Measuring Skeletal Changes with Calcaneal Ultrasound Imaging in Healthy Children and Adults: The Influence of Size and Location of the Region of Interest

Bergh, Joop van den; Noordam, C.; Thijssen, J.M.; Otten, B. J.; Smals, A. G. H.; Hermus, A.R.M.M.

doi:10.1007/s001980170027

Cited by 14 publications

(5 citation statements)

References 26 publications

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“…Bone size may affect the measurement of QUS variables, mainly at the heel (25,32,33). In growing children, it has been estimated that only 6% of AD-SoS values may be related to finger width, indicating that bone width is only a minor confounder on AD-SoS measurements at the proximal phalanges of the hand (22).…”

Section: Effect Of Bone Size and Geometry Soft Tissue Thickness Andmentioning

confidence: 99%

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Baroncelli¹

2008

Pediatr Res

223

179

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Measurement of bone mineral status may be a useful tool in identifying the children who could be exposed to an increased risk of osteoporosis in adulthood. Dual energy x-ray absorptiometry and peripheral quantitative computed tomography may be used to this purpose, but the exposure to ionizing radiation is a limiting factor for preventive studies in large populations of children. In the last years, quantitative ultrasound (QUS) methods have been developed to assess bone mineral status in some peripheral skeletal sites such as calcaneus, phalanges of the hand, and tibia. QUS techniques are safe, easy to use, radiation-free, and devices are portable, so that they are particularly indicated to assess bone mineral status in children. This review will concentrate on the main methodological principles of ultrasounds and the QUS variables derived from their application to bone tissue, technical differences and performance of QUS methods, factors influencing QUS measurements, normative data and results obtained in children with disturbances of growth or affected by disorders of bone and mineral metabolism, including the assessment of fracture risk, and comparison among QUS, dual energy x-ray absorptiometry, and peripheral quantitative computed tomography methods. (Pediatr Res 63: 220-228, 2008) I n the last years, the demand for measurement of bone mineral status to identify children who could be exposed to an increased risk of osteoporosis in adulthood is rapidly increased. Several disorders, by various mechanisms, may be associated with a reduced bone mineral status; in particular, patients with chronic or genetic diseases, malignancies, acute or chronic disabilities caused by neuromuscular disorders, and patients receiving prolonged glucocorticoid treatment are at risk of fractures by minimal trauma caused by a severe reduction in bone mineral status (1).Moreover, there is a growing demand for assessing the effects of some environmental factors on bone health, such as dietary habits and various degrees of physical activity by using radiationfree techniques. DENSITOMETRIC TECHNIQUES FOR ESTIMATING BONE MINERAL STATUS IN CHILDRENSome densitometric techniques to assess bone mineral status developed for adults have been adapted for the use in children. Dual energy x-ray absorptiometry (DXA) is the most commonly used technique for bone mineral status assessment worldwide. The main advantages of DXA are its wide availability and short scanning times, but the subject is exposed to ionized radiation that varies according to the machinery and the examined skeletal site; anyway, radiation dose to patient from DXA is minimal (0.08 -4.6 Sv and 6.7-31 Sv for pencil beam and fan beam methods, respectively) compared with that given by many other investigations involving ionizing radiation (2). Nevertheless, an important shortcoming of DXA is that it measures bone in two dimensions providing only an estimation of bone density. Indeed, DXA measures an integral areal density that is calculated as bone mineral content/bone su...

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Section: Effect Of Bone Size and Geometry Soft Tissue Thickness Andmentioning

confidence: 99%

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Baroncelli¹

2008

Pediatr Res

223

179

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“…There are several potential modifications which may improve performance, all of which deserve further study: taking and averaging together multiple ultrasound measurements, discarding unusually high SOS measurements, and developing different shims and positioning for children with small foot size. Although we used the smallest ROI setting available on the device, it is possible that using a smaller ROI would catch less cortical bone (van den Bergh et al 2001). Additionally, further research is warranted to determine whether BUA measurements in children with unusually high SOS are still valid.…”

Section: Discussionmentioning

confidence: 99%

Unusually High Calcaneal Speed of Sound Measurements in Children with Small Foot Size

Ramteke

Kaufman

Arpadi

et al. 2017

Ultrasound in Medicine & Biology

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The purpose of this clinical note is to describe the performance of the Lunar Achilles Insight device in assessing bone quality at the calcaneus in 142 children between the ages of 5–11 years accessing healthcare in Johannesburg, South Africa. We observed an asymmetric bimodal distribution in speed of sound (SOS). The minor mode consisted of unusually high SOS values (≥1625 m/sec) which were primarily observed among children with foot size <19 cm and height <119 cm. Cortical regions of the bone may have been inadvertently included in the region of interest for smaller feet, causing unusually high SOS values. The unusually high SOS values indicate that the validity of SOS in this device as it is currently used for measuring bone quality in young children is questionable. Future studies using this device in young children should develop new methodology to account for smaller foot size.

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“…It was assumed that the longitudinal wave velocity in trabecular bone and in water are equal. 17,18 The process is described by the formula:…”

Section: A Materials and Methodsmentioning

confidence: 99%

Statistics of the envelope of ultrasonic backscatter from human trabecular bone

Litniewski

Cieślik

Wójcik

et al. 2011

The Journal of the Acoustical Society of America

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The paper describes the investigations intended to compare the results of experimental measurements of backscattering properties of the trabecular bone with the results of computer simulations. Ultrasonic RF echoes were collected using two bone scanners operating at 0.58 and 1.3 MHz. The simulations of the backscattered RF echoes were performed using the scattering model of the trabecular bone that consisted of cylindrical and spherical elements uniformly distributed in water-like medium. For each measured or simulated RF backscatter the statistical properties of the signal envelope were determined. Experimental results suggest deviations of the backscattering properties from the Rayleigh distribution. The results of simulation suggest that deviation from Rayleigh distribution depends on the variation of trabeculae diameters and the number of thin trabeculae. Experimentally determined deviations corresponded well to the deviations calculated from simulated echoes assuming trabeculae thickness variation equaled to the earlier published histomorphometric study results.

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Measuring Skeletal Changes with Calcaneal Ultrasound Imaging in Healthy Children and Adults: The Influence of Size and Location of the Region of Interest

Cited by 14 publications

References 26 publications

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Unusually High Calcaneal Speed of Sound Measurements in Children with Small Foot Size

Statistics of the envelope of ultrasonic backscatter from human trabecular bone

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