Broadband ultrasound attenuation in the calcaneal region: a comparative study of single-position versus scanning systems

This work describes a system developed to measure the broadband ultrasound attenuation (BUA) in the calcaneal region. The patient's calcanei were inspected using a microcomputer-controlled X-Y axis displacement unit with two 500-kHz, central-frequency, ultrasound transducers. The transducers facing each other are submerged in a small water tank with a support for the patient's foot between them. The system allows data to be collected from a single position or by scanning the calcaneal region to obtain a BUA map. Tests were carried out on 201 patients (110 using the single-position method, and 91 using the scanning method). The results were compared with those of densitometry tests performed using the dual energy X-ray absorptiometry (DEXA) technique (single position: r=0.50; P<0.0001; scanner: r=0.75; P<0.0001). It was concluded that the single position method is more susceptible to errors due to the difficulty in positioning the transducers relative to the calcaneus. The scanning method provides better results and can be used to screen patients before referring them for DEXA.