Quantitative Ultrasound in Osteoporosis

Abstract

Quantitative ultrasound (QUS) has been applied to the assessment of bone for almost two decades. The physical interaction of ultrasound and bone is complex and not completely understood. However, it is considered that QUS provides information on bone mass and structure. Although dual-energy X-ray absorptiometry (DXA) is currently considered the "gold standard" for the diagnosis of osteoporosis, through the World Health Organisation definition, there is, in some parts of the world, limited availability to axial DXA. This has stimulated interest in smaller, more portable, and less expensive techniques to indentify those at risk of osteoporotic fracture. One such quantitative method is QUS, which has the added advantage over other photon absorptiometric bone density techniques of not using ionizing radiation. This article reviews the capabilities of QUS and indicates its appropriate application in clinical practice, based on current review of the scientific literature.

The role of DXA bone density scans in the diagnosis and treatment of osteoporosis

“…11 33 These include quantitative computed tomography (QCT) measurements of the spine and hip, 34 35 peripheral DXA (pDXA) systems for measuring the forearm, heel or hand, 36 and quantitative ultrasound (QUS) devices for measurements of the heel and other peripheral sites. 37 In principle, pDXA and QUS devices offer a quick, cheap and convenient method of evaluating skeletal status that makes them attractive for wider use. In practice, however, these alternative types of measurement correlate poorly with central DXA, with correlation coefficients in the range r = 0.5 to 0.65.…”

Estimated prevalence of osteoporosis from a Nationwide Health Insurance database in Taiwan

“…For almost 2 decades, QUS has proven to be widely and clinically useful for assessing the status of bone, especially the calcaneus [27]. Ultrasonography has great potential for widespread use owing to its portability, low cost, and lack of ionizing radiation.…”

The relationship between bone mineral density and fracture risk

“…Once hoped to provide unique information about bone structure as well as bone mass, the devices used in clinical practice appear simply to provide radiation-free measurements of bone mass [6]. Marked differences exist among the various ultrasound technologies, and generalizations cannot be made about the use of this entire class of bone density measurement devices.…”