Abstract
Quantitative ultrasound (QUS) techniques have recently been introduced as alternative methods free of ionizing radiation for non-invasive assessment of skeletal status in osteoporosis. We carried out an in vitro study on bone specimens to investigate whether broadband ultrasound attenuation (BUA) signals are associated with bone structure, specifically with the orientation of the trabeculae, and whether this association is independent of the association between orientation and bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry (DXA). BUA and BMD of 10 cubical specimens of purely trabecular bovine bone were examined along the three principal axes. The relative orientation of the trabeculae with respect to the direction of the ultrasound beam was evaluated on high-resolution conventional radiographs employing a semiquantitative ALIGNMENT score ranging from −2 (for perpendicular) to +2 (parallel). BUA variability was 27.6 dB/MHz, reflecting both inter-specimen (18.2 dB/MHz) and intra-specimen (19.4 dB/MHz) variability at comparable levels and to a much lesser extent reproducibility errors (1 dB/MHz). BUA was 44%–54% larger along the axis of the compressive trabeculae as compared with the two perpendicular axes. BMD and ALIGNMENT showed independent significant associations with BUA. A change in ALIGNMENT from perpendicular to parallel corresponded to a difference in BUA of 36.1 dB/MHz. The substantial level of intra-specimen variability suggests that BUA reflects anisotropical characteristics of trabecular bone. The association of BUA and ALIGNMENT indicates that BUA signals depend on trabecular orientation. This association is independent of BMD, indicating that BUA has considerable potential for non-invasive assessment of bone structure and strength, free of ionizing radiation, and for complementing existing bone densitometry examinations.
Similar content being viewed by others
References
Hui SL, Slemenda CW, Johnston CC. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 1988;81:1804–9.
Ross PD, Davis JW, Vogel JM, Wasnich RD. A critical review of bone mass and the risk of fractures in osteoporosis. Calcif Tissue Int 1990;46:149–61.
Cummings SR, Black DM, Nevitt MC, et al. Appendicular bone density and age predict hip fracture in women. JAMA 1990;263:665–8.
Genant HK, Faulkner KG, Glüer CC. Measurement of bone mineral density: current status. Am J Med 1991;91 (Suppl 5B):49–53.
Parfitt AM. Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med 1987;82 (Suppl 1B):68–72.
Cummings SR. Epidemiology of osteoporotic fractures. In: Genant HK, editor. Osteoporosis update 1987. San Francisco: Radiology Research and Education Foundation, 1987:7–12.
Heaney RP. Osteoporotic fracture space: an hypothesis. Bone Miner 1989;6:1–13.
Mosekilde L. Sex differences in age-related loss of vertebral trabecular bone mass and structure: biomechanical consequences. Bone 1989;10:425–32.
Kuhn JL, Goldstein SA, Choi K, et al. Comparison of the trabecular and cortical tissue moduli from human iliac crests. J Orthop Res 1989;7:876–84.
Hodgskinson R, Currey JD. Effects of structural variation on Young's modulus of non-human cancellous bone. Proc Inst Mech Eng 1990;204:43–52.
Hayes WC, Piazza SJ, Zysset PK. Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography. Radiol Clin North Am 1991;29:1–18.
Greenfield MA, Craven JD, Huddleston A, et al. Measurement of the velocity of ultrasound in human cortical bone in vivo. Radiology 1981;138:701–10.
Langton CM, Palmer SB, Porter RW. The measurement of broadband ultrasound attenuation in cancellous bone. Eng Med 1984;13:89–91.
Baran DT, Kelly AM, Karellas A, et al. Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif Tissue Int 1988;43:138–42.
Heaney RP, Avioli LV, Chestnut CH, et al. Osteoporotic bone fragility: detection by ultrasound transmission velocity. JAMA 1989;261:2986–90.
Engelke K, Lohmann M, Dix WR, Graeff W. Quantitative microtomography. Rev Sci Instrum 1989;60:2486–8.
