Pascal Laugier

Three-dimensional simulations of ultrasonic axial transmission velocity measurement on cortical bone models

The ultrasonic axial transmission technique, used to assess cortical shells of long bones, is investigated using numerical simulations based on a three-dimensional (3D) finite difference code. We focus our interest on the effects of 3D cortical bone geometry (curvature, cortical thickness), anisotropy, and microporosity on speed of sound (SOS) measurements for different frequencies in the MHz range. We first show that SOS values measured on tubular cortical shells are identical to those measured on cortical plates of equal thickness. Anisotropy of cortical bone is then shown to have a major impact on SOS measurement as a function of cortical thickness. The range of SOS values measured on anisotropic bone is half the range found when bone is considered isotropic. Dependence of thickness occurs for cortical shell thinner than 0.5 x lambda(bone) in anisotropic bone (lambda(bone): wavelength in bone), whereas it occurs for cortical shell thinner than lambda(bone) when anisotropy is neglected. Sensitivity of SOS along the bone axis to intracortical microporosity is shown to be approximately -20 m s(-1) per percent of porosity. Using homogenized porous bone, we finally show that the cortical depth that contributes to lateral wave SOS measurement is approximately 1-1.5 mm for frequencies ranging from 500 kHz to 2 MHz under classical in vivo measurement conditions.

In vitro assessment of the relationship between acoustic properties and bone mass density of the calcaneus by comparison of ultrasound parametric imaging and quantitative computed tomography

This in vitro study aimed to add new experimental evidence to clarify the relation between acoustic properties of bone and bone mineral density (BMD) of the human calcaneus. Parametric images of normalized broadband ultrasonic attenuation (nBUA) and ultrasound bone velocity (UBV) were compared with quantitative computed tomography (QCT) images of the calcaneus. The experimental protocol was designed to control the different potential sources of error in acoustic measurements, including the shape and thickness of the samples, intervening soft tissues and cortical bone, boundary effects, and variation in location of the regions of interest (ROIs) analyzed by ultrasound and X-ray. The present study was based on bone specimens from calcaneus removed from 15 cadavers (six male and nine female donors ranging from 69 to 89 years of age). Immersion ultrasonic measurements were performed in the through-thickness direction at normal incidence using a pair of focused broad-band 0.5-MHz transducers. QCT of the specimens was performed using standard 10-mm-thick slices with the Cann-Genant calibration standard. Identical, site-matched ROIs were selected for quantitative analysis on the three images. The pattern of acoustic parameters was similar to that of BMD with QCT. The relationships between nBUA and BMD (r2 = 0.75), between UBV and BMD (r2 = 0.88) and between nBUA and UBV (r2 = 0.84) were highly significant (p < 10(-4). From this study, it appears that ultrasound parameters as measured with current transmission techniques reflect mainly bone quantity and only reflect microarchitecture to a small extent and that BUA and UBV reflect the same bone property.

Effect of bone cortical thickness on velocity measurements using ultrasonic axial transmission: A 2D simulation study

In recent years, quantitative ultrasound (QUS) has played an increasing role in the assessment of bone status. The axial transmission technique allows to investigate skeletal sites such as the cortical layer of long bones (radius, tibia), inadequate to through-transmission techniques. Nevertheless, the type of propagation involved along bone specimens has not been clearly elucidated. Axial transmission is investigated here by means of two-dimensional simulations at 1 MHz. We focus our interest on the apparent speed of sound (SOS) of the first arriving signal (FAS). Its dependence on the thickness of the plate is discussed and compared to previous work. Different time criteria are used to derive the apparent SOS of the FAS as a function of source-receiver distance. Frequency-wave number analysis is performed in order to understand the type of propagation involved. For thick plates (thickness>lambdabone, longitudinal wavelength in bone), and for a limited range of source-receiver distances, the FAS corresponds to the lateral wave. Its velocity equals the longitudinal bulk velocity of the bone. For plate thickness less than lambdabone, some plate modes contribute to the FAS, and the apparent SOS decreases with the thickness in a way that depends on both the time criterion and on the source-receiver distance. The FAS corresponds neither to the lateral wave nor to a single plate mode. For very thin plates (thickness< lambdabone/4), the apparent SOS tends towards the velocity of the lowest order symmetrical vibration mode (S0 Lamb mode).

Velocity dispersion of acoustic waves in cancellous bone

Measurement of ultrasonic attenuation and velocity in cancellous bone are being applied to aid diagnosis of women with high fracture risk due to osteoporosis. However, velocity dispersion in cancellous bone has received little attention up to now. The overall goal of this research was to characterize the velocity dispersion of human cancellous bone based on a spectral analysis of ultrasound transmitted through the bone specimens. We have followed a systematic approach, beginning with the investigation of a test material, moving on to the investigation of bone specimens. Particular attention is given to diffraction effect, a potential source of artifacts. Parametric images of phase velocity (measured at the center frequency of the pulse spectrum), slope of attenuation coefficient (dB/cm/MHz) and velocity dispersion were obtained by scanning 15 bone specimens. We have demonstrated that the diffraction effect is negligible in the useful frequency bandwidth, and that the ultrasonic parameters reflect intrinsic acoustic properties of bone tissue. The measured attenuation showed approximately linear behavior over the frequency range 200 to 600 kHz. Velocity dispersion of cancellous bone in the frequency range 200 to 600 kHz was unexpectedly found to be either negative or positive and not correlated with the slope of attenuation coefficient. There was a highly significant correlation between the slope of attenuation coefficient and phase velocity at the center frequency of the spectrum. This behavior contrasts with other biological or nonbiological materials where the local form of the Kramers-Kronig relationship provides accurate prediction of velocity dispersion from the experimental frequency dependent-attenuation for unbounded waves.

