Investigating the effect of strontium in bone mineral density measurements of trabecular bone mimicking phantoms using quantitative ultrasound

Dual-energy x-ray absorptiometry (DXA) is the current gold standard method used for the diagnosis of osteoporosis. However, it is well-established that the presence of strontium in bone could lead to significant error in measurement of bone mineral density (BMD) and diagnosis of osteoporosis using DXA. The objectives of this study are: (1) to develop novel bone-mimicking phantoms containing different concentrations of strontium, and (2) to investigate the effect of bone strontium content on the BMD measurement using quantitative ultrasound (QUS) technique. Measurements using the research and clinical QUS systems showed a strong dependency of the BUA (broadband ultrasound attenuation) of the medium with the BMD. Moreover, increasing strontium concentrations in bone phantoms of up to 3 mol% strontium showed no effect on the BUA or the SOS values measured with either system. Therefore, the QUS technique is independent of level of bone strontium of up to 3 mol/mol [Sr/(Sr+Ca)] %.