Echographic technology for the diagnosis of osteoporosis based on the new proprietary method R.E.M.S. (Radiofrequency Echographic Multi Spectrometry)

R.E.M.S. represents an innovative echographic approach to the diagnosis of osteoporosis, which integrally exploits all the spectral features of the “raw” radiofrequency (RF) signals acquired during an echographic scan at the reference axial sites to determine the status of internal bone architecture.

Cuttin Edge Technology.

Echographic scans are performed by EchoS device equipped with a convex transducer operating at 3.5 MHz, allowing the simultaneous acquisition of conventional B-mode images and corresponding unprocessed RF signals.

The scan lasts about 1 min. Our approach is based on the idea that RF signals, acquired during an echographic scan can be used to determine the health status of the bone through advanced comparisons with previously derived reference spectral models of the possible pathological or normal conditions.

 The regions of interest (ROIs) for diagnostic calculations within the investigated bone are automatically identified exploiting both morphologic details and RF spectral features, and the simultaneous acquisition of several RF scan lines for each image frame provides a solid and reliable statistical basis for subsequent spectral processing.

Data analysis includes the calculation of the Osteoporosis Score and Fragility Score, based on the correlation between frequency spectra of acquired RF signals and the appropriate reference models of “osteoporotic” and “frail” bones, respectively. BMD, Tscore and Z-score are then derived from the O.S. value.

Diagnostic Investigation.

To perform the diagnostic investigation, the operator should preliminarily visualize the first target interface (i.e. vertebra L1 for lumbar acquisitions or femoral neck for hip scans) and set image depth and focal position to have the target interface in the central part of the image and in correspondence of the focus.

Afterwards, the software-assisted US acquisition starts. During the scan, the algorithm automatically detects the bone interfaces (red lines) and calculates the ROIs for data analysis (green areas). The automatic data processing is then started, including RF signal analysis and spectral comparison with reference models for calculation of diagnostic parameters and generation of the final medical report.

Operator independent.

Fully automatic identification of the bone volumes.

The peculiar feature of R.E.M.S. method is the exploitation of radiofrequency signals acquired during an echographic scan of the target bone structure to determine the internal bone architecture through detailed comparisons with reference spectral models.

Another important feature of the technology is its full automation, which reduces to a minimum the dependence on operator experience. In fact, the implemented algorithm automatically identifies and discards ‘‘noisy’’ acquisitions and artefacts, ensuring that diagnostic evaluations are performed only on US datasets reaching a specifically determined quality threshold.

Bone density and bone quality.

EchoS provides two new numerical parameters: Osteoporosis Score, which directly correlates with BMD measurements (in g/cm²) and consequently with DXA diagnostic evaluations (BMD; T-Score; ZScore), and Fragility Score (*to be released soon), which provides an independent estimate of bone fragility and fracture risk.

The medical report contains all the common parameters for the diagnosis of osteoporosis and each patient can be examined in less than 2 minutes, ensuring the compliance of the protocol with time constraints of clinical routine.

The new State-of-the-art.

Because of its accuracy levels and the complete absence of ionizing radiation this method can be effectively employed for diagnosis of osteoporotic disease at an earlier stage being the bone densitometry of the future and the new state-of -the-art in the early diagnosis of osteoporosis.

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