyaK1MzkvFyrtg%3D%3D Occurrence Handle10423021
PH Nicholson G Lowet XG Cheng S Boonen G Perre Particlevan der J Dequeker (1997) ArticleTitleAssessment of the strength of the proximal femur in vitro: relationship with ultrasonic measurements of the calcaneus Bone 20 219–224 Occurrence Handle10.1016/S8756-3282(96)00370-5 Occurrence Handle1:STN:280:ByiB38rgvF0%3D Occurrence Handle9071472
YQ He B Fan D Hans J Li CY Wu CF Njeh S Zhao Y Lu E Tsuda-Futami T Fuerst HK Genant (2000) ArticleTitleAssessment of a new quantitative ultrasound calcaneus measurement: precision and discrimination of hip fractures in elderly women compared with dual X-ray absorptiometry Osteoporos Int 11 354–360 Occurrence Handle10.1007/s001980070125 Occurrence Handle1:STN:280:DC%2BD3czptFKjtw%3D%3D Occurrence Handle10928226
E Diessel T Fuerst CF Njeh D Hans S Cheng HK Genant (2000) ArticleTitleComparison of an imaging heel quantitative ultrasound device (DTU-one) with densitometric and ultrasonic measurements Br J Radiol 73 23–30 Occurrence Handle1:STN:280:DC%2BD3c7os1Sqtg%3D%3D Occurrence Handle10721316
CF Njeh CM Boivin A Gough D Hans SK Srivastav N Bulmer J Devlin P Emery (1999) ArticleTitleEvaluation of finger ultrasound in the assessment of bone status with application of rheumatoid arthritis Osteoporos Int 9 82–90 Occurrence Handle10.1007/s001980050119 Occurrence Handle1:STN:280:DyaK1M3psFWjuw%3D%3D Occurrence Handle10367033
M Sundberg P Gardsell O Johnell E Ornstein I Sernbo (1998) ArticleTitleComparison of quantitative ultrasound measurements in calcaneus with DXA and SXA at other skeletal sites: a population-based study on 280 children aged 11–16 years Osteoporos Int 8 410–417 Occurrence Handle10.1007/s001980050084 Occurrence Handle1:STN:280:DyaK1M%2FmslegsQ%3D%3D Occurrence Handle9850347
SS Yeap D Pearson SA Cawte DJ Hosking (1998) ArticleTitleThe relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women Osteoporos Int 8 141–146 Occurrence Handle1:STN:280:DyaK1czjtFGlsA%3D%3D Occurrence Handle9666937
L Rosenthall J Caminis A Tenenhouse (1996) ArticleTitleCorrelation of ultrasound velocity in the tibial cortex, calcaneal ultrasonography, and bone mineral densitometry of the spine and femur Calcif Tissue Int 58 415–418 Occurrence Handle10.1007/s002239900068 Occurrence Handle1:CAS:528:DyaK28XjsVKmt7w%3D Occurrence Handle8661476
JL Cunningham JN Fordham TA Hewitt CA Speed (1996) ArticleTitleUltrasound velocity and attenuation at different skeletal sites compared with bone mineral density measured using dual energy X-ray absorptiometry Br J Radiol 69 25–32 Occurrence Handle1:STN:280:BymB2cnhsV0%3D Occurrence Handle8785618
SC Findlay R Eastell BM Ingle (2002) ArticleTitleMeasurement of bone adjacent to tibial shaft fracture Osteoporos Int 13 980–989 Occurrence Handle10.1007/s001980200136 Occurrence Handle1:STN:280:DC%2BD38npvVCitg%3D%3D Occurrence Handle12459941
TF Lang G Guglielmi C Kuijk Particlevan A Serio ParticleDe M Cammisa HK Genant (2002) ArticleTitleMeasurement of bone mineral density at the spine and proximal femur by volumetric quantitative computed tomography and dual-energy X-ray absorptiometry in elderly women with and without vertebral fractures Bone 30 247–250 Occurrence Handle10.1016/S8756-3282(01)00647-0 Occurrence Handle1:STN:280:DC%2BD38%2FmvVWmtQ%3D%3D Occurrence Handle11792593
