Detection, diagnosis and monitoring of osteoporosis by a photo-acoustic method
09833187 · 2017-12-05
Assignee
Inventors
Cpc classification
A61B5/0095
HUMAN NECESSITIES
A61B8/4483
HUMAN NECESSITIES
A61B5/0097
HUMAN NECESSITIES
A61B5/0035
HUMAN NECESSITIES
A61B5/7228
HUMAN NECESSITIES
International classification
A61B5/05
HUMAN NECESSITIES
A61B5/00
HUMAN NECESSITIES
Abstract
Method for examining bone in vivo, comprises obtaining a laser beam; modulating the laser beam to insert therein photoacoustic frequencies including optical frequencies and acoustic frequencies, the acoustic frequencies being able to give rise to acoustic waves; directing the modulated beam at a bone to cause acoustic waves resulting from the beam to travel through the bone; analyzing received signals from the bone including signals resulting from the acoustic waves, to determine a mineral density and a bone quality for said bone, and thus obtain in-vivo data that can be of assistance to a doctor when diagnosing osteoporosis.
Claims
1. An apparatus for examining bone in vivo, comprising: a laser source configured to produce a laser beam; an acousto-optic modulator, configured to modulate said laser beam at acoustic frequencies being frequencies that are able to give rise to acoustic waves; a waveform generator configured to drive said acousto-optic modulator with a modulation signal at a range of said acoustic frequencies, thereby to produce a modulated multiple frequency acousto-optic beam able to cause excitation at a plurality of frequencies; a spectrum analyzer, configured to analyze received signals from said bone, said received signals including signals resulting from acoustic waves traveling within said bone caused by said modulated multiple frequency acousto-optic beam, wherein said spectrum analyzer is further configured to analyze said received signals of said modulated multiple frequency acousto-optic beam at optical wavelengths and acoustic frequencies, and to scan said optical wavelengths and acoustic frequencies to map a bone transfer function, and further to analyze amplitude and phase with variation of said frequency to determine a speed of sound dispersion and a broadband ultrasonic attenuation, said spectrum analyzer being further configured to determine a mineral density and a bone quality for said bone from said analyzing.
2. The apparatus according to claim 1, wherein said spectrum analyzer is further configured to use said bone transfer function, said speed of sound dispersion and said broadband ultrasonic attenuation to determine biochemical composition of said bone.
3. The apparatus according to claim 1, further comprising a beam director to direct said laser beam towards said bone at an excitation point separated from a measurement point, such that acoustic waves enter said bone substantially at said excitation point and travel down said bone to said measurement point.
4. The apparatus according to claim 3, further comprising an ultrasonic transducer located on said limb at said measurement point to measure ultrasonic wave propagation at said measurement point.
5. The apparatus according to claim 1, wherein said waveform generator is configured to select a frequency to define said frequency range for said photoacoustic signals, the selected frequency being at or above half a megahertz.
6. An apparatus for examining bone in vivo, comprising: a laser source configured to produce a laser beam; an acousto-optic modulator, configured to modulate said laser beam at acoustic frequencies being frequencies that are able to give rise to acoustic waves; a waveform generator configured to drive said acousto-optic modulator with a modulation signal at a range of said acoustic frequencies, thereby to produce a modulated multiple frequency acousto-optic beam able to cause excitation at a plurality of frequencies; a spectrum analyzer, configured to analyze received signals from said bone, said received signals including signals resulting from acoustic waves traveling within said bone caused by said modulated multiple frequency acousto-optic beam, said spectrum analyzer being further configured to determine a mineral density and a bone quality for said bone, said spectrum analyzer further configured to obtain a measurement of quantitative ultrasound (QUS) parameters of the bone and a measurement of a near infra-red (NIR) absorption spectrum of the bone.
7. A method for examining bone in vivo, comprising: using a laser to provide a laser beam; modulating said laser beam using an acoustic signal, thereby to produce a laser beam at frequencies being able to give rise to acoustic waves within said bone; directing said modulated beam at a bone to cause acoustic waves caused by said beam to travel through said bone at a plurality of frequencies; analyzing received signals from said bone, said received signals including signals resulting from said acoustic waves traveling within said bone, wherein said analyzing comprises scanning optical wavelengths and acoustic frequencies, and further analyzing amplitude and phase as acoustic frequency varies to determine a speed of sound dispersion and a broadband ultrasonic attenuation; using results of said scanning of optical wavelengths and acoustic frequencies to map a bone transfer function; and determining a mineral density and a bone quality for said bone.
8. The method according to claim 7, further comprising using said bone transfer function, said speed of sound dispersion and said broadband ultrasonic attenuation to determine biochemical composition of said bone.
