A new method for quantitative ultrasound measurements at multiple skeletal sites: first results of precision and fracture discrimination.
We investigated a new multisite quantitative ultrasound device that measures the acoustic velocity in axial transmission mode along the cortex. Using a prototype of the Omnisense (Sunlight Ultrasound Technologies, Rehovot, Israel), we tested the performance of this instrument at four sites of the skeleton: radius, ulna, metacarpal, and phalanx. Intraobserver (interobserver) precision errors ranged from 0.2% to 0.3% (0.3% to 0.7%) for triplicate measurements with repositioning. Fracture discrimination was tested by comparing a group of 34 women who had previously suffered a fracture of the hip, spine, ankle, or forearm to a group of 28 healthy women who had not suffered a fracture. Age-adjusted standardized odds ratios ranged from 1.6 to 4.5. Except for the ulna the sites showed a significant fracture discrimination (p < 0.01). The areas under the receiver operating curves (ROC) curves were from 0.88 to 0.89 for radius, metacarpal, and phalanx. A combination of the results from the three sites showed a significant increase of the ROC area to 0.95 (p < 0. 05). Our results show promising performance of this new device. The ability to measure a large variety of sites and the potential to combine these measurements are promising with regard to optimizing fracture risk assessment.
Barkmann
R
R
Medizinische Physik, Diagnostische Radiologie, CAU Kiel, Germany. barkmann@rad.uni-kiel.de.
Kantorovich
E
E
Singal
C
C
Hans
D
D
Genant
H K
HK
Heller
M
M
Glüer
C C
CC
D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D015588:Observer Variation; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging; D010865:Pilot Projects; D012372:ROC Curve; D014463:Ultrasonography / Q000295:instrumentation* / Q000706:statistics & numerical data