Application of the dual-frequency ultrasonometer for osteoporosis detection

The paper presents results of a clinical validation study of Bone UltraSonic Scanner (BUSS), a novel dual-frequency axial transmission ultrasonometer, developed by Artann Laboratories. Assessment of bone conditions is based on evaluating relative changes of the axial profiles of ultrasonic characteristics in long bones and utilizes bulk and guided acoustic waves. The objective of this study was to determine the ability of BUSS to discriminate osteoporosis development stages. A total of 93 menopausal and post-menopausal women divided into five groups from normal to advanced osteoporosis according to their DXA hip t-score were enrolled in the study. The 2D waveform profiles at low (0.1 MHz) and high (1 MHz) frequencies were obtained by scanning 15 cm along the proximal tibia.A multi-parametric linear classifier based on a set of the parameters derived from 2D acoustic waveform profiles has been developed. The efficiency of this classifier in differentiating osteoporosis from a normal sample was assessed using a receiver operating characteristic (ROC) curve analysis. Based on the ROC analysis, BUSS demonstrated 76% sensitivity and 70% specificity to DXA-identified osteoporosis. The area under the ROC curve, which is a measure of how well a parameter can distinguish between the two diagnostic groups (diseased/normal) was 79.3%. The study confirmed BUSS’s capability to discriminate between stages of bone atrophy and in particular to distinguish early changes induced by osteoporosis.     

Multi-frequency axial transmission bone ultrasonometer

The last decade has seen a surge in the development of axial transmission QUS (Quantitative UltraSound) technologies for the assessment of long bones using various modes of acoustic waves. The condition of cortical bones and the development of osteoporosis are determined by numerous mechanical, micro-structural, and geometrical or macro-structural bone properties like hardness, porosity and cortical thickness. Such complex manifestations of osteoporosis require the evaluation of multiple parameters with different sensitivities to the various properties of bone that are affected by the disease. This objective may be achieved by using a multi-frequency ultrasonic examination The ratio of the acoustic wavelength to the cortical thickness can be changed by varying the frequency of the ultrasonic pulse propagating through the long bone that results in the change in composition of the induced wave comprised of a set of numerous modes of guided, longitudinal, and surface acoustic waves. The multi-frequency axial transmission QUS method developed at Artann Laboratories (Trenton, NJ) is implemented in the Bone Ultrasonic Scanner (BUSS). In the current version of the BUSS, a train of ultrasonic pulses with 60, 100, 400, 800, and 1200 kHz frequencies is used. The developed technology was tested on a variety of bone phantoms simulating normal, osteopenic, and osteoporotic bones. The results of this study confirm the feasibility of the multi-frequency approach for the assessment of the processes leading to osteoporosis.     

Blood oxygenation level dependent magnetic resonance imaging and diffusion weighted MRI imaging for benign and malignant breast cancer discrimination

PurposeThe purpose of this study is to assess Blood oxygenation level dependent Magnetic Resonance Imaging (BOLD-MRI) and Diffusion Weighted Magnetic Resonance Imaging (DW-MRI) in the differentiation of benign and malignant breast lesions.MethodsFifty-nine breast lesions (26 benign and 33 malignant lesions) pathologically proven in 59 patients were included in this retrospective study. As BOLD parameters were estimated basal signal S₀ and the relaxation rate R2*, diffusion and perfusion parameters were derived by DWI (pseudo-diffusion coefficient (Dp), perfusion fraction (fp) and tissue diffusivity (Dt)). Wilcoxon-Mann-Whitney U test and Receiver operating characteristic (ROC) analyses were calculated and area under ROC curve (AUC) was obtained. Moreover, pattern recognition approaches (linear discrimination analysis (LDA), support vector machine, k-nearest neighbours, decision tree) with least absolute shrinkage and selection operator (LASSO) method and leave one out cross validation approach were considered.ResultsA significant discrimination was obtained by the standard deviation value of S0, as BOLD parameter, that reached an AUC of 0.76 with a sensitivity of 65%, a specificity of 85% and an accuracy of 76%. No significant discrimination was obtained considering diffusion and perfusion parameters. Considering LASSO results, the features to use as predictors were all extracted parameters except that the mean value of R2* and the best result was obtained by a LDA that obtained an AUC = 0.83, with a sensitivity of 88%, a specificity of 77% and an accuracy of 83%.ConclusionsGood performance to discriminate benign and malignant lesions could be obtained using BOLD and DWI derived parameters with a LDA classification approach. However, these findings should be proven on larger and several dataset with different MR scanners.     