9. The method according to claim 7, wherein said directing said laser beam is to cause acoustic waves generated by said laser beam to travel through said bone substantially from a predetermined excitation point separated from a measurement point, such that said acoustic waves travel down said bone to said measurement point, the method further comprising measuring said acoustic waves at said measurement point.
10. The method according to claim 7, comprising selecting a frequency to define a range for said acoustic waves, the selected frequency being at or above half a megahertz.
11. Method A method for examining bone in vivo, comprising: using a laser to provide a laser beam; modulating said laser beam using an acoustic signal, thereby to produce a laser beam at frequencies being able to give rise to acoustic waves within said bone; directing said modulated beam at a bone to cause acoustic waves caused by said beam to travel through said bone at a plurality of frequencies; gathering signals from said bone; and analyzing received signals from said bone, said received signals including signals resulting from said acoustic waves traveling within said bone, wherein said analyzing obtains a measurement of quantitative ultrasound (QUS) parameters of the bone and a measurement of a near infra-red (NIR) absorption spectrum of the bone.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.
(2) Some embodiments of the invention are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of embodiments of the invention. In this regard, the description taken with the drawings makes apparent to those skilled in the art how embodiments of the invention may be practiced.
(3) In the drawings:
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DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION
(16) The present invention, in some embodiments thereof, relates to a method and apparatus for the detection, diagnosis and monitoring of osteoporosis and, more particularly, but not exclusively, to such a method and apparatus that does not require ionizing radiation.
(17) As explained above, photoacoustic (PA) imaging is renowned for its ability to produce high resolution in-vivo images at depths where none of the other optical bio-imaging techniques can. PA signals carry information about the molecular content and functional state at the absorption sites due to the direct dependence of PA signal generation on the absorption properties of the medium. In the present embodiments, such information may be gathered by using several excitation wavelengths (Multispectral Photo-Acoustics) and implementation of spectroscopic tools for substance analysis. Thus, photoacoustic measurements may offer an advantage over pure ultrasound (US) methods as they allow measurement of all QUS parameters as well as the measurement of the NIR absorption spectrum of the tested bone.
(18) Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details of construction and the arrangement of the components and/or methods set forth in the following description and/or illustrated in the drawings and/or the Examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.
(19) Referring now to the drawings,
(20) A multi spectral laser source 16 produces a laser beam with a defined wavelength. An internal or external modulator 18 (here shown as external) modulates the laser beam at ultrasonic frequencies f.sub.1 . . . f.sub.n. The ultrasound frequencies in particular are frequencies that are able to give rise to acoustic waves that may travel through the bone.
(21) Waveform generator 20 drives the modulator with a modulation signal to insert the range of frequencies described above. The output of the modulator may thus be a multiple frequency acousto-optic beam, and the beam as a whole is able to cause acoustic excitation at multiple frequencies to provide acoustic waves that may travel through bone.
(22) A DAQ or a spectrum analyzer 22 analyzes received signals from the bone. The received signals are acoustic signals resulting from acoustic waves within the bone caused by the modulated multiple frequency photoacousticoptical beam. The analyzing may determine a mineral density and a bone quality for the bone, as will be discussed in greater detail below.
(23) The spectrum analyzer 22 may measure different acoustic frequencies and the optical source might be set to scan different optical wavelengths to map a bone transfer function. The analyzer 22 may analyze amplitude and phase along an acoustic frequency axis to determine a speed of sound dispersion and a broadband ultrasonic attenuation, and from this analysis may be able to determine the mineral density and the bone quality.
(24) The apparatus 10 may further use the bone transfer function, the speed of sound dispersion of the bone and the broadband ultrasonic attenuation to determine the biochemical composition of the bone 12.
(25) The modulator may further provide a beam director to direct the modulated laser beam towards the bone at a selected point 24, referred to herein as the excitation point. The excitation point is separated from a measurement point 26, located at a certain distance along the bone. A primary wave may travel along the bone approximately from the excitation point to be sampled at the measurement point.
(26) An ultrasonic transducer 28 may be located on the limb opposite measurement point 26 to sample the ultrasonic wave propagation at the measurement point for analysis by the spectrum analyzer.
(27) As will be discussed below, the present embodiments may provide an integration of an ultrasonic system onto a photoacoustic system. Such an integration may be achieved by selecting the frequency range for the photoacoustic signals to be at and above half a megahertz.
(28) The analysis may obtain a measurement of QUS parameters of the bone and a measurement of the NIR absorption spectrum of the bone.
