Physiological iodine uptake of the spine’s bone marrow in dual-energy computed tomography – using artificial intelligence to define reference values based on 678 CT examinations of 189 individuals

Autor: Philipp Fervers, Florian Fervers, Miriam Rinneburger, Mathilda Weisthoff, Jonathan Kottlors, Robert Reimer, David Zopfs, Erkan Celik, David Maintz, Nils Große-Hokamp, Thorsten Persigehl
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Endocrinology, Vol 14 (2023)
Druh dokumentu: article
ISSN: 1664-2392
DOI: 10.3389/fendo.2023.1098898
Popis: PurposeThe bone marrow’s iodine uptake in dual-energy CT (DECT) is elevated in malignant disease. We aimed to investigate the physiological range of bone marrow iodine uptake after intravenous contrast application, and examine its dependence on vBMD, iodine blood pool, patient age, and sex.MethodRetrospective analysis of oncological patients without evidence of metastatic disease. DECT examinations were performed on a spectral detector CT scanner in portal venous contrast phase. The thoracic and lumbar spine were segmented by a pre-trained neural network, obtaining volumetric iodine concentration data [mg/ml]. vBMD was assessed using a phantomless, CE-certified software [mg/cm3]. The iodine blood pool was estimated by ROI-based measurements in the great abdominal vessels. A multivariate regression model was fit with the dependent variable “median bone marrow iodine uptake”. Standardized regression coefficients (β) were calculated to assess the impact of each covariate.Results678 consecutive DECT exams of 189 individuals (93 female, age 61.4 ± 16.0 years) were evaluated. AI-based segmentation provided volumetric data of 97.9% of the included vertebrae (n=11,286). The 95th percentile of bone marrow iodine uptake, as a surrogate for the upper margin of the physiological distribution, ranged between 4.7-6.4 mg/ml. vBMD (p
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