Ultrasonic characterization of human cancellous bone using transmission and backscatter measurements: relationships to density and microstructure.

The present study was designed to evaluate the relationships between ultrasonic backscatter, density, and microarchitecture of cancellous bone. The slopes of the frequency-dependent attenuation coefficient (nBUA), ultrasound bone velocity (UBV), the frequency-averaged backscatter coefficient (BUB) were measured in 25 cylindrical cancellous bone cores. Bone mineral density (BMD) was determined using X-ray quantitative computed tomography. Microarchitecture was investigated with synchrotron radiation microtomography with an isotropic spatial resolution of 10 microm. Several microstructural parameters reflecting morphology, connectivity, and anisotropy of the specimens were derived from the reconstructed three-dimensional (3D) microarchitecture. The association of the ultrasonic variables with density and microarchitecture was assessed using simple and multivariate linear regression techniques. For all ultrasonic variables, a strong association was found with density (r = 0.84-0.90). We also found that, with the exception of connectivity, all microstructural parameters correlated significantly with density, with r values of 0.54-0.92. For most microstructural parameters there was a highly significant correlation with ultrasonic parameters (r = 0.33-0.91). However, the additional variance explained by microstructural parameters compared with the variance explained by BMD alone was small (Delta r(2) = 6% at best). In particular, no significant independent association was found between microstructure and backscatter coefficient (a microstructure-related ultrasonic parameter) after adjustment for density. The source for the unaccounted variance of quantitative ultrasound (QUS) parameters remains unknown.

Bone quantitative ultrasound

1 Bone Overview, Pr. David Mitton, Pr. Christian Roux, Dr. Pascal Laugier 2 Introduction to the physics of ultrasound, Dr. Pascal Laugier, Dr. Guillaume Haiat.- 3 Quantitative ultrasound instrumentation for bone in vivo characterization, Dr. Pascal Laugier.- 4 Clinical applications, Dr. Reinhard Barkmann, Pr. C-C Gluer.- 5 Poromechanical Models: Biots theory - Modified Biots theory - Multilayer model, Dr. Michal Pakula, Pr. Mariusz Kaczmarek,Dr. Frederic Padilla.- 6 Scattering by trabecular bone, Dr. Frederic Padilla, Dr. Keith Wear.- 7 Guided waves in cortical bone, Dr. Maryline Talmant, Josquin Foiret,Dr. Jean-Gabriel Minonzio.- 8 Numerical methods for ultrasonic bone characterization, Dr. Emanuel Bossy, Dr. Quentin GRIMAL.- 9 Homogenization theories and inverse problems, Prof. Robert P. Gilbert, Dr. Ana Vasilic, Dr. Sandra Ilic.- 10 Linear acoustics of trabecular bone, Prof. Jukka S Jurvelin et al..- 11 The Fast and Slow Wave Propagation in Cancellous Bone -Experiments and Simulations, Prof. Atsushi Hosokawa, Dr. Yoshiki Nagatani, Prof. Mami Matsukawa.- 12 Phase Velocity of Cancellous Bone Negative dispersion arising from fast and slow waves, interference, diffraction, and phase cancellation at piezoelectric receiving elements, Prof. James G. Miller et al..- 13 Linear ultrasonic properties of cortical bone: in vitro studies, Dr. Guillaume Haiat.- 14 Ultrasonic monitoring of fracture healing, Dr. Vasilios Protopappas, Dr. Maria G. Vavva, Dr. Konstantinos N. Malizos, Prof. Dimitrios I. Fotiadis.- 15 Nonlinear acoustics for non-invasive assessment of bone micro-damage, Dr. Marie Muller, Dr. Guillaume Renaud.- 16 Microscopic elastic properties, Prof. Kay Raum.- 17 Ultrasonic Computed Tomography, Dr. Philippe Lasaygues.- Index.

