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San Cesario di Lecce, Italy

Casciaro S.,National Research Council Italy | Pisani P.,National Research Council Italy | Conversano F.,National Research Council Italy | Renna M.D.,National Research Council Italy | And 5 more authors.
IET Science, Measurement and Technology | Year: 2016

The aim of this study is to assess the accuracy of a novel ultrasound (US) approach for lumbar spine densitometry on overweight and obese women of variable age through a clinical validation study. The US method was originally developed in women with body mass index (BMI) < 25 kg/m2. In this study, 382 female patients were recruited (45-80 years, BMI > 25 kg/m2) and underwent dual X-ray absorptiometry (DXA) of lumbar spine (L1-L4) and an US scan of the same vertebrae L1-L4, performed with a dedicated device providing both echographic images and 'raw' radiofrequency signals. Acquired US data were analysed through a novel automatic algorithm that performed a series of spectral and statistical analyses to calculate bone mineral density employing an innovative method. Diagnostic accuracy of US investigations was quantitatively assessed through a direct comparison with DXA results. The average agreement between US and DXA diagnoses was acceptable for patients aged 45-65 years (81.5%), while a slight decrement was observed for older patients (69.6%), which can be partially due to a decrease in DXA accuracy because of age-related degenerations. The adopted method has a potential for early osteoporosis diagnosis in people younger than 65 years, independent of their BMI. © The Institution of Engineering and Technology.


Aventaggiato M.,Echolight Srl | Conversano F.,National Research Council Italy | Pisani P.,National Research Council Italy | Casciaro E.,National Research Council Italy | And 4 more authors.
IET Science, Measurement and Technology | Year: 2016

Aim of this study was to perform a detailed clinical validation of a new fully automatic algorithm for vertebral interface segmentation in echographic images. Abdominal echographic scans of lumbar vertebrae L1-L4 were carried out on 150 female subjects with variable age and body mass index (BMI). Acquired datasets were automatically processed by the algorithm and the accuracy of the obtained segmentations was then evaluated by three independent experienced operators. Obtained results showed a very good specificity in vertebra detection (93.3%), coupled with a reasonable sensitivity (68.1%), representing a suitable compromise between the detection of a sufficient number of vertebrae for reliable diagnoses and the limitation of the corresponding computation time. Importantly, there was only a minimum presence of 'false vertebrae' detected (2.8%), resulting in a very low influence on subsequent diagnostic analyses. Furthermore, the algorithm was specifically tuned to provide an improved sensitivity (up to 73.1%) with increasing patient BMI, to keep a suitable number of correctly detected vertebrae even when the acquisition was intrinsically more difficult because of the augmented thickness of abdominal soft tissues. The proposed algorithm will represent an essential added value for developing echographic methods for the diagnosis of osteoporosis on lumbar vertebrae. © The Institution of Engineering and Technology.


Franchini R.,National Research Council Italy | Conversano F.,National Research Council Italy | Pisani P.,National Research Council Italy | Casciaro E.,National Research Council Italy | And 5 more authors.
IET Science, Measurement and Technology | Year: 2016

Aim of this study was to perform a detailed clinical validation of a novel fully automatic method for vertebral morphometry. About 80 spine lateral radiographs were evaluated both automatically, by the proposed algorithm, and manually, by an experienced radiologist. The following metrics were used for algorithm performance assessment: Sensitivity and specificity in vertebra detection; errors in the localisation of characteristic points of vertebral border; errors in the measurement of six diagnostic parameters; level of agreement and correlation between manual and automatic morphometric measurements; overall accuracy of automatic diagnoses with respect to manual ones. Obtained results showed a very good performance in vertebra detection (sensitivity = 89.1% and specificity = 100.0%). Average errors in the localisation of vertebral characteristic points were always smaller than 3 mm (range 0.85-2.79 mm), causing relative errors in diagnostic parameter values ranging from -5.01 to +6.10%. Bland-Altman analysis documented a mean error in automatic measurements of diagnostic ratios of 0.01 ± 0.18 (bias ± 2 SDs), while Pearson's correlation coefficient resulted r = 0.71 (p < 0.001). Finally, an optimal diagnostic coincidence (92.8%) was found between automatic and manual diagnoses. Therefore, the adopted method has a potential for an effective employment in clinical routine for reliable diagnosis of vertebral fractures. © The Institution of Engineering and Technology.


Conversano F.,National Research Council Italy | Franchini R.,National Research Council Italy | Greco A.,Echolight Srl | Soloperto G.,National Research Council Italy | And 12 more authors.
Ultrasound in Medicine and Biology | Year: 2015

We investigated the possible clinical feasibility and accuracy of an innovative ultrasound (US) method for diagnosis of osteoporosis of the spine. A total of 342 female patients (aged 51-60y) underwent spinal dual X-ray absorptiometry and abdominal echographic scanning of the lumbar spine. Recruited patients were subdivided into a reference database used for US spectral model construction and a study population for repeatability and accuracy evaluation. US images and radiofrequency signals were analyzed via a new fully automatic algorithm that performed a series of spectral and statistical analyses, providing a novel diagnostic parameter called the osteoporosis score (O.S.). If dual X-ray absorptiometry is assumed to be the gold standard reference, the accuracy of O.S.-based diagnoses was 91.1%, with k=0.859 (p<0.0001). Significant correlations were also found between O.S.-estimated bone mineral densities and corresponding dual X-ray absorptiometry values, with r2 values up to 0.73 and a root mean square error of 6.3%-9.3%. The results obtained suggest that the proposed method has the potential for future routine application in US-based diagnosis of osteoporosis. © 2015 World Federation for Ultrasound in Medicine & Biology.


Casciaro S.,National Research Council Italy | Conversano F.,National Research Council Italy | Pisani P.,National Research Council Italy | Greco A.,National Research Council Italy | And 2 more authors.
2015 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2015 - Proceedings | Year: 2015

Aim of this work was to evaluate the effectiveness of a recently introduced ultrasound (US) method for osteoporosis diagnosis, when extensively used in a clinical context to investigate adult women of variable age. A total of 384 female patients (46-65 years; body mass index < 25 kg/m2) underwent a spinal dual X-ray absorptiometry (DXA) and an abdominal US scan of lumbar spine, acquiring both echographic images and unprocessed radiofrequency signals. US data were analyzed through a new fully automatic algorithm, which performed a series of spectral and statistical analyses to calculate the parameter called Osteoporosis Score (O.S.). Diagnostic effectiveness of O.S. was assessed through a direct comparison with DXA measurements (assumed as the gold standard reference), quantifying the agreement between the two methods through accuracy calculation, Cohen's kappa (k) and Pearson correlation coefficient (r). The overall accuracy of O.S.-based diagnoses resulted 84.6%, ranging from a minimum of 81.7% for the oldest patients (aged in 61-65 y) to a maximum of 87.2% for the youngest patients (aged in 46-50 y). Cohen's kappa showed an analogous trend, confirming a significant agreement between DXA and US-based diagnoses along the whole considered age interval (k=0.758, p<0.0001). A good correlation was also found between O.S.-derived BMD values and corresponding DXA measurements (r=0.72, p<0.001). These results demonstrated that US-measured O.S. is significantly correlated with spinal BMD in normal-and under-weight adult women belonging to a wide age interval. Therefore, the routine clinical application of this innovative approach to osteoporosis diagnosis can be envisioned. © 2015 IEEE.

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