Kuhn JL, Goldstein SA, Feldkamp LA, et al. Evaluation of a microcomputed tomography system to study trabecular bone structure. J Orthop Res 1990;8:833–42.
Greenfield MA, Craven JD, Wishko DS, et al. The modulus of elasticity of human cortical bone: an in-vivo measurement and its clinical implications. Radiology 1975;115:163–6.
Turner CH, Eich M. Ultrasonic velocity as a predictor of strength in bovine cancellous bone. Calcif Tissue Int 1991;49:116–9.
Antich PP, Anderson JA, Ashman RB, et al. Measurement of mechanical properties of bone material in vitro by ultrasound reflection: methodology and comparison with ultrasound transmission. J Bone Miner Res 1991;6:417–26.
Hosie CJ, Smith DA, Deacon AD, Langton CM. Comparison of broadband ultrasonic attenuation of the os calcis and quantitative computed tomography of the distal radius. Clin Phys Physiol Meas 1987;8:303–8.
McKelvie ML, Fordham J, Clifford C, Palmer SB. In vitro comparison of quantitative computed tomography and broadband ultrasonic attenuation of trabecular bone. Bone 1989;10:101–4.
McCloskey EV, Murray SA, Charlesworth D, et al. Assessment of broadband ultrasound attenuation in the os calcis in vitro. Clin Sci 1990;78:221–5.
Glüer CC, Vahlensieck M, Faulkner KG, et al. Site-matched calcaneal measurements of broadband ultrasound attenuation and single X-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res 1992;7:1071–9.
Glüer CC, Vahlensieck M, Engelke K, Faulkner KG, Genant HK. Assessment of skeletal status in osteoporosis: association of ultrasound, single X-ray absorptiometry, weight and age. Bone Miner 1992;17:153.
Chevalier F, Laval-Jeantet AM, Laval-Jeantet M, Bergot C. CT image analysis of the vertebral trabecular network in vivo. Calcif Tissue Int 1992;51:8–13.
Durand EP, Rüegsegger P. High-contrast resolution of CT images for bone structure analysis. Med Phys 1992;19:569–73.
Abendschein W, Hyatt GW. Ultrasonics and selected physical properties of bone. Clin Orthop Rel Res 1970;69:294–301.
Ashman RB, Corin JD, Turner CH. Elastic properties of cancellous bone: measurement by an ultrasonic technique. J Biomech 1987;20:979–86.
Biot MA. Generalized theory of acoustic propagation in porous dissipative media. J Acoust Soc Am 1962;34:1254–64.
Langton CM, Evans GP, Hodgskinson R, Riggs CM. Ultrasonic, elastic and structural properties of cancellous bone. London: British Institute of Radiology, 1990.
McKelvie M, Palmer S, The interaction of ultrasound with cancellous bone. In: Palmer S, Langton C, editors. Proceedings of ultrasonic studies of bone: meeting of the Physical Acoustic Group of the Institute of Physics and the Institute of Acoustics, Hull. IOP Short Meetings Series no. 6. Institute of Physics, 1987:1–12.
Brown TD, Ferguson AB. Mechanical property distributions in the cancellous bone of the human proximal femur. Acta Orthop Scand 1980;51:429–37.
Mosekilde L, Mosekilde L, Danielsen C. Biomechanical competence of vertebral trabecular bone in relation to ash density and age in normal individuals. Bone 1987;8:79–85.
Rice JC, Cowin SC, Bowman JA. On the dependence of the elasticity and strength of cancellous bone on apparent density. J Biomech 1988;21:155–68.
Agren M, Karellas A, Leahey D, Marks S, Baran D. Ultrasound attenuation of the calcaneus: a sensitive and specific discriminator of osteopenia in postmenopausal women. Calcif Tissue Int 1991;48:240–4.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Glüer, C.C., Wu, C.Y. & Genant, H.K. Broadband ultrasound attenuation signals depend on trabecular orientation: An in vitro study. Osteoporosis Int 3, 185–191 (1993). https://doi.org/10.1007/BF01623674
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623674