(29) Reference is now made to
(30) Initially a laser beam is provided 30. The beam is modulated 32 to insert therein photoacoustic frequencies. As discussed, the acoustic frequencies, typically ultrasonic frequencies, may give rise to acoustic waves that may travel along the bone, and multiple frequencies are used.
(31) The modulated beam is directed 34 towards a point on the bone, or on the flesh of the limb covering the bone, so as to allow light and ultrasound resulting from optical excitation to travel through the wave.
(32) The limb is monitored and signals received from the bone are gathered or transduced 36 and analyzed 38. The received signals include signals resulting from acoustic waves caused by excitation of the optical beam, the acoustic waves having traveled through a length of bone. Analyzing is carried out as discussed below to determine 40 a mineral density and a bone quality.
(33) The analyzing may typically involve scanning optical wavelengths and acoustic wavelengths to map 42 a bone transfer function. Analysis of amplitude and phase along an acoustic frequency axis may provide 44 a speed of sound dispersion and a broadband ultrasonic attenuation 46, and these may be used to obtain the mineral density and the bone quality 40.
(34) More specifically, the bone transfer function, the speed of sound dispersion and the broadband ultrasonic attenuation may be analyzed to determine the biochemical composition of the bone.
(35) As explained, the modulated beam may be directed at a specific point on the bone, or the flesh covering the bone. The point is separated from a measurement point, so that waves generated inside the bone at or around the excitation point travel down the bone to the measurement point over a distance that allows the waves to be affected by the bone qualities.
(36) The analyzing may obtain 48 a measurement of QUS parameters of the bone and a measurement of the NIR absorption spectrum of the bone.
(37) It is particularly pointed out that the method shown in
(38) It is noted that, in general, the excitation wavelength is determined solely by the laser source, and the modulator is completely is irrelevant for the choice of wavelength. Thus, the optical source may be a multi-spectral optical source—see
(39) The sole function of the modulator is to accept an optical beam with a particular wavelength, determined by the source as explained above, and modulate the intensity with suitable ultrasound frequencies (0.5-2.5 MHz). The use of a Modulator is only one embodiment and is not essential for the present embodiments. An Electro-optic modulator, a chopper or any other form of intensity modulation may be used instead. In the embodiments described in
(40) Signals may be analyzed in the frequency domain. However, they can be acquired either in the time domain by a data acquisition (DAQ) or directly in the frequency domain by a spectrum analyzer. A spectrum analyzer is thus not essential for the present embodiments.
(41) The ultrasound transducer is the only sensor that is needed and it is only sensitive to ultrasonic waves generated in the tissue, which may be both soft and hard tissue, due the intensity modulated optical beam. The spectrum analyzer or any other device does not measure anything optical. The strength of acoustic waves is related to the product of the laser peak intensity by the tissue optical absorption coefficient. Thus by measuring the intensity of the acoustic waves in different optical wavelengths one can deduce the optical spectrum of the bone.
(42) It is noted that the terms “Optoacoustic” and “Photoacoustic” are synonymous. The present text uses the term “Photoacoustic”, only for consistency.
(43) Reference is now made to
(44) As shown, the modulated laser beam is incident upon the skin surface. A portion of the beam is absorbed by the bone tissue, generating an ultrasonic wave within the bone which propagates along the bone axis and is picked up by a transducer.
(45) It is widely accepted that long bones with thick cortex act as a waveguide for transmitting ultrasonic waves with relatively low attenuation. The theory of flexural and longitudinal Rayleigh-Lamb waves in an irregular cylindrical structure with anisotropic elastic properties, and thus being representative of bone, is extremely complicated and predicts the existence of many dispersive interacting modes. However, most experimental reports phenomenologically concern waves of only two kinds: weak and fast circumferential waves (also known as First Arriving Signal—FAS) and the stronger and slower guided wave (also known as Energetic Late Arrival—ETA).
(46) As mentioned in the background, recently, Zhao et al. have demonstrated single wavelength photoacoustic excitation and detection on bone samples coated with Gelatin. They used low frequency ultrasound of 50 kHz to investigate the slow Fundamental Flexural Guided Wave.
(47) The present embodiments go beyond Zhao in using multiple frequencies. Furthermore, in general, the present embodiments make measurements in ultrasonic frequencies around 0.5 MHz which are more conventional in QUS and allow the integration of a photoacoustic system onto existing ultrasound machines. The present embodiments may also characterize the photoacoustically generated ultrasound waves in the frequency domain and in multiple wavelengths, which allows a more complete assessment of bone functionality.
(48) It was empirically found that a model based on two guided modes is sufficient to describe the measured amplitude and phase of the generated CW waves.