In vitro estimation of fast and slow wave parameters of thin trabecular bone using space-alternating generalized expectation-maximization algorithm

In testing cancellous bone using ultrasound, two types of longitudinal Biot’s waves are observed in the received signal. These are known as fast and slow waves and their appearance depend on the alignment of bone trabeculae in the propagation path and the thickness of the specimen under test (SUT). They can be used as an effective tool for the diagnosis of osteoporosis because wave propagation behavior depends on the bone structure. However, the identification of these waves in the received signal can be difficult to achieve.In this study, ultrasonic wave propagation in a 4 mm thick bovine cancellous bone in the direction parallel to the trabecular alignment is considered. The observed Biot’s fast and slow longitudinal waves are superimposed; which makes it difficult to extract any information from the received signal. These two waves can be separated using the space alternating generalized expectation maximization (SAGE) algorithm. The latter has been used mainly in speech processing.In this new approach, parameters such as, arrival time, center frequency, bandwidth, amplitude, phase and velocity of each wave are estimated. The B-Scan images and its associated A-scans obtained through simulations using Biot’s finite-difference time-domain (FDTD) method are validated experimentally using a thin bone sample obtained from the femoral-head of a 30 months old bovine.     

Diagnostic value of elastosonography for thyroid microcarcinoma

Objective

To assess the diagnostic value of elastosonography for thyroid microcarcinoma (TMC), particularly with regard to elasticity score (ES) and strain ratio (SR).

Methods

Conventional ultrasound and elastosonography were performed for 487 thyroid micronodules before surgery. We set the histology as the reference standard. The ES and SR values, as well as their diagnostic threshold and efficiency, were compared and analyzed by the receiver-operating characteristic (ROC) curve. Additional comparisons between TMC patients with and without extracapsular extension were also performed.

Results

Statistically significant differences (P < 0.05) in both ES and SR values were detected among the TMC and benign groups. The area under the ROC curve of SR was significantly greater than that of ES (0.956 and 0.844, respectively; P < 0.05). Using ES ? 3 and SR ? 3.65 as diagnostic threshold values, the diagnostic sensitivity, specificity, and accuracy of ES for differentiating benign and malignant nodules were 79.9%, 72.3%, and 80.5%, respectively, whereas those of SR were 86.6%, 85.3%, and 89.4%, respectively. The maximum diameter, microcalcification status, aspect ratio, bilateral cervical lymph node metastasis, and SR values of nodules with extracapsular extension (A1 subgroup) were greater than those of nodules without extracapsular extension (A2 subgroup).

Conclusions

Elasticity imaging technology not only can help differentiate between benign and malignant thyroid micronodules but also allow SR values to provide accurate and objective information on tissue hardness and to predict TMC extracapsular extension or even bilateral cervical lymph node metastasis.     

Nonlinear inversion of ultrasonic guided waves for in vivo evaluation of cortical bone properties

Ultrasonic guided waves (UGWs), which propagate throughout the entire thickness of cortical bone, are attractive for the early diagnosis of osteoporosis. However, this is challenging due to the impact of soft tissue and the inherent difficulties related to multiparametric inversion of cortical bone quality factors, such as cortical thickness and bulk wave velocity. Therefore, in this research, a UGW-based multi-parameter inversion algorithm is developed to predict strength-related factors. In simulation, a free plate (cortical bone) and a bilayer plate (soft tissue and cortical bone) are used to validate the proposed method. The inversed cortical thickness (CTh), longitudinal velocity (V_L) and transverse velocity (V_T) are in accordance with the true values. Then four bovine cortical bone plates were used in in vitro experiments. Compared with the reference values, the relative errors for cortical thickness were 3.96%, 0.83%, 2.87%, and 4.25%, respectively. In the in vivo measurements, UGWs are collected from the tibias of 10 volunteers. The theoretical dispersion curves depicted by the estimated parameters (V_T, V_L, CTh) match well with the extracted experimental ones. In comparison with dual-energy x-ray absorptiometry, our results show that the estimated transverse velocity and cortical thickness are highly sensitive to osteoporosis. Therefore, these two parameters (CTh and V_T) of long bones have potential to be used for diagnosis of bone status in clinical applications.     

Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI

Purposes

To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer.

Materials and methods

Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used.

Results

On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p < 0.001 for each), and eccentric cortical thickening (p < 0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤ 0.986 × 10–3 mm²/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%).

Conclusion

Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.     

The dual-frequency method for ultrasonic assessment of skeletal system

The article is a review of the new dual-frequency method in axial bone quantitative ultrasonometry for assessment of changes in cortical bones in osteoporosis. The method is based on the use of two frequencies for the generation of flexural and longitudinal ultrasonic waves, which opens possibilities for differential diagnostics of changes in various components of the state of the skeletal system, such as cortical layer thickness, porosity, and elastic properties of tissue. The axial scanning and composition of two-dimensional acoustic profiles of bones are carried out with the purpose of using topographic variations in the acoustic properties for diagnostics of the state of a bone. Results of laboratory and clinical tests of Bone UltraSonic Scanner (BUSS) developed in Artann Laboratories on the basis of the stated principles are presented. The sensitivity of measured characteristics to progression of osteoporosis and the detectability of early changes in bones related to this disease are shown.

     

Interrelationships between 3-T-MRI-derived cortical and trabecular bone structure parameters and quantitative-computed-tomography-derivedbone mineral density

Recently, 3-T magnetic resonance imaging (MRI) has been introduced for bone imaging. Through higher signal-to-noise ratios, as compared to 1.5-T MRI, it promises to be a more powerful tool for the assessment of cortical and trabecular bone measures. The goal of our study was to compare MRI-derived cortical and trabecular bone measures to quantitative computed tomography (QCT)-derived bone mineral density (BMD). Using 3-T MRI in 51 postmenopausal women, apparent (app.) measures of bone volume/total volume, trabecular number (Tb.N), trabecular thickness (Tb.Th) and trabecular separation were derived at the distal radius, distal tibia and calcaneus. Cortical thickness (Ct.Th) was calculated at the distal radius and distal tibia. These measures were compared to QCT-derived BMD of the spine, hip and radius. Significant correlations (^?P<.05; ^??P<.001; ^???P<.0001) were found between spine BMD- and MRI-derived Ct.Th (r_radius=.55, ^?P<.05; r_tibia=.67, ^???P<.0001) and app. Tb.N (r_radius=.33, ^?P<.05; r_tibia=.35, ^?P<.05) at the radius and tibia. Furthermore, within the first 10 mm at the radius, an inverse correlation for Ct.Th and app. BV/TV (r_6mm=−.56, P<.001; r_10mm=−.36, P<.05) and app. Tb.Th (r_6mm=−.54, P<.001; r_10mm=−.41, P<.05) was found.     

Perfusion quantification using dynamic contrast-enhanced ultrasound: The impact of dynamic range and gain on time-intensity curves

The objective of this study was to assess the impact of dynamic range and gain on perfusion quantification using linearized log-compressed data. An indicator-dilution experiment was developed with an in vitro flow phantom setup used with SonoVue contrast agent (Bracco SpA, Milan, Italy). Imaging was performed with a Philips iU22 scanner and a C5-1 curvilinear transducer using a contrast-specific nonlinear pulse sequence (power modulation) at 1.7 MHz. Clinical dynamic contrast-enhanced ultrasound image loops of liver tumors were also collected for preliminary validation of the in vitro findings. Time-intensity curves were extracted from image loops with two different approaches: from linearized log-compressed data and from linear (uncompressed) data. The error of time-intensity curve parameters derived from linearized log-compressed data (deviation from linear data) was found to be less than 2.1% and 5.4% for all studied parameters in the in vitro experiment and in the clinical study, respectively, when a high dynamic range setting (at least 50 dB on the iU22) is used. The gain must be carefully adjusted to ensure a high signal-to-noise ratio and to avoid signal saturation. From the time-intensity curve analysis it was also found that rise time of the bolus time-intensity curve is the least variable of all the studied time-intensity curve parameters.     

