Investigating the color Doppler twinkling artifact as an early detector of cellular mineralization

Abstract

Heterotopic ossification (HO) occurs when bone develops in areas where bone does not usually exist, often appearing after blast injuries or other musculoskeletal trauma. Current methods of diagnosis, such as three-phase bone scintigraphy, x-ray, or CT scans, take several weeks after the trauma before HO is visible. The color Doppler ultrasound twinkling artifact has been shown to detect the presence of kidney stones and other crystals. Twinkling could provide a more sensitive method of HO detection, which would allow for earlier diagnosis and treatment and limit HO severity. In our research, human bone marrow-derived stem cells (HBMSCs) were plated onto collagen scaffolds and cultured in osteogenic media to promote mineralization orgrowth media (controls). The cells were imaged every 3rd day from day 10 – day 25 using Phillips L7-4, L12-5, and Vermon L22-14v transducers and a Vantage-128 research ultrasound system; I/Q data were bulk saved for quantitative analysis. Samples with mineralization on 0.5% of their surface showed a 17% increase in Doppler magnitude compared to controls, suggesting that the twinkling artifact is a sensitive method for detection of mineralization in vitro. Further studies will investigate whether this method is effective in a murine model. [Work supported by DoD CDMRP PR201164.]