A new method for quantitative ultrasound measurements at multiple skeletalsites - First Results of precision and fracture discrimination

We investigated a new multisite quantitative ultrasound device that measure s the acoustic velocity in axial transmission mode along the cortex. Using a prototype of the Omnisense (Sunlight Ultrasound Technologies, Rehovot, Is rael), we tested the performance of this instrument at four sites of the sk eleton: radius, ulna, metacarpal, and phalanx. Intraobserver (interobserver ) precision errors ranged from 0.2% to 0.3% (0.3% to 0.7%) for triplicate m easurements with repositioning. Fracture discrimination was tested by compa ring a group of 34 women who had previously suffered a fracture of the hip, spine, ankle, or forearm to a group of 28 healthy women who had not suffer ed a fracture. Age-adjusted standardized odds ratios ranged from 1.6 to 4.5 . Except for the ulna, the sites showed a significant fracture discriminati on (p < 0.01). The areas under the receiver operating curves (ROC) were fro m 0.88 to 0.89 for radius, metacarpal, and phalanx. A combination of the re sults from the three sites showed a significant increase of the ROC area to 0.95 (p < 0.05). Our results show promising performance of this new device . The ability to measure a large variety of sites and the potential to comb ine these measurements are promising with regard to optimizing fracture ris k assessment.