Effects of arterial input function selection on kinetic parameters in brain dynamic contrast-enhanced MRI

PurposeKinetic parameters derived from dynamic contrast-enhanced MRI (DCE-MRI) were suggested as a possible instrument for multi-parametric lesion characterization, but have not found their way into clinical practice yet due to inconsistent results. The quantification is heavily influenced by the definition of an appropriate arterial input functions (AIF). Regarding brain tumor DCE-MRI, there are currently several co-existing methods to determine the AIF frequently including different brain vessels as sources. This study quantitatively and qualitatively analyzes the impact of AIF source selection on kinetic parameters derived from commonly selected AIF source vessels compared to a population-based AIF model.Material and methods74 patients with brain lesions underwent 3D DCE-MRI. Kinetic parameters [transfer constants of contrast agent efflux and reflux K^trans and k_ep and, their ratio, v_e, that is used to measure extravascular-extracellular volume fraction and plasma volume fraction v_p] were determined using extended Tofts model in 821 ROI from 4 AIF sources [the internal carotid artery (ICA), the closest artery to the lesion, the superior sagittal sinus (SSS), the population-based Parker model]. The effect of AIF source alteration on kinetic parameters was evaluated by tissue type selective intra-class correlation (ICC) and capacity to differentiate gliomas by WHO grade [area under the curve analysis (AUC)].ResultsArterial AIF more often led to implausible v_e > 100% values (p < 0.0001). AIF source alteration rendered different absolute kinetic parameters (p < 0.0001), except for k_ep. ICC between kinetic parameters of different AIF sources and tissues were variable (0.08–0.87) and only consistent > 0.5 between arterial AIF derived kinetic parameters. Differentiation between WHO III and II glioma was exclusively possible with v_p derived from an AIF in the SSS (p = 0.03; AUC 0.74).ConclusionThe AIF source has a significant impact on absolute kinetic parameters in DCE-MRI, which limits the comparability of kinetic parameters derived from different AIF sources. The effect is also tissue-dependent. The SSS appears to be the best choice for AIF source vessel selection in brain tumor DCE-MRI as it exclusively allowed for WHO grades II/III and III/IV glioma distinction (by v_p) and showed the least number of implausible v_e values.     

Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.     

Preliminary quantitative analysis of vertebral microenvironment changes in type 2 diabetes mellitus using FOCUS IVIM-DWI and IDEAL-IQ sequences

PurposeTo explore the application of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) on account of field-of-view optimized and constrained undistorted single shot (FOCUS) and iteraterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation(IDEAL-IQ) sequences in evaluating the vertebral microenvironment changes of type 2 diabetes mellitus(T2DM) patients and the correlation with bone mineral density(BMD).Method128 T2DM patients (mean age 63.4 ± 5.28 years) underwent both dual-energy X-ray absorptiometry (DEXA) and spine MRI. The FOCUS IVIM-DWI and IDEAL-IQ derived parameters of the vertebral body(L1, L2, L3, L4)were measured on corresponding maps of the lumbar spine. The subjects were divided into 3 groups according to T-scores as follows: normal (n = 37), osteopenia (n = 43), and osteoporosis(n = 48) group.One-way analysis of variance (ANOVA) were used to compare the vertebral parameters(ADC_slow, ADC_fast, f, FF, R2*) among three BMD cohorts.Receiver operating characteristic (ROC) analyses and Spearman's rank correlation were performed to test the diagnostic performance and the correlation between them respectively.ResultsThere were significant differences in vertebral ADC_slow, ADC_fast, FF and R2* between the three groups (P < 0.05).Statistically, BMD was moderately negatively correlated with FF (r = −0.584, P < 0.001) and weakly positively with ADC_slow (r = 0.334, P < 0.001), meanwhile moderately positively correlated with R2*(r = 0.509, P < 0.001) and ADC_fast(0.545, P < 0.001).ADC_fast was moderately negatively correlated with FF (r = −0.417, P < 0.001), weakly positively correlated with R2*(0.359, P < 0.001).Compared with the area under the curve (AUC) of ADC_slow, ADC_fast, FF and R2*, the AUC of ADC_fast was higher in identifying between normal and abnormal(osteopenia and osteoporosis), normal from osteopenia, while the AUC of FF was higher in identifying osteopenia from osteoporosis.ConclusionsFOCUS IVIM-DWI and IDEAL-IQ of lumbar spine might be useful to evaluate the vertebral microenvironment changes of T2DM patients.     