C Chappard P Laugier B Fournier C Roux G Berger (1997) ArticleTitleAssessment of the relationship between broadband ultrasound attenuation and bone mineral density at the calcaneus using BUA imaging and DXA Osteoporos Int 7 316–322 Occurrence Handle1:STN:280:DyaK1c%2FktVyqtw%3D%3D Occurrence Handle9373564
O Louis L Kaufman M Osteaux (2000) ArticleTitleQuantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women Eur J Radiol 35 65–69 Occurrence Handle10.1016/S0720-048X(99)00147-3 Occurrence Handle1:STN:280:DC%2BD3cvnt1Snug%3D%3D Occurrence Handle10930769
CM Langton DK Langton (2000) ArticleTitleComparison of bone mineral density and quantitative ultrasound of the calcaneus: site-matched correlation and discrimination of axial BMD status Br J Radiol 73 31–35 Occurrence Handle1:STN:280:DC%2BD3c7os1Sqtw%3D%3D Occurrence Handle10721317
S Cheng H Suominen S Ollikainen J Goll S Sipila D Taaffe T Fuerst CF Njeh HK Genant (1999) ArticleTitleComparison of ultrasound and bone mineral density assessment of the calcaneus with different regions of interest in healthy early menopausal women J Clin Densitom 2 117–126 Occurrence Handle10.1385/JCD:2:2:117 Occurrence Handle1:STN:280:DyaK1MvjtVSntw%3D%3D Occurrence Handle10499970
WC Graafmans A Lingen ParticleVan ME Ooms PD Bezemer P Lips (1996) ArticleTitleUltrasound measurements in the calcaneus: precision and its relation with bone mineral density of the heel, hip, and lumbar spine Bone 19 97–100 Occurrence Handle10.1016/8756-3282(96)00134-2 Occurrence Handle1:STN:280:ByiD3cnlsFw%3D Occurrence Handle8853851
CC Gluer CY Wu HK Genant (1993) ArticleTitleBroadband ultrasound attenuation signals depends on trabecular orientation: an in vitro study Osteoporos Int 3 185–191 Occurrence Handle1:STN:280:ByyA3szhtlE%3D Occurrence Handle8338973
D Hans C Wu CF Njeh S Zhao P Augat D Newitt T Link Y Lu S Majumdar HK Genant (1999) ArticleTitleUltrasound velocity of trabecular cubes reflects mainly bone density and elasticity Calcif Tissue Int 64 18–23 Occurrence Handle10.1007/s002239900572 Occurrence Handle1:CAS:528:DyaK1MXktVynsA%3D%3D Occurrence Handle9868278
KA Wear (2000) ArticleTitleAnisotropy of ultrasonic backscatter and attenuation from human calcaneus: implications for relative roles of absorption and scattering in determining attenuation J Acous Soc Am 107 3474–3479 Occurrence Handle10.1121/1.429417 Occurrence Handle1:STN:280:DC%2BD3czps1yksA%3D%3D
CM Langton CF Njeh R Hodgskinson JD Currey (1996) ArticleTitlePrediction of mechanical properties of the human calcaneus by broadband ultrasonic attenuation Bone 18 495–503 Occurrence Handle10.1016/8756-3282(96)00086-5 Occurrence Handle1:STN:280:BymA1MbltFM%3D Occurrence Handle8805988
S Chaffaï F Padilla B Berger P Laugier (2000) ArticleTitle In vitro measurement of the frequency dependent attenuation in cancellous bone between 0,2-2 MHz J Acous Soc Am 108 1281–1289 Occurrence Handle10.1121/1.1288934
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Padilla, F., Akrout, L., Kolta, S. et al. In Vitro Ultrasound Measurement at the Human Femur. Calcif Tissue Int 75, 421–430 (2004). https://doi.org/10.1007/s00223-004-0216-8
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DOI: https://doi.org/10.1007/s00223-004-0216-8