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Table 2 Selected literature on accuracy of ultrasonic cartilage thickness measurement

From: Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT

Author, year

Joint

Species

Setup

n

Ground truth

Ultrasonic measurement

Accuracy

Aisen et al., 1984 [21]

Knee

Bovine

Cadaver a

3

Ruler

B-mode, 7.5 MHz, 1750 m/s speed of sound, immersed mineral oil bad

Mean difference ranging from 0.1 to 0.2 mm (cartilage thickness from 1.0 to 4.2 mm)

Modest et al., 1989 [25]

Hip

Human

Cadavera

24

Microscope

Thawed cadaver, toluidine O staining

A-mode, 7.5 MHz, 1760 m/s speed of sound, thawed plugs

Comparison of the average of 5 ultrasonic with 12 microscopic measurements; 88% of the ultrasonic values within one standard deviation of the microscopic measurements

Martino et al., 1993 [22]

Knee

Human

In vivob

18

Microscope

Fixed in 90% ethanol, resection following TKA

B-mode, 7.5 MHz, fixed in 90% ethanol, transcutaneous

Significant difference of 0.3 mm for the minimum cartilage difference, no significant difference of 0.2 mm for the maximum cartilage thickness

Jurvelin et al., 1995 [4]

Knee

Canine and bovine

Cadavera

45

Microscope/needle probe

Temporarily stored in 4 °C Ringer solution

A-mode, 10 MHz, temporarily stored at 4 °C Ringer solution, 1760 m/s speed of sound

A strong correlation was found between ultrasonic and microscopic measurement (r = 0.91) or needle probe measurement (p = 0.90). The mean difference between microscopic and ultrasonic measurement was 0.03 ± 0.16 mm

Ostergaard et al., 1995 [18]

Knee

Human

In vivob

39

MRI

1.5 Tesla, 3D fast imaging by steady-state precession, slice thickness of 1.56 mm

B-mode, 7.5 MHz, 1750 m/s speed of sound, transcutaneous

Mean difference of 0.2 mm (95% confidence interval − 1.4–1.0 mm) and a strong correlation with r = 0.82

Chérin et al., 2001 [19]

Patella

Murine

Cadavera

48

Microscope

Decalcified and fixated, hematoxylin–eosin–safran staining

B-mode, 50 MHz, measurement within minutes of sacrifice in 0.9% saline solution, 1600 m/s speed of sound

A strong correlation with r = 0.8923 (least square linear fit y = 0.6589x + 79.758) was found

Töyräs et al., 2002 [20]

Patella

Bovine

Cadavera

60

Needle probe

Plugs obtained within few hours after slaughter

A-mode, 22 MHz, 1654 m/s speed of sound. Plugs obtained within few hours after slaughter

Mean difference of 0.02 ± 0.99 mm with a strong correlation of r = 0.943.

Pellaumail et al., 2002 [26]

Patella

Murine

Cadavera

16

Microscope

Decalcified, paraffin fixated and stained with toluidine blue

B-mode, 50 MHz, measurement within minutes of sacrifice in 0.9% saline solution, 1600 m/s speed of sound

Difference ranging from 0.09 to 0.79 mm depending on age and cartilage degeneration

Tarhan et al., 2003 [8]

Knee

Human

In vivob

206

MRI

0.23 Tesla, proton density and T2-weighted images, 4.5 mm slice thickness with 0.5 mm interslice gap

B-mode, 5–10 MHz, transcutaneous

Correlation coefficient r ranging from 0.38 to 0.74. No difference between non-arthritic (r ranging from 0.38 to 0.74) and arthritic knee joints (0.44 to 0.61).

Mathiesen et al., 2004 [27]

Knee

Human

Cadaverb

24

Caliper gauge

Thawed at room temperature

B-mode, 10 MHz, thawed at room temperature

Mean difference was 0.0 ± 0.4 mm.