METHODS AND EXPERIMENTAL SETUP
(49) A particular embodiment provides a system based on a tunable Ti:Sapph laser at 750-950 nm, followed by a modulator to generate photoacoustic signals with frequencies of 0.5-2.5 MHz.
(50) A second embodiment was based on two directly modulated 830 nm laser diodes. The systems were used to photoacoustically excite the proximal end of a rat tibia. A spectrum analyzer with tracking generator was used for measuring both the amplitude and the phase at the distal end. Scanning along both the optical wavelength and the acoustic frequency may enable full mapping of the bone transfer function. Analyzing the bone transfer function along the wavelength axis may allow deducing of the gross biochemical composition related to the bone functional and pathological state. Analyzing the amplitude and phase along the acoustic frequency axis yields the speed of sound dispersion and the broadband ultrasonic attenuation—both have shown clinical relevance.
(51) Frequency domain measurements of the phase and amplitude of photoacoustically generated ultrasound waves were performed. Single frequency phase measurements allow for greater accuracy in the measurement of the speed of sound (SOS) than the conventional time-domain methods which measures the Time Of Flight (TOF). This is due to the extreme dispersion present in the bone which renders the TOF measurement to be highly dependent on the SNR, the post measurement signal processing and the criterion for determining the exact time of arrival. When performing measurements in the frequency domain, electromagnetic interference is omni-present due to the electronics used to drive the optical excitation at the desired frequency. Thus, the signal received in the ultrasonic detector can be modelled as a sum of a phasor describing the EM interference and additional phasors which represents the guided modes that were excited by the modulated light. In the case of two significant guided modes the output signal can be described as:
(52)
where x is the distance from the transducer, f is the ultrasonic frequency, A.sub.EM, A.sub.slow A.sub.fast are the amplitudes of the electromagnetic, slow and fast waves respectively, φ.sub.EM, φ.sub.slow, φf.sub.ast.sub._ are the constant phases of each phasor, α.sub.slow, α.sub.fast, are the attenuation coefficients (also known as the Broadband Ultrasonic Attenuation—BUA usually expressed in dB.Math.MHz.sup.−1.Math.cm.sup.−1) of the slow and fast waves and c.sub.slow(f), c.sub.fast(f) are the phase velocities of the slow and fast waves.
(53) The electromagnetic interference phasor was found to be nearly constant throughout the experiment. Thus, it was possible to measure and subtract the interference phasor from the signal. In addition, to further reduce the complexity of the model it was assumed that e.sup.−α.sup.
P−A.sub.EMe.sup.iφ.sup.
where A(x,f) and φ(x,f) are the measured amplitude and phase after reduction of the EM interference phasor and A.sub.fs=A.sub.fast/A.sub.slow is the relative amplitude between the two modes.
(54) The analysis of the measured data was as follows: First we estimated the SOS and relative amplitude for each mode by fitting the measured phase φ(x,f) (after removal of the EM interference) using the following estimator:
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(56) Then we found the common amplitude and Broadband Ultrasonic Attenuation by fitting the following measured amplitude using the following estimator:
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(58) Thus full characterization of the fast and slow modes was possible based on the measurements of the phase and amplitude as a function of distance along the bone, as well as measurement of the electromagnetic interference constant phase and amplitude.
(59) To experimentally test the model in-vitro, a fiber-coupled laser diode based, single, wavelength photoacoustic system was developed. The system is described schematically in
(60) Signals were sampled at 10M samples/sec rate over 5 seconds time intervals at DAQ 70. The resulting waveforms were then Fourier transformed and their phase and amplitude at the modulation frequency were calculated with respect to a reference channel 72 sampled directly from the AWG. The apparatus was controlled by computer 74. Upon completion of measurements at all frequencies, the bone was soaked in mild acetic acid for 2.5 hours to simulate the effect of osteoporosis. This process is known to dematerialize and thus weaken the strength of bones since the insoluble calcium reacts with the acetate to form calcium acetate, which is soluble and thus removed from the bone. It should be noted that complete removal of the calcium from the bone might take days.
(61) Thus, a 2.5 hour acid treatment has a very gentle effect on bone strength. Upon completion of the acid treatment the bone was rinsed with water to remove any acid traces and all measurements were performed again for comparison.
(62) Reference is now made to
(63) In the experiment of
RESULTS AND DISCUSSION
(64) Reference is now made to
(65) In the graphs, blue dots represent measurements of the naive bone, and the green line represents the model of naive bone. Black asterisks represent measurements on treated bone and the red lines represent the model of treated bone.
