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Abstract
Osteoporosis is a critical problem during aging. Ultrasound signals backscattered from bone contain information associated with microstructures. This study proposed using entropy imaging to collect the information in bone microstructures as a possible solution for ultrasound bone tissue characterization. Bone phantoms with different pounds per cubic foot (PCF) were used for ultrasound scanning by using single-element transducers of 1 (nonfocused) and 3.5 MHz (nonfocused and focused). Clinical measurements were also performed on lumbar vertebrae (L3 spinal segment) in participants with different ages (n = 34) and postmenopausal women with low or moderate-to-high risk of osteoporosis (n = 50; identified using the Osteoporosis Self-Assessment Tool for Taiwan). The signals backscattered from the bone phantoms and subjects were acquired for ultrasound entropy imaging by using sliding window processing. The independent t-test, one-way analysis of variance, Spearman correlation coefficient rs, and the receiver operating characteristic (ROC) curve were used for statistical analysis. The results indicated that ultrasound entropy imaging revealed changes in bone microstructures. Using the 3.5-MHz focused ultrasound, small-window entropy imaging (side length: one pulse length of the transducer) was found to have high performance and sensitivity in detecting variation among the PCFs (rs = − 0.83; p < 0.05). Small-window entropy imaging also performed well in discriminating young and old participants (p < 0.05) and postmenopausal women with low versus moderate-to-high osteoporosis risk (the area under the ROC curve = 0.80; cut-off value = 2.65; accuracy = 86.00%; sensitivity = 71.43%; specificity = 88.37%). Ultrasound small-window entropy imaging has great potential in bone tissue characterization and osteoporosis assessment.
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Details
1 Chang Gung University, Department of Medical Imaging and Radiological Sciences, College of Medicine, Taoyüan, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922)
2 Chang Gung Memorial Hospital at Linkou, Department of Medical Imaging and Intervention, Taoyüan, Taiwan (GRID:grid.454210.6) (ISNI:0000 0004 1756 1461)
3 Chang Gung Memorial Hospital, Keelung and Chang Gung University, Department of Medical Imaging and Intervention, Taoyüan, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593)
4 Chang Gung University, Graduate Institute of Biomedical Engineering, Taoyüan, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922)
5 National Taiwan University, Department of Family Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241)
6 Chang Gung University, Department of Medical Imaging and Radiological Sciences, College of Medicine, Taoyüan, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922); Chang Gung Memorial Hospital at Linkou, Department of Medical Imaging and Intervention, Taoyüan, Taiwan (GRID:grid.454210.6) (ISNI:0000 0004 1756 1461); Chang Gung Memorial Hospital at Linkou, Division of Pediatric Gastroenterology, Department of Pediatrics, Taoyüan, Taiwan (GRID:grid.454210.6) (ISNI:0000 0004 1756 1461)