Comparative examination of human proximal tibiae in vitro by ultrasonic guided waves and pQCT

Cortical bone viscoelastic damping assessed with resonant ultrasound spectroscopy reflects porosity and mineral content

Viscoelasticity is an essential property of bone related to fragility, which is altered in aging and bone disease. Bone viscoelastic behavior is attributed to several mechanisms involving collagen and mineral properties, porosities, and bone hierarchical tissue organization. We aimed to assess the relationships between cortical bone viscoelastic damping measured with Resonant Ultrasound Spectroscopy (RUS), microstructural and compositional characteristics. We measured 52 bone specimens from the femur of 26 elderly human donors. RUS provided a shear damping coefficient at a frequency of the order of 150 kHz. The characteristics of the structure of the vascular pore network and tissue mineral density were measured using synchrotron radiation high-resolution computed tomography (SR-μCT). Fourier transformed infrared microspectroscopy (FTIRM) was used to quantify mineral-to-organic phase ratio, mineral maturity, crystallinity, and collagen maturity. Cross-links were quantified from biochemistry. Viscoelastic damping was found to increase with vascular porosity (r=0.68), to decrease with the degree of mineralization of the extravascular matrix (r=-0.68), and was marginally affected by collagen. We built a multilinear model suggesting that when porosity is controlled, the variation of mineral content explains a small additional part of the variability of damping. The work supports the consideration of viscoelasticity measurement as a potential biomarker of fragility and provides a documentation of bone viscoelastic behavior and its determinants in a frequency range rarely investigated.

Ex vivo cortical porosity and thickness predictions at the tibia using full-spectrum ultrasonic guided-wave analysis

The estimation of cortical thickness (Ct.Th) and porosity (Ct.Po) at the tibia using axial transmission ultrasound was successfully validated ex vivo against site-matched micro-computed tomography. The assessment of cortical parameters based on full-spectrum guided-wave analysis might improve the prediction of bone fractures in a cost-effective and radiation-free manner.

PURPOSE

Cortical thickness (Ct.Th) and porosity (Ct.Po) are key parameters for the identification of patients with fragile bones. The main objective of this ex vivo study was to validate the measurement of Ct.Po and Ct.Th at the tibia using a non-ionizing, low-cost, and portable 500-kHz ultrasound axial transmission system. Additional ultrasonic velocities and site-matched reference parameters were included in the study to broaden the analysis.

METHODS

Guided waves were successfully measured ex vivo in 17 human tibiae using a novel 500-kHz bi-directional axial transmission probe. Theoretical dispersion curves of a transverse isotropic free plate model with invariant matrix stiffness were fitted to the experimental dispersion curves in order to estimate Ct.Th and Ct.Po. In addition, the velocities of the first arriving signal (υ_FAS) and A₀ mode (υ_A0) were measured. Reference Ct.Po, Ct.Th, and vBMD were obtained from site-matched micro-computed tomography. Scanning acoustic microscopy (SAM) provided the acoustic impedance of the axial cortical bone matrix.

RESULTS

The best predictions of Ct.Po (R² = 0.83, RMSE = 2.2%) and Ct.Th (R² = 0.92, RMSE = 0.2 mm, one outlier excluded) were obtained from the plate model. The second best predictors of Ct.Po and Ct.Th were vBMD (R² = 0.77, RMSE = 2.6%) and υ_A0 (R² = 0.28, RMSE = 0.67 mm), respectively.

CONCLUSIONS

Ct.Th and Ct.Po were accurately predicted at the human tibia ex vivo using a transverse isotropic free plate model with invariant matrix stiffness. The model-based predictions were not further enhanced when we accounted for variations in axial tissue stiffness as reflected by the acoustic impedance from SAM.

Simulation study of axial ultrasonic wave propagation in heterogeneous bovine cortical bone

The effect of the heterogeneity of the long cortical bone is an important factor when applying the axial transmission technique. In this study, the axial longitudinal wave velocity distributions in specimens from the mid-shaft of a bovine femur were measured, in the MHz range. Bilinear interpolation and the piecewise cubic Hermite interpolating polynomial method were used to construct three-dimensional (3D) axial velocity models with a resolution of 40 μm. By assuming the uniaxial anisotropy of the bone and using the results of previous experimental studies [Yamato, Matsukawa, Yanagitani, Yamazaki, Mizukawa, and Nagano (2008b). Calcified Tissue Int. 82, 162-169; Nakatsuji, Yamamoto, Suga, Yanagitani, Matsukawa, Yamazaki, and Matsuyama (2011). Jpn. J. Appl. Phys. 50, 07HF18], the distributions of all elastic moduli were estimated to obtain a 3D heterogeneous bone model and a uniform model. In the heterogeneous model, moduli at the surface were smaller than those inside the model. The elastic finite-difference time-domain method was used to simulate axial ultrasonic wave propagation in these models. In the heterogeneous model, the wavefront of the first arriving signal (FAS) was dependent on the heterogeneity, and the FAS velocity depended on the measured position. These phenomena were not observed in the uniform model.