(66) All plots were made after the subtraction of the electromagnetic interference as described in equation 1. Phases are plotted as a function of the distance from the transducer in dots for naïve bone or asterisks for dematerialized bone for each ultrasonic frequency. Also plotted are the fitted phases using equation 2. It is clear that the at least two different ultrasonic modes with different phases are present as the measured phases deviate considerably from linear phase accumulation. It is also evident that the two phasors model explains the measurement quite accurately. This correlates well with theoretical models of guided waves in bone such as that presented by Zhou et al—Ta, D., Wang, W., Wang, Y. Y., Le, L. H. & Zhou, Y. Measurement of the dispersion and attenuation of cylindrical ultrasonic guided waves in long bone. Ultrasound in medicine & biology 35, 641-652 (2009)—which predicts the existence of only two guided modes for 0.5 MHz and 1 mm cortical thickness.
(67) Estimated by equation 2, the speed of sound for naïve bone was between 750 m/s up to 900 m/s for the slow wave and was 2500 m/s-3500 m/s for the fast wave. For the dematerialized bone, results varied greatly. Slow wave speeds were estimated in a wide spectrum around 1500 m/s and fast wave estimated speeds varied around 4200 m/s. The great variability in measurements can be explained by both numerical inaccuracies due to the fitting of a complicated model as well as the extreme dispersion (up to hundreds of m/s per 100 KHz) predicted by theoretical models in the frequency/cortical thickness regime.
(68) Finally, the ratio between the slow and fast mode generation efficiency A.sub.fs was also estimated by equation 2. This ratio was estimated to be in the range of 8 to 10 for naive bone, while dematerialized bone exhibited significantly lower values of 2 to 4. Thus, dematerialized bones allow for the generation of both modes on a more equal footing.
(69) Reference is now made to
(70) The amplitudes of the ultrasonic signal were analyzed using equation 3. Here the fitting quality was not as good as for the phase measurements. Although the exponential decay in signal amplitudes is clearly seen, inhomogeneities in the bone absorption along its axis render this measurement quite noisy. Ultrasonic attenuations estimated using the model were high—around 30 dB/(cm.Math.Mhz) for naive bones and around 40 dB/(cm.Math.Mhz) for dematerialized bones.
(71) Reference is now made to
(72) In
(73) Reference is now made to
(74) As with
(75) In use, the AWG 210 intensity modulates the diode laser output. The laser is fiber coupled and guided via collimator to the bone sample. The excitation location is scanned over the bone axis using a motorized stage. Guided acoustic modes are generated inside the bone in the excitation compartment 202 and travel through the bone to the detection compartment 204. The PA signal is picked up by the transducer 220, amplified and measured by Vector Signal Analyzer 224. All parts of the setup may be computer controlled.
(76) Reference is now made to
(77) TABLE-US-00001 TABLE 1 analysis of measurements in FIGS. 10A-C. Measurement Measurement Measurement Standard Relative 1 2 3 Mean Deviation Error C.sub.fast [m/s] 4344 4329 4382 4352 27.32 0.63% C.sub.slow [m/s] 2575 2559 2581 2572 11.37 0.44% A.sub.fs [#] 1.350 1.342 1.367 1.353 0.013 0.94%
(78) Table 1—analysis of measurements in
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CONCLUSIONS
(82) Frequency domain photoacoustic measurements of bone parameters were demonstrated over multiple acoustic and optical frequencies. The measurements of phase and amplitude of the photoacoustic signal in the modulation frequency may reveal the existence of fast and slow modes which propagate in the bone. The speed of each mode and their relative amplitude convey biomechanical information regarding the bone strength. Though some of the measurements are still noisy and require further research to be interrupted and processed correctly, it was shown that such a method has the potential to provide important information regarding the bone status. Amplitude measurements over the bone axis were greatly affected by bone absorption inhomogeneities. In addition, it was shown that the measurement of PA generation in multiple wavelengths can be used to obtain information about the bone chemical content. These results suggest that a complete characterization of the bone over a region of both acoustic and spectral frequencies can be used as a powerful tool for in-vivo bone evaluation.
(83) The terms “comprises”, “comprising”, “includes”, “including”, “having” and their conjugates mean “including but not limited to”.
(84) The term “consisting of” means “including and limited to”.
(85) As used herein, the singular form “a”, “an” and “the” include plural references unless the context clearly dictates otherwise.
(86) It is appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment, and the above description is to be construed as if this combination were explicitly written. Conversely, various features of the invention, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination or as suitable in any other described embodiment of the invention, and the above description is to be construed as if these separate embodiments were explicitly written. Certain features described in the context of various embodiments are not to be considered essential features of those embodiments, unless the embodiment is inoperative without those elements.
(87) Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.
(88) All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting.