Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2010 | 5 | 4 | 478-485

Article title

Accuracy of quantitative ultrasound parameters in the diagnosis of osteoporosis


Title variants

Languages of publication



Quantitative ultrasound (QUS) is of increasing interest for evaluation of osteoporosis because, compared with dual-energy X-ray absorptiometry (DXA), it is portable, less expensive, and radiation-free. The aim of our study was to determine the sensitivity, specificity, and cut-off values of quantitative ultrasound parameters in identifying patients with osteoporosis compared to the World Health Organization (WHO) standard definition. We performed a cross-sectional investigational study of 73 subjects, and determined total hip and lumbar spine T-scores by dual-energy X-ray absorptiometry (DXA) (Prodigy Advance Lunar-GE). The QUS parameters (broadband ultrasound attenuation [BUA], speed of sound, bone mineral density, the stiffness index, and QUS T-score) were determined with Sahara Hologic equipment. The AUC was 0.81 (95% CI 0.67–0.95, p<0.05) for speed of sound (SOS) and 0.76 (95% CI 0.62–0.90, p<0.05) for BUA for the patients with DXA T-scores ≥ −1 DS; the cut-off values were 1542.2 meters per second for SOS and 63.3 dB/MHz for BUA. In patients with DXA T-scores ≤ − 2.5 DS, AUC was 0.80 (95% CI 0.70–0.90, p<0.05) for SOS, and 0.76 (95% CI 0.65–0.87, p<0.05) for BUA. The cut-off values were 1504.95 meters per second for SOS and 49.5 dB/MHz for BUA. Pearson correlation coefficients were positive and statistically significant (> 50%) for all QUS parameters in both groups, (2-tailed, p<0.05). QUS parameters correctly identified normal patients (false negative 34.21% and false positive 2.53%) and those with osteoporosis (false negative 8.55% and false positive 7.82%). The patients with QUS parameters between the cut-off values corresponding to DXA T-scores of −1 SD and − 2.5 SD should be further evaluated by DXA.










Physical description


1 - 8 - 2010
30 - 5 - 2010


  • Department of Internal Medicine II and Rheumatology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania
  • Department of Statistics, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania
  • Department of Internal Medicine II and Rheumatology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania
  • Department of Radiology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania
  • Department of Internal Medicine II and Rheumatology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania
  • Department of Internal Medicine II and Rheumatology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, 400012, Cluj-Napoca, Romania


