Predictions of angle dependent tortuosity and elasticity effects on sound propagation in cancellous bone

Mechanisms of Interaction of Ultrasound With Cancellous Bone: A Review

Ultrasound is now a clinically accepted modality in the management of osteoporosis. The most common commercial clinical devices assess fracture risk from measurements of attenuation and sound speed in cancellous bone. This review discusses fundamental mechanisms underlying the interaction between ultrasound and cancellous bone. Because of its two-phase structure (mineralized trabecular network embedded in soft tissue-marrow), its anisotropy, and its inhomogeneity, cancellous bone is more difficult to characterize than most soft tissues. Experimental data for the dependencies of attenuation, sound speed, dispersion, and scattering on ultrasound frequency, bone mineral density, composition, microstructure, and mechanical properties are presented. The relative roles of absorption, scattering, and phase cancellation in determining attenuation measurements in vitro and in vivo are delineated. Common speed of sound metrics, which entail measurements of transit times of pulse leading edges (to avoid multipath interference), are greatly influenced by attenuation, dispersion, and system properties, including center frequency and bandwidth. However, a theoretical model has been shown to be effective for correction for these confounding factors in vitro and in vivo. Theoretical and phantom models are presented to elucidate why cancellous bone exhibits negative dispersion, unlike soft tissue, which exhibits positive dispersion. Signal processing methods are presented for separating "fast" and "slow" waves (predicted by poroelasticity theory and supported in cancellous bone) even when the two waves overlap in time and frequency domains. Models to explain dependencies of scattering on frequency and mean trabecular thickness are presented and compared with measurements. Anisotropy, the effect of the fluid filler medium (marrow in vivo or water in vitro), phantoms, computational modeling of ultrasound propagation, acoustic microscopy, and nonlinear properties in cancellous bone are also discussed.

Bayesian-based estimation of acoustic surface impedance: Finite difference frequency domain approach

Acoustic performance for an interior requires an accurate description of the boundary materials' surface acoustic impedance. Analytical methods may be applied to a small class of test geometries, but inverse numerical methods provide greater flexibility. The parameter estimation problem requires minimizing prediction vice observed acoustic field pressure. The Bayesian-network sampling approach presented here mitigates other methods' susceptibility to noise inherent to the experiment, model, and numerics. A geometry agnostic method is developed here and its parameter estimation performance is demonstrated for an air-backed micro-perforated panel in an impedance tube. Good agreement is found with predictions from the ISO standard two-microphone, impedance-tube method, and a theoretical model for the material. Data by-products exclusive to a Bayesian approach are analyzed to assess sensitivity of the method to nuisance parameters.

Estimation of fast and slow wave properties in cancellous bone using Prony's method and curve fitting

The presence of two longitudinal waves in poroelastic media is predicted by Biot's theory and has been confirmed experimentally in through-transmission measurements in cancellous bone. Estimation of attenuation coefficients and velocities of the two waves is challenging when the two waves overlap in time. The modified least squares Prony's (MLSP) method in conjuction with curve-fitting (MLSP + CF) is tested using simulations based on published values for fast and slow wave attenuation coefficients and velocities in cancellous bone from several studies in bovine femur, human femur, and human calcaneus. The search algorithm is accelerated by exploiting correlations among search parameters. The performance of the algorithm is evaluated as a function of signal-to-noise ratio (SNR). For a typical experimental SNR (40 dB), the root-mean-square errors (RMSEs) for one example (human femur) with fast and slow waves separated by approximately half of a pulse duration were 1 m/s (slow wave velocity), 4 m/s (fast wave velocity), 0.4 dB/cm MHz (slow wave attenuation slope), and 1.7 dB/cm MHz (fast wave attenuation slope). The MLSP + CF method is fast (requiring less than 2 s at SNR = 40 dB on a consumer-grade notebook computer) and is flexible with respect to the functional form of the parametric model for the transmission coefficient. The MLSP + CF method provides sufficient accuracy and precision for many applications such that experimental error is a greater limiting factor than estimation error.

Mechanical competence of bone: a new parameter to grade trabecular bone fragility from tortuosity and elasticity

With the elderly population increase, osteoporosis and its consequences have become not just a health issue but also a serious economic burden. The trabecular bone structure plays a very important role for the bone quality and mechanical competence of the scaffold. Currently, it is claimed that the trabecular microarchitecture understanding can improve the fracture risk prediction above 65%. Several parameters seem to be correlated providing structural details of the trabecular bone network. However, the tortuosity of the trabeculae has not yet been systematically taken into account and its contribution has not been fully investigated and understood. In this paper, we discuss the relationship between the trabecular tortuosity, connectivity, volume fraction, and elasticity, and provide a unified parameter to estimate the mechanical competence of the structure. It is shown that the trabecular network tortuosity presents high linear correlation with the other parameters and that the trabeculae tend to get aligned in the direction where the structure is mostly submitted to stress, corresponding to higher stiffness orientation. This new parameter will help to integrate the relevant information of bone microarchitecture quality and assess more directly the real trabecular fragility in osteoporotic patients.

Relationships of quantitative ultrasound parameters with cancellous bone microstructure in human calcaneus in vitro

Ultrasound parameters (attenuation, phase velocity, and backscatter), bone mineral density (BMD), and microarchitectural features were measured on 29 human cancellous calcaneus samples in vitro. Regression analysis was performed to predict ultrasound parameters from BMD and microarchitectural features. The best univariate predictors of the ultrasound parameters were the indexes of bone quantity: BMD and bone volume fraction (BV/TV). The most predictive univariate models for attenuation, phase velocity, and backscatter coefficient yielded adjusted squared correlation coefficients of 0.69-0.73. Multiple regression models yielded adjusted correlation coefficients of 0.74-0.83. Therefore attenuation, phase velocity, and backscatter are primarily determined by bone quantity, but multiple regression models based on bone quantity plus microarchitectural features achieve slightly better predictive performance than models based on bone quantity alone.

Ultrasonic wave propagation in stereo-lithographical bone replicas

Predictions of a modified anisotropic Biot-Allard theory are compared with measurements of pulses centered on 100 kHz and 1 MHz transmitted through water-saturated stereo-lithographical bone replicas. The replicas are 13 times larger than the original bone samples. Despite the expected effects of scattering, which is neglected in the theory, at 100 kHz the predicted and measured transmitted waveforms are similar. However, the magnitude of the leading negative edge of the waveform is overpredicted, and the trailing parts of the waveforms are not predicted well. At 1 MHz, although there are differences in amplitudes, the theory predicts that the transmitted waveform is almost a scaled version of that incident in conformity with the data.