Femur ultrasound (FemUS)—first clinical results on hip fracture discrimination and estimation of femoral BMD

Barkmann, Reinhard; Dencks, Stefanie; Laugier, Pascal; Padilla, F.; Brixen, Kim; Ryg, Jesper; Seekamp, Andreas; Mahlke, L.; Bremer, Alexander; Heller, Martin; Glüer, Claus C.

doi:10.1007/s00198-009-1037-4

Cited by 52 publications

(37 citation statements)

References 33 publications

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“…The feasibility of in vivo quantitative ultrasound (QUS) measurements at the hip has been demonstrated, with a good clinical performance for hip fracture discrimination. (22,23) Interestingly-and similar to results previously obtained at the finger phalanges (24) -a thorough analysis of signals transmitted through the proximal femur suggested that different propagation pathways through the trabecular or cortical compartments could be identified, leading to the concept of multimodal QUS assessment of the proximal femur, by which both the trabecular and the cortical compartments could be assessed separately. Simulation studies of measurements at the proximal femur QUS (25) predicted the existence of a guided wave propagating circumferentially exclusively in the cortical shell of the neck.…”

Section: Introductionsupporting

confidence: 69%

“…(22) The prototype scanner uses spherically focused transducers moving in a 2D scan to achieve an image of QUS variables (attenuation and speed of sound) at the proximal femur. With this approach, different regions can be measured, such as the great trochanter, the shaft, or the surrounding soft tissue.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, trabecular bone may be more important for strength in regard to trochanteric fractures, (48) but it has been shown that other QUS measurement modes also allow the assessment of this type of fracture risk. (22) Another limitation, the spatial resolution of QCT scans (in-plane pixel size of about 200 mm), may have led to an underestimation of the respective correlations with TOF. The question arises regarding the in vivo applicability of the method to measure the cortical part of the FN.…”

Section: Discussionmentioning

confidence: 99%

“…The aim was twofold: (1) testing the concept that this QUS modality reaches a targeted measurement of the neck cortical compartment and is sensitive to variations of its properties; (2) assessing the potential of the modality to predict femur strength. If successful, such modality could be coupled to other modalities of femur QUS specifically interrogating trabecular bone (22,34) to provide a new tool for the assessment of proximal femur. Nine human femurs were subjected to the following: (1) ultrasound measurements with the newly developed system dedicated to cortical bone assessment; (2) QCT measurements to assess site-matched cortical bone properties; (3) DXA to provide a reference; and (4) mechanical tests to assess femur strength.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative ultrasound of cortical bone in the femoral neck predicts femur strength: Results of a pilot study

Grimal

Grondin

Guérard

et al. 2012

Journal of Bone and Mineral Research

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A significant risk of femoral neck (FN) fracture exists for men and women with an areal bone mineral density (aBMD) higher than the osteoporotic range, as measured with dual-energy X-ray absorptiometry (DXA). Separately measuring the cortical and trabecular FN compartments and combining the results would likely be a critical aspect of enhancing the diagnostic capabilities of a new technique. Because the cortical shell determines a large part of FN strength a novel quantitative ultrasound (QUS) technique that probes the FN cortical compartment was implemented. The sensitivity of the method to variations of FN cortical properties and FN strength was tested. Nine femurs (women, mean age 83 years) were subjected to QUS to measure the through transmission time-of-flight (TOF) at the FN and mechanical tests to assess strength. Quantitative computed tomography (QCT) scans were performed to enable analysis of the dependence of TOF on bone parameters. DXA was also performed for reference. An ultrasound wave propagating circumferentially in the cortical shell was measured in all specimens. Its TOF was not influenced by the properties of the trabecular compartment. Because the method involves mechanical guided waves, the QUS variable is related to the geometric and material properties of the cortical shell (cortical thickness, tissue elasticity, and porosity). This work opens the way to a multimodal QUS assessment of the proximal femur, combining our approach targeting the cortical shell with the existing modality sensitive to the trabecular compartment. In vivo feasibility of our approach has to be confirmed with experimental data in patients. ß

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Section: Introductionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantitative ultrasound of cortical bone in the femoral neck predicts femur strength: Results of a pilot study

Grimal

Grondin

Guérard

et al. 2012

Journal of Bone and Mineral Research

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“…However, aBMD alone is not sufficient to account for bone strength [3,4]. The development of a quantitative ultrasound (QUS) hip scanner [5,6] aims at providing an alternative to aBMD measurements. Because the cortical shell at the proximal femur determines a large part of bone strength [7,8], there is substantial interest in developing QUS measurements with improved sensitivity to cortical bone geometrical and material properties.…”

Section: Introductionmentioning

confidence: 99%

A hybrid FDTD-Rayleigh integral computational method for the simulation of the ultrasound measurement of proximal femur

Cassereau¹,

Nauleau²,

Bendjoudi³

et al. 2014

Ultrasonics

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International audienceThe development of novel quantitative ultrasound (QUS) techniques to measure the hip is critically dependent on the possibility to simulate the ultrasound propagation. One specificity of hip QUS is that ultrasounds propagate through a large thickness of soft tissue, which can be modeled by a homogeneous fluid in a first approach. Finite difference time domain (FDTD) algorithms have been widely used to simulate QUS measurements but they are not adapted to simulate ultrasonic propagation over long distances in homogeneous media. In this paper, an hybrid numerical method is presented to simulate hip QUS measurements. A two-dimensional FDTD simulation in the vicinity of the bone is coupled to the semi-analytic calculation of the Rayleigh integral to compute the wave propagation between the probe and the bone. The method is used to simulate a setup dedicated to the measurement of circumferential guided waves in the cortical compartment of the femoral neck. The proposed approach is validated by comparison with a full FDTD simulation and with an experiment on a bone phantom. For a realistic QUS configuration, the computation time is estimated to be sixty times less with the hybrid method than with a full FDTD approach

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Current Imaging Techniques

Miedany

2022

New Horizons in Osteoporosis Management

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Femur ultrasound (FemUS)—first clinical results on hip fracture discrimination and estimation of femoral BMD

Cited by 52 publications

References 33 publications

Quantitative ultrasound of cortical bone in the femoral neck predicts femur strength: Results of a pilot study

Quantitative ultrasound of cortical bone in the femoral neck predicts femur strength: Results of a pilot study

A hybrid FDTD-Rayleigh integral computational method for the simulation of the ultrasound measurement of proximal femur

Current Imaging Techniques

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