Influence of overlying soft tissues on trabecular bone acoustic measurement at various ultrasound frequencies.

Ultrasound (US) has been introduced as a promising tool for osteoporosis diagnostics. However, soft tissues overlying the bones affect reliability of the ultrasound (US) techniques. In this in vitro study, the effect of soft tissues on bone US measurements was investigated numerically and experimentally. Particularly, the dependence of the error induced by soft tissues on the applied US frequency (0.3 to 6.7 MHz) was addressed. For these aims, human trabecular bone samples (n = 25) were measured using acoustic, dual energy x-ray absorptiometry (DXA) and mechanical techniques. US attenuation, speed, reflection and backscattering were determined from the through-transmission and pulse-echo measurements. Numerical correction, based on the inclusion of acoustic characteristics of specific soft tissue components, i.e., adipose and lean tissues, was derived for the analysis of experimental measurements. Values of US parameters, interrelationships between the US parameters and mechanical properties, as well as the errors induced by the soft tissues, were significantly dependent on the US frequency. The errors induced by the soft tissues on the US measurement were typically reduced by approximately 50% after introduction of the numerical correction technique. Thereby, the acoustic prediction of mechanical properties of trabecular bone was also improved. We conclude that the numerical correction of the contribution of overlying soft tissues on acoustic measurements can reduce uncertainties related to in vivo US measurements.