Multi-frequency axial transmission bone ultrasonometer

The last decade has seen a surge in the development of axial transmission QUS (Quantitative UltraSound) technologies for the assessment of long bones using various modes of acoustic waves. The condition of cortical bones and the development of osteoporosis are determined by numerous mechanical, micro-structural, and geometrical or macro-structural bone properties like hardness, porosity and cortical thickness. Such complex manifestations of osteoporosis require the evaluation of multiple parameters with different sensitivities to the various properties of bone that are affected by the disease. This objective may be achieved by using a multi-frequency ultrasonic examination The ratio of the acoustic wavelength to the cortical thickness can be changed by varying the frequency of the ultrasonic pulse propagating through the long bone that results in the change in composition of the induced wave comprised of a set of numerous modes of guided, longitudinal, and surface acoustic waves. The multi-frequency axial transmission QUS method developed at Artann Laboratories (Trenton, NJ) is implemented in the Bone Ultrasonic Scanner (BUSS). In the current version of the BUSS, a train of ultrasonic pulses with 60, 100, 400, 800, and 1200 kHz frequencies is used. The developed technology was tested on a variety of bone phantoms simulating normal, osteopenic, and osteoporotic bones. The results of this study confirm the feasibility of the multi-frequency approach for the assessment of the processes leading to osteoporosis.

Experimental observation of cumulative second-harmonic generation of lamb waves propagating in long bones

The experimental observation of cumulative second-harmonic generation of fundamental Lamb waves in long bones is reported. Based on the modal expansion approach to waveguide excitation and the dispersion characteristics of Lamb waves in long bones, the mechanism underlying the generation and accumulation of second harmonics by propagation of the fundamental Lamb waves was investigated. An experimental setup was established to detect the second-harmonic signals of Lamb wave propagation in long bones in vitro. Through analysis of the group velocities of the received signals, the appropriate fundamental Lamb wave modes and the duration of the second-harmonic signals could be identified. The integrated amplitude of the time-domain second-harmonic signal was introduced and used to characterize the efficiency of second-harmonic generation by fundamental Lamb wave propagation. The results indicate that the second-harmonic signal generated by fundamental Lamb waves propagating in long bones can be observed clearly, and the effect was cumulative with propagation distance when the fundamental Lamb wave mode and the double-frequency Lamb wave mode had the same phase velocities. The present results may be important in the development of a new method to evaluate the status of long bones using the cumulative second harmonic of ultrasonic Lamb waves.

Axial transmission method for long bone fracture evaluation by ultrasonic guided waves: simulation, phantom and in vitro experiments

Mode conversion occurs when the ultrasonic guided waves encounter fractures. The aim of this study was to investigate the feasibility of fracture assessment in long cortical bone using guided-mode conversion. Mode conversion behavior between the fundamental modes S0 and A0 was analyzed. The expressions proposed for modal velocity were used to identify the original and converted modes. Simulations and phantom experiments were performed using 1.0-mm-thick steel plates with a notch width of 0.5 mm and notch depths of 0.2, 0.4, 0.6 and 0.8 mm. Furthermore, in vitro experiments were carried out on nine ovine tibias with 1.0-mm-wide partial transverse gap break and cortical thickness varying from 2.10 to 3.88 mm. The study confirmed that mode conversion gradually becomes observable as fracture depth increases. Energy percentages of the converted modes correlated strongly with fracture depth, as illustrated by the frequency-sweeping experiments on steel phantoms (100-1100 kHz, r(2) = 0.97, p < 0.0069) and the fixed-frequency experiments on nine ovine tibias (250 kHz, r(2) = 0.97, p < 0.0056). The approaches described, including mode excitation, velocity expressions and energy percentage criteria, may also contribute to ultrasonic monitoring of long bone fracture healing.