Related Experiment Video
Updated: Jun 27, 2026
Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population
Published on: January 31, 2025
Quantitative ultrasound (QUS): a useful tool for monitoring bone health in preterm infants?
M S Fewtrell1, K L Loh, S Chomtho
1MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. m.fewtrell@ich.ucl.ac.uk
Insights
Quantitative ultrasound (QUS) speed of sound (SOS) measurements in preterm infants decrease with age. This study found no evidence that SOS predicts metabolic bone disease (MBD) indicators in neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Bone Health
- Medical Imaging
Background:
- Preterm infants face risks of osteopenia and metabolic bone disease (MBD).
- Simple, reliable methods are needed for detecting and monitoring MBD in this vulnerable population.
Purpose of the Study:
- To describe longitudinal changes in speed of sound (SOS) using quantitative ultrasound (QUS) in preterm neonates.
- To determine if SOS measurements can predict the development of MBD in preterm infants.
Main Methods:
- SOS was measured longitudinally in the tibia of 99 preterm infants (mean gestation 29.7 weeks).
- SOS z-scores were generated based on gestation and sex.
- Clinical data, including biochemical markers of MBD, were recorded.
Main Results:
- SOS and SOS z-scores decreased with age in preterm infants.
- Baseline SOS was positively associated with gestational age.
- Neither baseline SOS nor SOS z-scores predicted biochemical indicators of MBD, such as peak alkaline phosphatase or low phosphate levels.
Conclusions:
- While SOS measurements decrease with age in preterm infants, they did not predict biochemical markers of MBD in this study.
- The potential utility of QUS-derived SOS for monitoring therapeutic interventions for bone health in preterm infants cannot be excluded.
Unlabelled:
Preterm infants are at risk of osteopenia and metabolic bone disease (MBD) of prematurity. There is a need for simple, reliable methods to detect and monitor this condition.
Aims:
The aims were first to describe longitudinal changes in speed of sound (SOS) measured using quantitative ultrasound (QUS; Sunlight Omnisense, Israel) in preterm neonates: and second to determine whether SOS predicts the development of MBD.
Methods:
SOS was measured in the tibia in 99 preterm infants (mean (SD)) gestation 29.7 (3.6) weeks; birthweight 1340 (550) g, with longitudinal measurements in 75. SOS z-scores were generated for gestation and sex. Clinical data were recorded.
Results:
Baseline SOS (but not SOS z-score) was positively associated with gestational age. SOS and SOS z-score fell with age. In multivariate models, peak ALP, minimum phosphate concentrations and markers of illness severity were not predictors of the fall in SOS z-score, and baseline SOS measurements did not predict the development of high peak ALP or low phosphate.
Interpretation:
Speed of sound measurements fell with age in all infants, but we found no evidence that this measurement could predict biochemical indicators of MBD. We cannot exclude the possibility that this technique could be useful in monitoring the response to interventions designed to improve bone health in this population.
