title: Femur ultrasound (FemUS)--first clinical results on hip fracture discrimination and estimation of femoral BMD.
abstract: CONCLUSIONS
  A quantitative ultrasound (QUS) device for measurements at the proximal femur was developed and tested in vivo (Femur Ultrasound Scanner, FemUS). Hip fracture discrimination was as good as for DXA, and a high correlation with hip BMD was achieved. Our results show promise for enhanced QUS-based assessment of osteoporosis.
  
  
  BACKGROUND
  Dual X-ray absorptiometry (DXA) at the femur is the best predictor of hip fractures, better than DXA measurements at other sites. Calcaneal quantitative ultrasound (QUS) can be used to estimate the general osteoporotic fracture risk, but no femoral QUS measurement has been introduced yet. We developed a QUS scanner for measurements at the femur (Femur Ultrasound Scanner, FemUS) and tested its in vivo performance.
  
  
  METHODS
  Using the FemUS device, we obtained femoral QUS and DXA on 32 women with recent hip fractures and 30 controls. Fracture discrimination and the correlation with femur bone mineral density (BMD) were assessed.
  
  
  RESULTS
  Hip fracture discrimination using the FemUS device was at least as good as with hip DXA and calcaneal QUS. Significant correlations with total hip bone mineral density were found with a correlation coefficient R (2) up to 0.72 and a residual error of about one half of a T-score in BMD.
  
  
  CONCLUSIONS
  QUS measurements at the proximal femur are feasible and show a good performance for hip fracture discrimination. Given the promising results, this laboratory prototype should be reengineered to a clinical applicable instrument. Our results show promise for further enhancement of QUS-based assessment of osteoporosis.
authors.affiliation: Arbeitsgruppe Medizinische Physik, Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Str 3, Haus 23, 24105 Kiel, Germany. barkmann@rad.uni-kiel.de
authors.forename: R
authors.initials: R
authors.lastname: Barkmann
authors.forename: S
authors.initials: S
authors.lastname: Dencks
authors.forename: P
authors.initials: P
authors.lastname: Laugier
authors.forename: F
authors.initials: F
authors.lastname: Padilla
authors.forename: K
authors.initials: K
authors.lastname: Brixen
authors.forename: J
authors.initials: J
authors.lastname: Ryg
authors.forename: A
authors.initials: A
authors.lastname: Seekamp
authors.forename: L
authors.initials: L
authors.lastname: Mahlke
authors.forename: A
authors.initials: A
authors.lastname: Bremer
authors.forename: M
authors.initials: M
authors.lastname: Heller
authors.forename: C C
authors.initials: CC
authors.lastname: Glüer
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014463:Ultrasonography
references.citation: J Clin Densitom. 2008 Jan-Mar;11(1):75-91
references.pmid: 18442754
references.citation: BMJ. 1993 Nov 13;307(6914):1248-50
references.pmid: 8166806
references.citation: Ultrasound Med Biol. 2007 Jun;33(6):970-80
references.pmid: 17445965
references.citation: J Bone Miner Res. 2006 Sep;21(9):1457-63
references.pmid: 16939404
references.citation: J Bone Miner Res. 2006 Mar;21(3):413-8
references.pmid: 16491289
references.citation: Osteoporos Int. 2009 Jul;20(7):1117-29
references.pmid: 19048180
references.citation: Ultrasound Med Biol. 2008 Jul;34(7):1186-90
references.pmid: 18294756
references.citation: Osteoporos Int. 2005 May;16(5):468-74
references.pmid: 15448985
references.citation: Bone. 2007 Jan;40(1):37-44
references.pmid: 16949896
references.citation: Dtsch Med Wochenschr. 2003 Jul 25;128(30):1615-6
references.pmid: 12884151
references.citation: J Bone Miner Res. 1997 Aug;12(8):1316-7
references.pmid: 9258764
references.citation: Ultrasound Med Biol. 2005 May;31(5):633-42
references.pmid: 15866413
references.citation: Bone. 2004 Aug;35(2):357-63
references.pmid: 15268884
references.citation: Osteoporos Int. 2008 Apr;19(4):399-428
references.pmid: 18266020
references.citation: BMJ. 1996 May 18;312(7041):1254-9
references.pmid: 8634613
references.citation: IEEE Trans Ultrason Ferroelectr Freq Control. 2008;55(6):1277-86
references.pmid: 18599415
references.citation: Ultrasound Med Biol. 2005 Sep;31(9):1225-35
references.pmid: 16176789
references.citation: J Bone Miner Res. 2004 Jun;19(6):924-30
references.pmid: 15125791
references.citation: Br J Radiol. 2006 Apr;79(940):336-41
references.pmid: 16585728
references.citation: Ultrasound Med Biol. 2009 Jan;35(1):165-8
references.pmid: 18723270
references.citation: Clin Lab Med. 2000 Sep;20(3):603-22, viii
references.pmid: 10986624
references.citation: Radiologe. 2006 Oct;46(10):861-9
references.pmid: 16896637
references.citation: IEEE Trans Ultrason Ferroelectr Freq Control. 2008;55(6):1197-204
references.pmid: 18599408
references.citation: Osteoporos Int. 2006;17(9):1346-52
references.pmid: 16799755
references.citation: Osteoporos Int. 2005 Dec;16(12):2149-56
references.pmid: 16228104
references.citation: IEEE Trans Ultrason Ferroelectr Freq Control. 2008;55(6):1304-15
references.pmid: 18599418
references.citation: J Clin Densitom. 2006 Jan-Mar;9(1):15-21
references.pmid: 16731427
references.citation: IEEE Trans Ultrason Ferroelectr Freq Control. 2008 Jul;55(7):1529-38
references.pmid: 18986943
references.citation: J Bone Miner Res. 2004 May;19(5):782-93
references.pmid: 15068502