The ability of peripheral quantitative ultrasound to identify patients with low bone mineral density in the hip or spine

This study aims to assess the sensitivity and specificity of two commercially available quantitative ultrasound (QUS) scanners (CUBA Clinical, Sunlight Omnisense), to differentiate patients with osteoporosis (OP) or osteopenia at the spine and hip confirmed by dual-energy x-ray absorptiometry (DXA) and to investigate the optimum cut-off values to maximize the effectiveness of the screening technique. Participants (n = 268) received DXA scans on their lumbar spine (L1-L4) and hip, with paired QUS scans on their distal radius, proximal phalanx, midshaft tibia and calcaneus. Scanners were evaluated by using receiver-operating characteristics curves and their area under the curve (AUC) values. Measurement of the calcaneus by the CUBA Clinical showed a superior ability to predict DXA, with AUC values between 0.75 to 0.83 in comparison with AUC values of 0.60 to 0.70 for the Sunlight Omnisense. Cut-off values varied according to the technique used and the accuracy of the screening required. Assessment of the calcaneus was the best QUS technique for the prediction of low bone density at the axial skeleton as diagnosed by DXA.