Three quantitative ultrasound parameters reflect bone structure

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.

[1]  Jean Serra,et al.  Image Analysis and Mathematical Morphology , 1983 .

[2]  D D Moyle,et al.  Correlation of mechanical properties of vertebral trabecular bone with equivalent mineral density as measured by computed tomography. , 1988, The Journal of bone and joint surgery. American volume.

[3]  K Engelke,et al.  Site‐matched calcaneal measurements of broad‐band ultrasound attenuation and single X‐ray absorptiometry: Do they measure different skeletal properties? , 1992, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[4]  A M Schott,et al.  Ultrasonic assessment of bone: a review. , 1993, The European journal of medicine.

[5]  S C Cowin,et al.  Errors induced by off-axis measurement of the elastic properties of bone. , 1988, Journal of biomechanical engineering.

[6]  W M O'Fallon,et al.  Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. , 1990, The New England journal of medicine.

[7]  S. Bentzen,et al.  The predictive value of quantitative computed tomography for vertebral body compressive strength and ash density. , 1989, Bone.

[8]  R. Lew,et al.  The relationship between ultrasound and densitometric measurements of bone mass at the calcaneus in women , 1992, Calcified Tissue International.

[9]  J M Vogel,et al.  Selection of the optimal skeletal site for fracture risk prediction. , 1987, Clinical orthopaedics and related research.

[10]  Use of ultrasound attenuation and velocity to estimate Young's modulus in trabecular bone , 1993, 1993 IEEE Annual Northeast Bioengineering Conference.

[11]  H. Genant,et al.  Measurement of bone mineral density: current status. , 1991, The American journal of medicine.

[12]  R. Mann,et al.  Characterization of microstructural anisotropy in orthotropic materials using a second rank tensor , 1984 .

[13]  S. Cummings,et al.  Bone density at various sites for prediction of hip fractures , 1993, The Lancet.

[14]  R. C. Murry,et al.  Measurement of mechanical properties of bone material in vitro by ultrasound reflection: Methodology and comparison with ultrasound transmission , 1991, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[15]  M. Kleerekoper,et al.  Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. , 1983, The Journal of clinical investigation.

[16]  W. Bonfield,et al.  Ultrasonic analysis of the Youngs modulus of cortical bone. , 1982, Journal of biomedical engineering.

[17]  W C Hayes,et al.  Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography. , 1991, Radiologic clinics of North America.

[18]  K J Rothman,et al.  No Adjustments Are Needed for Multiple Comparisons , 1990, Epidemiology.

[19]  G. Blake,et al.  Ultrasonic velocity measurements through the calcaneus: Which velocity should be measured? , 2005, Osteoporosis International.

[20]  S. Goldstein,et al.  Evaluation of a microcomputed tomography system to study trabecular bone structure , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[21]  H. Genant,et al.  Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women , 1993, Osteoporosis International.

[22]  Thomas A. Einhorn,et al.  Perspectives: Ultrasound assessment of bone , 1993 .

[23]  S. Goldstein,et al.  The direct examination of three‐dimensional bone architecture in vitro by computed tomography , 1989, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[24]  C. Langton,et al.  The measurement of broadband ultrasonic attenuation in cancellous bone. , 1984, Engineering in medicine.

[25]  J. A. Evans,et al.  Ultrasonic attenuation and velocity in bone. , 1990, Physics in medicine and biology.

[26]  S C Cowin,et al.  The fabric dependence of the orthotropic elastic constants of cancellous bone. , 1990, Journal of biomechanics.

[27]  H. K. Genant,et al.  Broadband ultrasound attenuation signals depend on trabecular orientation: An in vitro study , 1993, Osteoporosis International.

[28]  Robert P. Heaney,et al.  Osteoporotic bone fragility. Detection by ultrasound transmission velocity , 1989 .

[29]  William M. O'Fallon,et al.  Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. , 1990 .

[30]  S. Goldstein,et al.  Evaluation of orthogonal mechanical properties and density of human trabecular bone from the major metaphyseal regions with materials testing and computed tomography , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[31]  S A Goldstein,et al.  The relationship between the structural and orthogonal compressive properties of trabecular bone. , 1994, Journal of biomechanics.

[32]  W. Abendschein,et al.  Ultrasonics and selected physical properties of bone. , 1970, Clinical orthopaedics and related research.

[33]  W. Hayes,et al.  Mechanical properties of trabecular bone from the proximal femur: a quantitative CT study. , 1990, Journal of computer assisted tomography.

[34]  Steven A. Goldstein,et al.  Measurement and significance of three-dimensional architecture to the mechanical integrity of trabecular bone , 2005, Calcified Tissue International.

[35]  C. Slemenda,et al.  Baseline measurement of bone mass predicts fracture in white women. , 1989, Annals of internal medicine.

[36]  W C Van Buskirk,et al.  A continuous wave technique for the measurement of the elastic properties of cortical bone. , 1984, Journal of biomechanics.