Recent bone quantitative ultrasound approaches exploit the multimode waveguide response of long bones for assessing properties such as cortical thickness and stiffness. Clinical applications remain, however, challenging, as the impact of soft tissue on guided waves characteristics is not fully understood yet. In particular, it must be clarified whether soft tissue must be incorporated in waveguide models needed to infer reliable cortical bone properties. We hypothesize that an inverse procedure using a free plate model can be applied to retrieve the thickness and stiffness of cortical bone from experimental data. This approach is first validated on a series of laboratory-controlled measurements performed on assemblies of bone- and soft tissue mimicking phantoms and then onin vivomeasurements. The accuracy of the estimates is evaluated by comparison with reference values. To further support our hypothesis, these estimates are subsequently inserted into a bilayer model to test its accuracy. Our results show that the free plate model allows retrieving reliable waveguide properties, despite the presence of soft tissue. They also suggest that the more sophisticated bilayer model, although it is more precise to predict experimental data in the forward problem, could turn out to be hardly manageable for solving the inverse problem.

A method to recover the elastic properties, thickness, or orientation of the principal symmetry axes of anisotropic plates is presented. This method relies on the measurements of multimode guided waves, which are launched and detected in arbitrary directions along the plate using a multi-element linear transducer array driven by a programmable electronic device. A model-based inverse problem solution is proposed to optimally recover the properties of interest. The main contribution consists in defining an objective function built from the dispersion equation, which allows accounting for higher-order modes without the need to pair each experimental data point to a specific guided mode. This avoids the numerical calculation of the dispersion curves and errors in the mode identification. Compared to standard root-finding algorithms, the computational gain of the procedure is estimated to be on the order of 200. The objective function is optimized using genetic algorithms, which allow identifying from a single out-of-symmetry axis measurement the full set of anisotropic elastic coefficients and either the plate thickness or the propagation direction. The efficiency of the method is demonstrated using data measured on materials with different symmetry classes. Excellent agreement is found between the reported estimates and reference values from the literature.

Cortical bone loss is not fully assessed by the current X-ray methods, and there is an unmet need in identifying women at risk of osteoporotic fracture, who should receive a treatment. The last decade has seen the emergence of the ultrasound (US) axial transmission (AT) techniques to assess a cortical bone. Recent AT techniques exploit the multimode waveguide response of the long bones such as the radius. A recent ex vivo study by our group evidenced that a multimode AT approach can yield simultaneous estimates of cortical thickness (Ct.Th) and stiffness. The aim of this paper is to move one step forward to evaluate the feasibility of measuring multimode guided waves (GW) in vivo and to infer from it cortical thickness. Measurements were taken on the forearm of 14 healthy subjects with the goal to test the accuracy of the estimated thickness using the bidirectional AT method implemented on a dedicated 1-MHz linear US array. This setup allows determining in vivo the dispersion curves of GW transmitted in the cortical layer of the radius. An inverse procedure based on the comparison between the measured and modeled dispersion curves predicted by a 2-D transverse isotropic free plate waveguide model allowed an estimation of cortical thickness, despite the presence of soft tissue. The Ct.Th values were validated by comparison with the site-matched estimates derived from X-ray high-resolution peripheral quantitative computed tomography. Results showed a significant correlation between both measurements (r ² = 0.7, p <; 0.05, and RMSE = 0.21 mm). This pilot study demonstrates the potential of bidirectional AT for the in vivo assessment of cortical thickness, a bone strength-related factor.

Recent progress in quantitative ultrasound has exploited the multimode waveguide response of long bones. Measurements of the guided modes, along with suitable waveguide modeling, have the potential to infer strength-related factors such as stiffness (mainly determined by cortical porosity) and cortical thickness. However, the development of such model-based approaches is challenging, in particular because of the multiparametric nature of the inverse problem. Current estimation methods in the bone field rely on a number of assumptions for pairing the incomplete experimental data with the theoretical guided modes (e.g. semi-automatic selection and classification of the data). The availability of an alternative inversion scheme that is user-independent is highly desirable. Thus, this paper introduces an efficient inversion method based on genetic algorithms using multimode guided waves, in which the mode-order is kept blind. Prior to its evaluation on bone, our proposal is validated using laboratory-controlled measurements on isotropic plates and bone-mimicking phantoms. The results show that the model parameters (i.e. cortical thickness and porosity) estimated from measurements on a few ex vivo human radii are in good agreement with the reference values derived from x-ray micro-computed tomography. Further, the cortical thickness estimated from in vivo measurements at the third from the distal end of the radius is in good agreement with the values delivered by site-matched high-resolution x-ray peripheral computed tomography.