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In vivo CortBS - „Numerical Simulation and in-vivo Detection of Mikrostructural Tissue Alterations in Cortical Bone by Cortical Backscatter"

Osteoporosis (OP) is one of the most underdiagnosed common diseases both in Germany and worldwide. The risk of osteoporosis-associated bone fractures is currently determined indirectly by assessing general risk factors and measuring bone mineral density (BMD). However, fractures occur most frequently in people who do not have pathologically reduced BMD values. This underdiagnosis often leads to therapeutic undertreatment of affected individuals. By applying novel patented quantitative bone ultrasound imaging, the diagnosis of pathological changes in bone structure can be made early. The multidirectional excitation and acquisition of sound waves was developed in the DFG project "TacoSound". It allows precise three-dimensional image reconstruction of soft tissues and the outer bone contour as well as separation and spectral evaluation of reflected and backscattered signal components using the special acquisition sequences. The CortBS method makes it possible for the first time to determine the microscopic pore size distribution in cortical bone non-invasively and without ionizing X-rays. Which serves as an indicator for surgery. The method was developed with an experimental prototype ex-vivo on cadaveric bone, optimized for in vivo measurements in a BMBF-funded project, and a prototype for in vivo applications was developed. The further development and clinical in-vivo validation of the "CortBS" method was realized within a project funded by the BMWi. Currently, a further clinical study is supported by the German Society for Ultrasound in Medicine (DEGUM) and the further development to a medical product is supported by the state of Brandenburg.

Project Funding:

  • DFG -ANR (Ra1380/9-1, Ra1380/13-1)
  • EU EIC
  • BMBF KMUi 
  • Land Brandenburg ILB Profit

Project members:

  • Jennifer Hartwigs
  • Sajad Rahmatian
  • Huong Minh Nguyen


Armbrecht, G., Nguyen Minh, H., Massmann, J., & Raum, K. (2021). Pore-Size Distribution and Frequency-Dependent Attenuation in Human Cortical Tibia Bone Discriminate Fragility Fractures in Postmenopausal Women With Low Bone Mineral Density. JBMR Plus, 5(11), e10536.