Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study
Autor: | Jürgen Mews, Nils Engelhard, Michael Fuchs, Torsten Diekhoff, Matthias Pumberger, Bernd Hamm, Michael Putzier, Kay-Geert A. Hermann, Marcus R. Makowski |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Image quality 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Bone Marrow Fractures Compression medicine Edema Humans Radiology Nuclear Medicine and imaging Prospective Studies Bone Marrow Diseases Aged Neuroradiology Aged 80 and over Lumbar Vertebrae medicine.diagnostic_test business.industry Vertebral compression fracture Ultrasound Reproducibility of Results Magnetic resonance imaging Dual-Energy Computed Tomography Interventional radiology General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Vertebra medicine.anatomical_structure ROC Curve 030220 oncology & carcinogenesis Spinal Fractures Female Radiology Tomography X-Ray Computed business Algorithms |
Zdroj: | European Radiology. 29:31-39 |
ISSN: | 1432-1084 0938-7994 |
Popis: | To evaluate the diagnostic accuracy of single-source dual-energy computed tomography (DECT) for the detection of bone marrow oedema (BME) in patients with vertebral compression fractures. Patients over 50 years of age with radiographically suspected vertebral compression fracture of the thoracic or lumbar spine were prospectively enrolled. All patients underwent DECT with sequential acquisition of 80 and 135 kVp datasets on a 320-row detector CT scanner and 1.5-Tesla magnetic resonance imaging (MRI) including T1-weighted and short-tau inversion recovery (STIR) sequences. Virtual non-calcium (VNCa) images were reconstructed using a three-material decomposition algorithm. Vertebrae with height loss in CT were scored for the presence of BME in both MRI and DECT and used to determine signal- and contrast-to-noise ratios (SNR and CNR). Contingency analysis using MRI as standard of reference and Fleiss’s kappa were calculated. IRB approval was obtained. In total 192 vertebral compression fractures in 70 patients (23 men, 47 women; mean age 70.7 years (SD 9.8)) were included in our analysis. DECT showed a reader-dependent sensitivity of 72% and specificity of 70% for BME. Fleiss’s kappa was .40 for DECT and .58 for MRI. T1-weighted images had significantly better SNR and CNR compared to STIR, CT, and VNCa (p < .0001); however, there was no difference between STIR and VNCa. VNCa images depict BME with adequate sensitivity and specificity and can be acquired on a single-source system. Image quality is adequate but trained readers are needed for image interpretation. • Dual-energy CT in a single-source technique can help to detect bone marrow oedema in patients with vertebral compression fractures. • However, given the inferior inter-rater reliability and limited specificity compared to MRI, experienced readers are needed for image interpretation. • Dual-energy CT of the spine has limited sensitivity for the detection of bone marrow oedema in vertebra with previous surgical intervention. |
Databáze: | OpenAIRE |
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