References

Scientific articles on Oscare Sono® Axial Transmission Ultrasound Technology

R. Pfaffen, S. Soares, A. Casmarrinha-Vieira, M. Metzger, O. Lamy, D. Hans, “Assessment of a New Low Frequency Quantitative Ultrasound (QUS) of the Radius”, Poster presented at the International Society of Clinical Densitometry meeting 1.-4.6.2016.

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The aims of this study were to evaluate the precision of the OsCare Sono® device as well as its relationship with 1/3 radius bone mineral density as assessed by DXA. OsCare Sono® was used to measure the axial speed of low frequency ultrasound (VLF) at the radius. A total of 45 women were included (mean age of 66.3 years). The mean 1/3 radius BMD T-score was -1.23 ± 1.43. Each woman had 3 QUS measurements in a row with repositioning. A built-in quality assessment of the OsCare Sono® signal was used to score the measurement quality (Poor, Good or Excellent).

For about 98 % of the women, all 3 measurements were qualified as Excellent or Good and were subsequently included into the statistical analysis. The intra-operator RMS-CV of a skilled technologist was 0.33 % (RMS-Standard deviation 12.2 m/s) and the multi-operator RMS-CV, including 3 technologists (1 skilled and 2 beginners), was 0.41 % (RMS-SD 15.4 m/s). VLF was explaining up to 67 % of the 1/3 radius BMD (r = +0.82).

Conclusion: The reported precision for this new QUS device of the radius is good. The very good correlation with 1/3 radius BMD thanks to the use of low frequency ultrasound may make this device suitable for a potential surrogate of pDXA if clinical performance is at least equal in the fracture prediction and/or to help finding those individuals at a high risk for osteoporosis.

M. Määttä, P. Moilanen, J. Timonen, P. Pulkkinen, R. Korpelainen, T. Jämsä, ”Association between low-frequency ultrasound and hip fractures – comparison with DXA-based BMD”, BMC Musculoskelet Disord, 15:208, 2014.

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This study investigates the association between speed of low-frequency ultrasound measured from tibia and the occurrence of fractures. The measurement from the tibia has a wider standard deviation than the measurement from the radius which is the method used in the commercial Oscare product, however despite this the study is able to show an association between ultrasound velocity and hip fractures with an odds ratio of 3.3.

Background: New methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women.

Methods: The study population consisted of 490 community-dwelling women (78-82 years). Ultrasound velocity (V(LF)) at mid-tibia was measured in 2006 using a lowfrequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997.

Results: During the total follow-up period (1997-2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low V(LF) (the lowest quartile) was associated with increased hip fracture risk when compared with V(LF) in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, V(LF) was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0).

Conclusion: Low V(LF) at mid-tibia was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors.

P. Moilanen, M. Määttä, V. Kilappa, L. Xu, P.H. Nicholson, M. Alén, J. Timonen, T. Jämsä, S. Cheng, ” Discrimination of fractures by low-frequency axial transmission ultrasound in postmenopausal females”, Osteoporos Int, 24(2):723-730, 2013.

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The aim of the study was to evaluate the ability of low-frequency axial transmission ultrasound to discriminate fractures retrospectively in postmenopausal women. The study involved 95 female subjects aged 45-88 years, whose fracture information was gathered retrospectively. The fracture group was defined as subjects with one or more low or moderate energy fractures. The radius and tibial shaft were measured with a low-frequency ultrasonometer to assess the velocity of the first arriving signal. Site-matched pQCT was used to measure volumetric cortical and subcortical bone mineral density and cortical thickness. DXA was used to measure areal BMD for the whole body, lumbar, spine and hip.

The majority of the fractures were in the upper limb. V(LF) in the radius (but not in the tibia) discriminated fractures with an age and BMI adjusted odds ratio of 2.06 (95% CI 1.21-3.50, p<0.01), better than pQCT or DXA.

V. Kilappa, P. Moilanen, L. Xu, P.H. Nicholson, J. Timonen, S. Cheng, “Low-frequency axial ultrasound velocity correlates with bone mineral density and cortical thickness in the radius and tibia in pre- and postmenopausal women”, Osteoporos Int 22(4):1103-13, 2010.

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LF US provides enhanced sensitivity to thickness and endosteal properties of the cortical wall of radius and tibia compared to using higher frequencies (e.g. 1 MHz). The aim of this study was to evaluate the extent to which LF measurement reflects cortical thickness and bone mineral density. LF US velocity was compared to site matched pQCT measurements. The study included 159 premenopausal and 95 postmenopausal females.

V(LF) correlated best with cortical bone mineral density in postmenopausal females in the radius (R=0,85, p<0.001), but significantly also with subcortical bone mineral density (R=0.759) and with cortical thickness (R=0.761), p<0.001. Similar trends but weaker correlations were found for tibia and for premenopausal women.

P. Moilanen, “Ultrasonic guided waves in bone”, IEEE Trans. Ultrason. Ferroelect. Freq. Contr., 55(6): 1277-1286, 2008.

P. Moilanen, V. Kilappa, P.H.F. Nicholson, J. Timonen, S. Cheng, “Thickness sensitivity of ultrasound velocity in long bone phantoms”, Ultrasound Med Biol 30: 1517-1521, 2004.

P. Moilanen, P.H.F. Nicholson, T. Kärkkäinen, Q. Wang, J. Timonen, S. Cheng, “Assessment of the tibia using ultrasonic guided waves in pubertal girls”, Osteoporos Int, 14: 1020-1027, 2003.

P.H.F. Nicholson, P. Moilanen, T. Kärkkäinen, J. Timonen, S. Cheng, “Guided ultrasonic waves in long bones: modelling, experiment and in vivo application”, Physiol Meas, 23: 755-68, 2002.