非理想1/4波片对泵浦光偏振态的影响

为了研究调整架角度误差以及波片与光源波长不匹配对线偏振光经过1/4波片之后偏振态的影响,本文利用坐标变换法得到1/4波片的琼斯矩阵,并用琼斯矩阵表示各偏振态。推导出波片与光源不匹配时对偏振态的影响理论模型。当考虑到调整架的角度误差时,对入射光偏振态以及波片的琼斯矩阵表达式做引入角度误差的泰勒展开,最后得到和实验结果匹配的仿真曲线。仿真结果表明,当采用808 nm 1/4波片对795 nm波长的线偏振光作用时,在不考虑调整误差的理想情况下出射光椭圆度最高为0.9746,考虑调整误差时,对应理想情况下椭圆度最高为0.96,椭圆度最高点偏移1.72°。仿真和实验结果为进一步分析泵浦光椭圆度对原子参数的影响提供了依据。     

Evaluation of left ventricular function with cardiac magnetic resonance imaging using Fourier fitting

The aims of this study were to investigate the applicability of Fourier fitting in the magnetic resonance (MR) evaluation of left ventricular (LV) function and to determine the optimal number of harmonics for fitting. Cine cardiac MR imaging was performed in 10 subjects, and an LV time–volume curve was generated. Fourier fitting was applied to the original curve using 1–10 harmonics, and the qualities of the time–volume curve and first-derivative curve were evaluated. LV functional parameters were calculated from curves generated with and without fitting. The quality of the original time–volume curve was good, and Fourier fitting had no substantial effect on functional parameters obtained directly from the time–volume curve such as ejection fraction. The first-derivative curve generated without fitting showed substantial artificial fluctuation. The application of Fourier fitting depressed the fluctuation and tended to decrease estimates of peak ejection rate and peak filling rate. Five or six harmonics appeared to be appropriate for obtaining a high-quality first-derivative curve. In conclusion, Fourier fitting was indicated to aid in reducing the artificial fluctuation of the first-derivative curve generated from cine cardiac MR imaging and to contribute to the evaluation of functional parameters derived from the first-derivative curve.     

Two-wave behavior under various conditions of transition area from cancellous bone to cortical bone

The two-wave phenomenon, the wave separation of a single ultrasonic pulse in cancellous bone, is expected to be a useful tool for the diagnosis of osteoporosis. However, because actual bone has a complicated structure, precise studies on the effect of transition conditions between cortical and cancellous parts are required. This study investigated how the transition condition influenced the two-wave generation using three-dimensional X-ray CT images of an equine radius and a three-dimensional simulation technique. As a result, any changes in the boundary between cortical part and trabecular part, which gives the actual complex structure of bone, did not eliminate the generation of either the primary wave or the secondary wave at least in the condition of clear trabecular alignment. The results led us to the possibility of using the two-wave phenomenon in a diagnostic system for osteoporosis in cases of a complex boundary.     

Bispectral Analysis of Heart Rate Variability to Characterize and Help Diagnose Pediatric Sleep Apnea

Pediatric obstructive sleep apnea (OSA) is a breathing disorder that alters heart rate variability (HRV) dynamics during sleep. HRV in children is commonly assessed through conventional spectral analysis. However, bispectral analysis provides both linearity and stationarity information and has not been applied to the assessment of HRV in pediatric OSA. Here, this work aimed to assess HRV using bispectral analysis in children with OSA for signal characterization and diagnostic purposes in two large pediatric databases (0–13 years). The first database (training set) was composed of 981 overnight ECG recordings obtained during polysomnography. The second database (test set) was a subset of the Childhood Adenotonsillectomy Trial database (757 children). We characterized three bispectral regions based on the classic HRV frequency ranges (very low frequency: 0–0.04 Hz; low frequency: 0.04–0.15 Hz; and high frequency: 0.15–0.40 Hz), as well as three OSA-specific frequency ranges obtained in recent studies (BW1: 0.001–0.005 Hz; BW2: 0.028–0.074 Hz; BWRes: a subject-adaptive respiratory region). In each region, up to 14 bispectral features were computed. The fast correlation-based filter was applied to the features obtained from the classic and OSA-specific regions, showing complementary information regarding OSA alterations in HRV. This information was then used to train multi-layer perceptron (MLP) neural networks aimed at automatically detecting pediatric OSA using three clinically defined severity classifiers. Both classic and OSA-specific MLP models showed high and similar accuracy (Acc) and areas under the receiver operating characteristic curve (AUCs) for moderate (classic regions: Acc = 81.0%, AUC = 0.774; OSA-specific regions: Acc = 81.0%, AUC = 0.791) and severe (classic regions: Acc = 91.7%, AUC = 0.847; OSA-specific regions: Acc = 89.3%, AUC = 0.841) OSA levels. Thus, the current findings highlight the usefulness of bispectral analysis on HRV to characterize and diagnose pediatric OSA.     

