Preliminary clinical validation of a new ultrasound-based methodology for femoral neck densitometry

Hip fracture has been recognized as the worst consequence of osteoporosis, as it represents one of the most important causes of disability and mortality in elderly people. An accurate knowledge of the osteoporotic fracture risk in asymptomatic individuals through population mass screenings may be the only way to reduce the occurrence of hip fractures. Aim of this study was to perform a preliminary clinical validation of a new ultrasound (US)- based method for bone densitometry directly applicable on femoral neck. A total of 112 female patients were enrolled for this study (61-75 years of age, body mass index (BMI)<40 kg/m2) and all of them underwent two different diagnostic investigations: a conventional DXA (dual-energy X-ray absorptiometry) of the femoral neck and an US scan of the same bone district, acquiring both echographic images and unfiltered radiofrequency signals. US data were analyzed by a new algorithm that calculated the same diagnostic parameters obtained from DXA examination (BMD, T-score, Z-score). Accuracy of each parameter calculated by this algorithm was then evaluated through a direct comparison with DXA results as a function of both patient age and BMI. For 81.3% of the patients US diagnosis (osteoporotic, osteopenic, healthy) coincided with the corresponding DXA one and this accuracy level was not appreciably influenced by patient age nor by BMI. The illustrated method has the potential to be used for routine population screening programs for early osteoporosis diagnosis and hip fracture prevention.