Evaluation of acoustical parameter sensitivity to age-related and osteoarthritic changes in articular cartilage using 50-MHZ ultrasound

The current study reports the sensitivity of acoustical parameters estimated at high frequency to the osteoarthritic morphological and structural changes in patellar cartilage in rat knees. Osteoarthritis (OA) was induced by a single intra-articular injection of mono-iodo-acetic acid in right knees. OA patellas and their contralateral controls were excised at regular intervals after injection and were examined in vitro with a scanning acoustical microscope operating with a poly(vinylidene di-fluoride) (PVDF) 80-MHz focused transducer. Cartilage thickness was estimated using B-scan images. The quantitative analysis of the radiofrequency signal backscattered by the cartilage was performed using integrated reflection coefficient (IRC) and apparent integrated backscatter (AIB), which were estimated in the 20-60-MHz frequency range. One week after injection, a cartilage thickness decrease was detected (-6%, on average) that preceded the significant hypertrophy (20.1%) that occurred 2 weeks after injection and could be due to tissue repair. From 1 week to 3 weeks after injection, the IRC of OA patellas was significantly lower than that of control patellas. The IRC difference increased with time from -3.3 +/- 2.4 dB at 1 week to -8.4 +/- 1.7 dB at 3 weeks. An AIB decrease was observed with time for both OA and control patellas (-2.9 to -4.2 dB per week). An AIB difference between OA and control patellas was detected from 1 week to 3 weeks after injection. This difference decreased with time. IRC variation reflects a change in acoustical impedance of the superficial layer of the cartilage and could be linked to a change in constituent content and/or to a disruption of fibers of the collagen network that led to the fibrillation of the cartilage surface. AIB variation reflects a change in shape, size and/or density of the scatterers and could be related to changes in the constituent content and in the organization of the matrix in the internal layer of the cartilage. IRC and AIB could provide information about the structural modifications of the cartilage due to osteoarthritis or to cartilage maturation.

Three-dimensional simulation of ultrasound propagation through trabecular bone structures measured by synchrotron microtomography

Three-dimensional numerical simulations of ultrasound transmission were performed through 31 trabecular bone samples measured by synchrotron microtomography. The synchrotron microtomography provided high resolution 3D mappings of bone structures, which were used as the input geometry in the simulation software developed in our laboratory. While absorption (i.e. the absorption of ultrasound through dissipative mechanisms) was not taken into account in the algorithm, the simulations reproduced major phenomena observed in real through-transmission experiments in trabecular bone. The simulated attenuation (i.e. the decrease of the transmitted ultrasonic energy) varies linearly with frequency in the MHz frequency range. Both the speed of sound (SOS) and the slope of the normalized frequency-dependent attenuation (nBUA) increase with the bone volume fraction. Twenty-five out of the thirty-one samples exhibited negative velocity dispersion. One sample was rotated to align the main orientation of the trabecular structure with the direction of ultrasonic propagation, leading to the observation of a fast and a slow wave. Coupling numerical simulation with real bone architecture therefore provides a powerful tool to investigate the physics of ultrasound propagation in trabecular structures. As an illustration, comparison between results obtained on bone modelled either as a fluid or a solid structure suggested the major role of mode conversion of the incident acoustic wave to shear waves in bone to explain the large contribution of scattering to the overall attenuation.

Instrumentation for in vivo ultrasonic characterization of bone strength

Although it has been more than 20 years since the first recorded use of a quantitative ultrasound (QUS) technology to predict bone fragility, the field has not yet reached its maturity. QUS has the potential to predict fracture risk in several clinical circumstances and has the advantages of being nonionizing, inexpensive, portable, highly acceptable to patients, and repeatable. However, the wide dissemination of QUS in clinical practice is still limited and suffering from the absence of clinical consensus on how to integrate QUS technologies in bone densitometry armamentarium. Several critical issues need to be addressed to develop the role of QUS within rheumatology. These include issues of technologies adapted to measure the central skeleton, data acquisition, and signal processing procedures to reveal bone properties beyond bone mineral quantity and elucidation of the complex interaction between ultrasound and bone structure. This article reviews the state-of-the-art in technological developments applied to assess bone strength in vivo. We describe generic measurement and signal processing methods implemented in clinical ultrasound devices, the devices and their practical use, and performance measures. The article also points out the present limitations, especially those related to the absence of standardization, and the lack of comprehensive theoretical models. We conclude with suggestions of future lines and trends in technology challenges and research areas such as new acquisition modes,, advanced signal processing techniques, and modelization.

Bidirectional axial transmission can improve accuracy and precision of ultrasonic velocity measurement in cortical bone: a validation on test materials

The axial transmission technique uses a linear arrangement of ultrasonic emitters and receivers placed on a same side of a cortical bone site in contact with the skin, involving ultrasonic propagation along the axis of bone. The velocity of the waves radiated from bone has been shown to reflect bone status. The thickness and composition of soft tissue may vary along the length of the bone, between different skeletal sites, or between subjects. Hence, accurate estimates of velocity require first to eliminate the effect of the overlying soft tissue that is traversed by the ultrasound wave. To correct for such bias without measuring soft tissue properties, we designed new ultrasonic probes in the 1-2 MHz frequency range. It is based on propagation along the bone surface in two opposite directions from two sources placed on both sides of a unique group of receivers. The aim is to obtain an unbiased estimate of the velocity without any intermediate calculation of soft tissue properties, such as thickness variation or velocity. Validation tests were performed on academic material such as Perspex or aluminium. We found that head wave velocity values could be biased by more than 10% for inclination of a few degrees between the test specimen surface and the probe. On test materials, the compensation procedure implemented in our probe led to a relative precision error on velocity measurement lower than 0.2 to 0.3%. These results suggest that the correction procedure allows measuring in vivo velocities independently of soft tissue properties.