# Assessment of metabolic bone disease of prematurity using an acoustic method

> **NIH NIH R21** · MAYO CLINIC ROCHESTER · 2020 · $209,880

## Abstract

Metabolic bone disease in preterm newborn or osteopenia of prematurity (OP), or neonatal rickets or rickets of
prematurity, are terms used to describe a common and significant problem that refers to hypo-mineralized
skeleton of premature infants that is hallmarked by radiographic evidence of decreased bone mineralization
and often leads to fractures of long bone and ribs. In an effort to maximize bone mineralization and minimize
OP, clinicians use biochemical measurements of serum calcium, inorganic phosphorus, and alkaline
phosphatase to make decisions for optimizing infant nutrition, but are limited to radiographic evidence over
time to monitor this progress. Currently, no screening test has been shown to provide both sensitive and
specific evidence of developing OP over the first several weeks of life in the premature infants. Such
information would greatly facilitate clinicians’ efforts to optimize nutrition for preterm infants in an effort to
minimize the risk of OP. Current bone assessment tools include plain radiography, dual-energy X-ray
absorption (DXA), and quantitative ultrasonography (QUS). Due to the use of ionizing radiation and bulky
equipment, the first two methods are not suitable for infants and especially for the low-birth-weight pre-term
neonates, a group at particular risk of mineral compromise. QUS is designed to measure the speed of sound in
large extremity bones by transmitting a single-frequency ultrasound. Adaptation of this device to infants and
especially premature infants is very poor. The most important shortcoming of conventional QUS for evaluation
of infant bone is that the results are greatly affected by subcutaneous tissues, particularly by the subcutaneous
fat layer. Another shortcoming of the current QUS technology is that the system operates on a single-
frequency basis. Based on our investigations, to be described later in this application, acquiring ultrasound
data in a wide range of frequencies, especially in the kilo-Hertz range, can provide valuable information about
the mechanical structure of bone and may lead to improved bone assessment. The goal of the proposed
project is to develop a new ultrasound based technology, called vibro-acoustic analysis (VAA), which is based
on a fundamentally new mechanism that allows evaluation of infant bone properties in a wide frequency range
without the interference from subcutaneous tissues. In Aim 1, optimization of the VAA method for quantitative
assessment, we will optimize and validate the technique for in vivo study. In Aim 2, we will determine the
efficacy of the VAA method for quantitative assessment of tibia bone in a pilot study.The proposed technique
will be tested on term and preterm infants to detect and monitor the treatment in a longitudinal study. The
technology to be developed in this project may provide clinicians with valuable information to monitor and treat
developing OP at a stage where radiographic evidence is not yet apparent. Additionally, qua...

## Key facts

- **NIH application ID:** 10005122
- **Project number:** 5R21AR075370-02
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Azra Alizad
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $209,880
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005122

## Citation

> US National Institutes of Health, RePORTER application 10005122, Assessment of metabolic bone disease of prematurity using an acoustic method (5R21AR075370-02). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10005122. Licensed CC0.

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