In conclusion, this numerical and experimental study demonstrates an accurate and precise estimation of Ct.Th and Ct.v11. The ex-vivo accuracy and precision for Ct.v11 were 29.9 m/s and 0.94%, respectively, and those for Ct.Th were 0.04 mm and 1.09%, respectively. Ct.Th and Ct.v11 obtained ex vivo showed a high correlation (R2>0.99) with reference values. Moreover, a dependency of Ct.v11 on both porosity and pore density was observed. ![]() In-silico results revealed the necessity to account for inclination-dependent transmission losses at the bone surface. ![]() Plane wave pulse-echo measurements provided reference values to assess precision and accuracy of our method. The method was validated in-silico on porous bone plate models using a two-dimensional finite-difference time domain method and ex vivo on plate-shaped plastic reference materials and on plate-shaped cortical bovine tibia samples. In this study, we have developed a method using a conventional ultrasound array transducer to determine thickness (Ct.Th) and the compressional sound velocity propagating in the radial bone direction (Ct.v11) using a refraction-corrected multi-focus imaging approach. Ct.Th and cortical sound velocity, i.e., a surrogate marker for changes of cortical porosity (Ct.Po), are key biomarkers for the identification of patients at high fracture risk. ![]() Decreased cortical thickness (Ct.Th) and the prevalence of large pores at the tibia are associated with reduced bone strength at the hip. Most bone loss during the development of osteoporosis occurs in cortical bone at the peripheral skeleton.
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