Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population

Area of Science:

• Orthopedics
• Biomedical Engineering
• Gerontology

Background:

• Fragility fractures pose a significant global health challenge, exacerbated by an aging population.
• Hip fracture incidence is projected to double by 2050, underscoring the need for scalable fracture risk detection.
• Dual X-ray absorptiometry (DXA) is the standard for bone mineral density assessment but has limitations.

Purpose of the Study:

• To present and validate a detailed measurement protocol for a bi-directional axial transmission (BDAT) ultrasonic device.
• To assess the reproducibility of the BDAT protocol across different operators and participants.
• To establish BDAT as a reliable screening tool for fragility fracture risk.

Main Methods:

• A novel BDAT ultrasonic protocol was developed, utilizing a forearm probe and a guided interface.
• The protocol involves real-time acquisition of bone parameters: vFAS, vA0, Ct.Th, and Ct.Po.
• A reproducibility study involved 3 operators and 14 healthy participants, with measurements completed in approximately 5 minutes.

Main Results:

• The BDAT protocol demonstrated good to excellent reproducibility, with intraclass correlation coefficients (ICC) ranging from 0.76 to 0.91.
• Standard deviations for key parameters were consistently below 10% of the total clinical range.
• The protocol proved robust across both expert and novice operators.

Conclusions:

• The detailed BDAT ultrasonic protocol is reproducible and robust for assessing bone health at the distal radius.
• This ultrasonic method offers a promising, operator-independent alternative to DXA for large-scale fragility fracture screening.
• BDAT technology can aid in identifying at-risk populations, addressing the growing burden of fragility fractures.