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Quantitative Analysis of Patellar Tendon Abnormality in Asymptomatic Professional “Pallapugno” Players: A Texture-Based Ultrasound Approach

Biolab, Department of Electronics and Telecomunications, Politecnico di Torino, 10129 Turin, Italy
Medical Lab, 14100 Asti, Italy
Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore 599489, Singapore
Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore 599484, Singapore
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
Cardiovascular Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
Author to whom correspondence should be addressed.
Appl. Sci. 2018, 8(5), 660;
Received: 30 March 2018 / Revised: 20 April 2018 / Accepted: 23 April 2018 / Published: 25 April 2018
(This article belongs to the Special Issue Ultrasound Elastography)
PDF [2241 KB, uploaded 3 May 2018]


Abnormalities in B-mode ultrasound images of the patellar tendon often take place in asymptomatic athletes but it is still not clear if these modifications forego or can predict the development of tendinopathy. Subclinical tendinopathy can be arbitrarily defined as either (1) the presence of light structural changes in B-mode ultrasound images in association with mild neovascularization (determined with Power Doppler images) or (2) the presence of moderate/severe structural changes with or without neovascularization. Up to now, the structural changes and neovascularization of the tendon are evaluated qualitatively by visual inspection of ultrasound images. The aim of this study is to investigate the capability of a quantitative texture-based approach to determine tendon abnormality of “pallapugno” players. B-mode ultrasound images of the patellar tendon were acquired in 14 players and quantitative texture parameters were calculated within a Region of Interest (ROI) of both the non-dominant and the dominant tendon. A total of 90 features were calculated for each ROI, including 6 first-order descriptors, 24 Haralick features, and 60 higher-order spectra and entropy features. These features on the dominant and non-dominant side were used to perform a multivariate linear regression analysis (MANOVA) and our results show that the descriptors can be effectively used to determine tendon abnormality and, more importantly, the occurrence of subclinical tendinopathy. View Full-Text
Keywords: ultrasonography; tendinopathy; texture analysis; quantitative ultrasonography; tendinopathy; texture analysis; quantitative

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Meiburger, K.M.; Salvi, M.; Giacchino, M.; Acharya, U.R.; Minetto, M.A.; Caresio, C.; Molinari, F. Quantitative Analysis of Patellar Tendon Abnormality in Asymptomatic Professional “Pallapugno” Players: A Texture-Based Ultrasound Approach. Appl. Sci. 2018, 8, 660.

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