BROAD-BAND ULTRASOUND ATTENUATION OF THE CALCANEUS AND BONE-DENSITY MEASUREMENTS

Broadband ultrasound attenuation (BUA) is a new technique for investig ating bone status. We evaluated its use in osteoporosis. To assess in vivo reproducibility, we determined the coefficient of variation (cv) on the basis of five measurements (with repositioning) of the same foo t in 50 women. The cv was 2.8 +/- 1.7%. BUA values were similar in the right feet and left foot and were correlated with bone density in the calcaneal area investigated (r = 0.8, p < 10-4). BUA of the calcaneus was correlated with bone density in the lumbar spine, femur, and fore arm in 240 healthy postmenopausal women (correlation coefficients 0.36 to 0.55; p < 10(-4)). BUA decreased with age, with a sharper drop dur ing the first years following menopause. Mean broadband ultrasonic att enuation in 37 females with osteoporosis (58.92 +/- 11.59 dB/MHz) is l ower than controls (66.10 +/- 15.29 dB/MHz, p = 0.04). Areas under rec eiver operating characteristic curves, used to evaluate the discrimina ting value of BUA in osteoporosis and osteopenia, were 0.79 and 0.72, respectively. The kappa coefficient of concordance between BUA and spi nal density was 0.59. These data demonstrate that BUA cannot replace b one density measurements. Prospective studies are needed to investigat e the potential role of this technique for identifying women at high r isk for osteoporotic fractures.