Noninvasive ultrasound imaging for bone quality assessment using scanning confocal acoustic diagnosis, μCT, DXA measurements, and mechanical testing

Osteoporosis is a disease characterized by decreased bone mass and progressive deterioration of the microstructure, affecting both mineral density and bone's fragility. Current diagnoses are only measuring apparent bone mineral density (AppBMD). Using our newly developed scanning confocal acoustic diagnostic (SCAD) system, we evaluated the ability of quantitative ultrasound in noninvasively predicting bone's quantity and quality on 19 human cadaver calcanei. Results show that ultrasound attenuation image on intact calcaneus represents bone mass distribution. High correlation (R=0.82) exists between SCAD determined broadband ultrasound attenuation (BUA) and DXA determined AppBMD at the calcaneus, as well as in the AppBMD result at femoral neck (R=0.81). SCAD determined BUA and ultrasound velocity (UV) are highly correlated with the micro-CT and mechanical testing determined bone quantity and quality parameters. These results suggest that image-based quantitative ultrasound is able to identify ROI and predict both bone mass and strength.