  • [1] Kanis J.A., McCloskey E.V., Johansson H., Oden A., Melton J.L., Khaltaev N., A reference standard for the description of osteoporosis, Bone, 2008, 42, 467–475 http://dx.doi.org/10.1016/j.bone.2007.11.001[Crossref][WoS]
  • [2] Laugier P., Quantitative ultrasound of bone: looking ahead, Joint Bone Spine, 2006, 73, 125–128 http://dx.doi.org/10.1016/j.jbspin.2005.10.012[Crossref]
  • [3] Kanis J.A., Burlet N., Cooper C., Delmas P.D., Reginster J.Y., Borgstrom F., Rizzoli R., European guidance for the diagnosis and management of osteoporosis in postmenopausal women, Osteoporos Int., 2008, 19, 399–428 http://dx.doi.org/10.1007/s00198-008-0560-z[Crossref]
  • [4] Sahara Clinical User’s Guide, 1998, Hologic Inc, USA
  • [5] Holi M.S., Radhakrishnan S., Swaranamani S., Ayavelan N.A., Quantitative ultrasound technique for the assessment of osteoporosis and prediction of fracture risk J. Pure Appl. Ultrason., 2005, 27, 55–60
  • [6] Cook R.B., Collins D., Tucker J., Zioupos P., Comparison of questionnaire and quantitative ultrasound techniques as screening tools for DXA, Osteoporos Int., 2005, 16, 1565–1575 http://dx.doi.org/10.1007/s00198-005-1864-x[Crossref]
  • [7] Khaw K.T., Reeve J., Luben R., Prediction of total and hip fracture risk in men and women by quantitative ultrasound of the calcaneus: EPIC-Norfolk prospective population study, Lancet, 2004, 363, 197–202 http://dx.doi.org/10.1016/S0140-6736(03)15325-1[Crossref]
  • [8] Hans D., Dargent-Molina P., Schott A.M., Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study, Lancet 1996, 348, 511–514 http://dx.doi.org/10.1016/S0140-6736(95)11456-4[Crossref]
  • [9] Krieg M.A., Cornuz J., Ruffieux C., Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or = 70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study, J Bone Miner Res., 2006, 21, 1457–1463 http://dx.doi.org/10.1359/jbmr.060615[Crossref]
  • [10] Frost M.L., Blake G.M., Fogelman I., Can the WHO criteria for diagnosing osteoporosis be applied to calcaneal quantitative ultrasound? Osteoporos Int., 2000, 11, 321–330 http://dx.doi.org/10.1007/s001980070121[Crossref]
  • [11] Boonen S., Nijs J., Borghs H., Peeters H., Vanderschueren D., Luyten F.P., Identifying postmenopausal women with osteoporosis by calcaneal ultrasound, metacarpal digital X-ray radiogrammetry and phalangeal radiographic absorptiometry: a comparative study, Osteoporos Int., 2005, 16, 93–100 http://dx.doi.org/10.1007/s00198-004-1660-z[Crossref]
  • [12] Kanis J.A., Glüer C.C., An update on the diagnosis and assessement of osteoporosis with densitometry, Osteoporosis Int., 2000, 11, 192–202 http://dx.doi.org/10.1007/s001980050281[Crossref]
  • [13] Ikeda I., Iki M., Morita A., Aihara H., Kagawa Y., Matsuzaki T., et al, Age-specific values and cutoff levels for the diagnosis of osteoporosis in quantitative ultrasound measurements at the calcaneus with SAHARA in healthy Japanese women: Japanese Population-Based Osteoporosis (JPOS) study, Calcif Tissue Int., 2002, 71, 1–9 http://dx.doi.org/10.1007/s00223-001-2079-6[Crossref]
  • [14] Agren M., Karellas A., Leahey D., Marks S., Baran D., Ultrasound attenuation of the calcaneus: a sensitive and specific discriminator of osteopenia in postmenopausal women, Calcif Tissue Int., 1991, 48, 240–244 http://dx.doi.org/10.1007/BF02556374[Crossref]
  • [15] Dubois E.F., Van den Bergh J.P., Smals A.G., Van de Meerendonk C.W., Zwinderman A.H., Schweitzer D.H., Comparison of quantitative ultrasound parameters with dual energy x-ray absorptiometry in pre- and postmenopausal women, Neth J Med., 2001, 58, 62–70 http://dx.doi.org/10.1016/S0300-2977(00)00102-9[Crossref]
  • [16] Falgarone G., Porcher R., Duche’ A., Kolta S., Dougados M., Roux C., Discrimination of osteoporotic patients with quantitative ultrasound using imaging or non-imaging device, Joint Bone Spine, 2004, 71, 419–423 http://dx.doi.org/10.1016/j.jbspin.2003.09.011[Crossref]
  • [17] Trimpou P., Bosaeus I., Bengtsson B.A., Landin-Wilhelmsen K., High correlation between quantitative ultrasound and DXA during 7 years of follow-up, Eur J Radiol 2009, (in press), doi:10.1016/j.ejrad.2008.11.024 [Crossref]
  • [18] Damilakis J., Perisinakis K., Gourtsoyiannis N., Ultrasonometry of the Calcaneus: Optimum T-Score Thresholds for the Identification of Osteoporotic Subjects, Calcif Tissue Int., 2001, 68, 219–224 http://dx.doi.org/10.1007/s002230020014[Crossref]
  • [19] Nayak S., Olkin I., Liu H., Grabe M., Gould M.K., Allen E., et al, Meta-Analysis: Accuracy of Quantitative Ultrasound for Identifying Patients with Osteoporosis, Ann Intern Med., 2006, 144, 832–841 [Crossref]
  • [20] Kung A.W., Ho A.Y., Ross P.D., Reginster J.Y., Development of a clinical assessment tool in identifying Asian men with low bone mineral density and comparison of its usefulness to quantitative bone ultrasound, Osteoporos Int., 2005, 16, 849–855 http://dx.doi.org/10.1007/s00198-004-1778-z[Crossref]
  • [21] Hodson J., Marsh J., Quantitative ultrasound and risk factor enquiry as predictors of postmenopausal osteoporosis: comparative study in primary care, BMJ, 2003, 326, 1250–1251 http://dx.doi.org/10.1136/bmj.326.7401.1250[Crossref]
  • [22] Cetin A., Ertürk H., Celiker R., Sivri A., Hascelik Z., The role of quantitative ultrasound in predicting osteoporosis defined by dual x-ray absorptiometry, Rheumatol Int., 2001, 20, 55–59 http://dx.doi.org/10.1007/PL00006857[Crossref]
  • [23] Hans D., Hartl F., Krieg M. A., “Device-specific weighted Tscore for two quantitative ultrasounds: Operational propositions for the management of osteoporosis for 65 years and older women in Switzerland,” Osteoporos. Int., 2003, 14, 251–258
  • [24] Welch A., Camus J., Dalzell N., Oakes S., Reeve J., Khaw K.T., Broadband ultrasound attenuation (BUA) of the heel bone and its correlates in men and women in the EPIC-Norfolk cohort: a crosssectional population-based study, Osteoporos Int., 2004, 15, 217–225 http://dx.doi.org/10.1007/s00198-003-1410-7[Crossref]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.