Yoon et al., 2008 [10]

Knee

Human

In vivob

102

MRI

1.5 Tesla, fat-suppressed spoiled gradient echo images, 1.5-mm slice thickness

B-mode, 12.5 MHz, transcutaneous

Correlation coefficient r for the minimal and maximal cartilage thickness in arthritic knees ranged from 0.568 to 0.844 for the medial epicondyle and from 0.314 to 0.507 for the lateral epicondyle

Naredo et al., 2009 [24]

Knee

Human

Cadaverb

24

Stereoscopic magnifying loupe

Fixed in formalin solution

B-mode, 14 MHz, thawed knees, transcutaneous

Agreement of the two methods was assessed using the ICC (intraclass correlation coefficient). The ICC was 0.719 for the medial epicondyle, 0.285 for the lateral epicondyle, and 0.267 for the intercondyle region. Mean difference ranged from 0.266 to 0.326 mm.

Aula et al., 2010 [17]

Knee

Bovine

Cadavera

10

Contrast agent CT

Slice thickness of 2.3 mm, pixel size of 0.2 × 0.2 mm2, thawed and stored in phosphate-buffered saline

A-mode, 30 MHz, thawed and stored in phosphate-buffered saline

Correlation coefficient r was 0.84.

Spannow et al., 2011 [28]

Knee, ankle, wrist, finger

Human

In vivob

143

MRI

1.5 Tesla, fat-suppressed T1, slice thickness 1.4–1.6 mm, voxel size 0.5 × 0.8 × 1.6 mm

B-mode, 6-14 MHz, transcutaneous

Mean difference ranging from 0.08 to 0.48 mm.

Ohashi et al., 2012 [5]

Knee

Porcine

In vitroa

62

Microscope

Thawed cadaver

Conventional B-mode and real-time spatial compound B-mode, 10 MHz, 1488 and 1709 m/s speed of sound, thawed, stored in saline solution

Correlation coefficient r was 0.961 for conventional and 0.976 for real-time spatial sonography. The mean difference was 0.0073 ± 0.171 for conventional and 0.0139 ± 0.131 for real-time spatial sonography

Ohashi et al., 2012 [6]

Knee

Human

In vivob

505

MRI

3 Tesla, double echo steady state sequence, slice thickness 0.29 mm, in plane resolution 0.31 mm × 0.31 mm

B-mode, 10 MHz, transcutaneous

Correlation coefficient r was 0.976 for non-arthritic and 0.964 for arthritic knees. The mean difference was 0.085 ± 0.405 mm for non-arthritic and 0.154 ± 0.413 mm for arthritic knees

Mandl et al., 2015 [7]

Finger

Human

Cadaverb

19

Calibrated photos

Frozen cadavers

B-mode, 7-15 MHz, 1696 m/s speed of sound

Correlation coefficient r was 0.509 (R2 = 0.2595)

Pradsgaard et al., 2015 [11]

Knee

Human

In vivob

69

MRI

1.5 Tesla, gradient fat saturation

B-mode, 6–14 MHz, transcutaneous, 1696 m/s speed of sound

Correlation coefficient rho was 0.86 for the medial condyle, 0.71 for the lateral condyle, and 0.70 for the intercondylar region. The mean difference was 0.31 mm for the medial condyle, 0.23 mm for the lateral condyle, and 0.33 mm for the intercondylar region

Current study

Hip, knee, and shoulder

Bovine and porcine

Cadavera

50

Contrast agent micro-CT

Voxel size/slice thickness of 0.016 mm, stored in phosphate-buffered saline solution for max. 18 h, iodine contrast agent

A-mode, 20 MHz, 1580 m/s and 1696 m/s speed of sound, non-frozen, evaluated within few hours of sacrifice

A strong correlation with a correlation coefficient of r = 0.973 was found. The mean difference was 0.074 ± 0.061 mm (0.002–0.256 mm)

  1. n number of measurements, TKA total knee arthroplasty, MRI magnetic resonance imaging, CT computer tomography
  2. aUltrasonic measurements were performed with the probe directly on cartilage surface without interfering soft tissue
  3. bUltrasonic measurements were performed with soft tissue between the probe and cartilage potentially resulting in increased measurement error