Using ultrasonic wave reflection to measure solution properties

Ultrasonic wave reflection coefficients of aqueous solutions were measured using high-impact polystyrene as a buffer material to provide enhanced sensitivity over metal or ceramic buffer materials. The wave reflection values showed linear reduction when the concentration of chemical species in solution was increased, but a distinct relation between concentration and reflection coefficient was obtained for each solute species tested. However, more unified relationships were observed between reflection coefficient and other solution parameters – solution density, acoustic impedance, and P-wave velocity – that were consistent for all solution species. Based on this behavior an expression to compute solution density solely from reflection coefficient is derived, which can be applied to estimate solution density in solutions of unknown solute species and concentration when other measurements, such as wave velocity, are not possible.     

Predictions of the modified Biot-Attenborough model for the dependence of phase velocity on porosity in cancellous bone

The modified Biot–Attenborough (MBA) model for acoustic wave propagation in porous media has been found useful to predict wave properties in cancellous bone. The present study is aimed at applying the MBA model to predict the dependence of phase velocity on porosity in cancellous bone. The MBA model predicts a phase velocity that decreases nonlinearly with porosity. The optimum values for input parameters of the MBA model, such as compressional speed c_m of solid bone and phase velocity parameter s₂, were determined by comparing the predictions with previously published measurements in human calcaneus and bovine cancellous bone. The value of the phase velocity parameter s₂ = 1.23 was obtained by curve fitting to the experimental data for 53 human calcaneus samples only, assuming a compressional speed c_m = 2500 m/s of solid bone. The root-mean-square error (RMSE) of the curve fit was 15.3 m/s. The optimized value of s₂ for all 75 cancellous bone samples including 22 bovine samples was 1.42 with a value of 55 m/s for the RMSE of the curve fit. The latter fit was obtained by using of a value of c_m = 3200 m/s. Although the MBA model relies on the empirical parameters determined from experimental data, it is expected that the model can be usefully employed as a practical tool in the field of clinical ultrasonic bone assessment.     

Ultrasonic contrast agents in transcranial perfusion sonography (TPS) for follow-up of patients with high grade gliomas

PURPOSE: The aim of this study was to evaluate brain perfusion differences in patients with high grade gliomas after partial tumor resection and irradiation/chemotherapy between tumor and non-tumor hemisphere by transcranial perfusion sonography (TPS) employing a contrast burst imaging (CBI) technique. METHODS: Six patients with glioblastoma (WHO Grade IV) in the temporoparietal region within the defined axial diencephalic scanning plane were examined by TPS during follow-up. All subjects had an adequate acoustic temporal bone window. Transtemporal insonation on brain tumor and non-tumor hemisphere was performed with a bolus-injection of sulphur hexafluoride-based contrast agent (10 mg i.v., 5mg/ml--SonoVue, Bracco, Altana, Switzerland). Recorded images were analysed off-line by Quanticon Software (3D-Echotech, Munich, Germany) and time intensity curve parameters [area under the curve (AUC, dB s), peak intensity (PI, dB), time to peak (TTP, s)] in five regions of interest (ROI) [thalamus anterior, thalamus posterior, nucleus lentiformis, white matter, whole hemisphere] were evaluated. Statistical analyses were performed. RESULTS: Perfusion differences between brain tumor and non-tumor hemispheres were detected with contrast burst imaging (CBI) technique with a significantly greater mean AUC (5343.69 dB s vs. 4625.04 dB s, p<0.028) and a significantly prolonged TTP (32.72 s vs. 28.91 s, p<0.046) in the tumor hemisphere. CONCLUSION: Within our study population, TTP and AUC seem to be the most robust parameters for the evaluation of cerebral perfusion differences assessed by transcranial perfusion sonography with CBI technique. We hypothesize that these results correlate with microvascular changes due to treatment regimens, such as microvessel necrosis after irradiation and chemotherapy. Above that, TPS may be of value for the long-term follow-up of brain tumor therapy concept.