Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma
Objective Computed tomography (CT) is used to assess for fracture after knee trauma, but identification of ligamentous injuries may also be beneficial. Our purpose is to assess the potential of dual-energy computed tomography (DECT) for the detection of complete anterior cruciate ligament (ACL) disr...
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| Veröffentlicht in: | Skeletal radiology 2014-03, Vol.43 (3), p.297-305 |
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| creator | Glazebrook, Katrina N. Brewerton, Lee J. Leng, Shuai Carter, Rickey E. Rhee, Peter C. Murthy, Naveen S. Howe, B. Mathew Ringler, Michael D. Dahm, Diane L. Stuart, Michael J. McCollough, Cynthia H. Fletcher, J. G. |
| description | Objective
Computed tomography (CT) is used to assess for fracture after knee trauma, but identification of ligamentous injuries may also be beneficial. Our purpose is to assess the potential of dual-energy computed tomography (DECT) for the detection of complete anterior cruciate ligament (ACL) disruption.
Methods
Sixteen patients with unilateral traumatic ACL disruption (average of 58 days following trauma) confirmed by MRI, and 11 control patients without trauma, underwent DECT of both knees. For each knee, axial, sagittal, and oblique sagittal images (with DECT bone removal, single-energy (SE) bone removal, and DECT tendon-specific color mapping) were reconstructed. Four musculoskeletal radiologists randomly evaluated the 324 DECT reconstructed series (54 knees with 6 displays) separately, to assess for ACL disruption using a five-point scale (1 = definitely not torn, to 5 = definitely torn). ROC analysis was used to compare performance across readers and displays.
Results
Sagittal oblique displays (mixed kV soft tissue, SE bone removal, and DECT bone removal) demonstrated higher areas under the curve for ACL disruption (AUC = 0.95, 0.93 and 0.95 respectively) without significant differences in performance between readers (
p
> 0.23). Inter-reader agreement was also better for these display methods (ICC range 0.62–0.69) compared with other techniques (ICC range 0.41–0.57). Mean sensitivity for ACL disruption was worst for DECT tendon-specific color map and axial images (24 % and 63 % respectively).
Conclusion
DECT knee images with oblique sagittal reconstructions using either mixed kV or bone removal displays (either DECT or SE) depict ACL disruption in the subacute or chronic setting with reliable identification by musculoskeletal radiologists. |
| doi_str_mv | 10.1007/s00256-013-1784-3 |
| format | Article |
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Computed tomography (CT) is used to assess for fracture after knee trauma, but identification of ligamentous injuries may also be beneficial. Our purpose is to assess the potential of dual-energy computed tomography (DECT) for the detection of complete anterior cruciate ligament (ACL) disruption.
Methods
Sixteen patients with unilateral traumatic ACL disruption (average of 58 days following trauma) confirmed by MRI, and 11 control patients without trauma, underwent DECT of both knees. For each knee, axial, sagittal, and oblique sagittal images (with DECT bone removal, single-energy (SE) bone removal, and DECT tendon-specific color mapping) were reconstructed. Four musculoskeletal radiologists randomly evaluated the 324 DECT reconstructed series (54 knees with 6 displays) separately, to assess for ACL disruption using a five-point scale (1 = definitely not torn, to 5 = definitely torn). ROC analysis was used to compare performance across readers and displays.
Results
Sagittal oblique displays (mixed kV soft tissue, SE bone removal, and DECT bone removal) demonstrated higher areas under the curve for ACL disruption (AUC = 0.95, 0.93 and 0.95 respectively) without significant differences in performance between readers (
p
> 0.23). Inter-reader agreement was also better for these display methods (ICC range 0.62–0.69) compared with other techniques (ICC range 0.41–0.57). Mean sensitivity for ACL disruption was worst for DECT tendon-specific color map and axial images (24 % and 63 % respectively).
Conclusion
DECT knee images with oblique sagittal reconstructions using either mixed kV or bone removal displays (either DECT or SE) depict ACL disruption in the subacute or chronic setting with reliable identification by musculoskeletal radiologists.</description><identifier>ISSN: 0364-2348</identifier><identifier>EISSN: 1432-2161</identifier><identifier>DOI: 10.1007/s00256-013-1784-3</identifier><identifier>PMID: 24337491</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Anterior Cruciate Ligament - diagnostic imaging ; Anterior Cruciate Ligament Injuries ; Case-Control Studies ; CT imaging ; Female ; Humans ; Imaging ; Knee Injuries - diagnostic imaging ; Lacerations - diagnostic imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nuclear Medicine ; Orthopedics ; Pathology ; Radiography, Dual-Energy Scanned Projection - methods ; Radiology ; Reproducibility of Results ; Rupture, Spontaneous - diagnostic imaging ; Scientific Article ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods ; Young Adult</subject><ispartof>Skeletal radiology, 2014-03, Vol.43 (3), p.297-305</ispartof><rights>ISS 2013</rights><rights>COPYRIGHT 2014 Springer</rights><rights>ISS 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-132c03431ae89a40c7953a61501144862d858c5d58236c36ae55e902cd08c5873</citedby><cites>FETCH-LOGICAL-c439t-132c03431ae89a40c7953a61501144862d858c5d58236c36ae55e902cd08c5873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00256-013-1784-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00256-013-1784-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24337491$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glazebrook, Katrina N.</creatorcontrib><creatorcontrib>Brewerton, Lee J.</creatorcontrib><creatorcontrib>Leng, Shuai</creatorcontrib><creatorcontrib>Carter, Rickey E.</creatorcontrib><creatorcontrib>Rhee, Peter C.</creatorcontrib><creatorcontrib>Murthy, Naveen S.</creatorcontrib><creatorcontrib>Howe, B. Mathew</creatorcontrib><creatorcontrib>Ringler, Michael D.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>McCollough, Cynthia H.</creatorcontrib><creatorcontrib>Fletcher, J. G.</creatorcontrib><title>Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma</title><title>Skeletal radiology</title><addtitle>Skeletal Radiol</addtitle><addtitle>Skeletal Radiol</addtitle><description>Objective
Computed tomography (CT) is used to assess for fracture after knee trauma, but identification of ligamentous injuries may also be beneficial. Our purpose is to assess the potential of dual-energy computed tomography (DECT) for the detection of complete anterior cruciate ligament (ACL) disruption.
Methods
Sixteen patients with unilateral traumatic ACL disruption (average of 58 days following trauma) confirmed by MRI, and 11 control patients without trauma, underwent DECT of both knees. For each knee, axial, sagittal, and oblique sagittal images (with DECT bone removal, single-energy (SE) bone removal, and DECT tendon-specific color mapping) were reconstructed. Four musculoskeletal radiologists randomly evaluated the 324 DECT reconstructed series (54 knees with 6 displays) separately, to assess for ACL disruption using a five-point scale (1 = definitely not torn, to 5 = definitely torn). ROC analysis was used to compare performance across readers and displays.
Results
Sagittal oblique displays (mixed kV soft tissue, SE bone removal, and DECT bone removal) demonstrated higher areas under the curve for ACL disruption (AUC = 0.95, 0.93 and 0.95 respectively) without significant differences in performance between readers (
p
> 0.23). Inter-reader agreement was also better for these display methods (ICC range 0.62–0.69) compared with other techniques (ICC range 0.41–0.57). Mean sensitivity for ACL disruption was worst for DECT tendon-specific color map and axial images (24 % and 63 % respectively).
Conclusion
DECT knee images with oblique sagittal reconstructions using either mixed kV or bone removal displays (either DECT or SE) depict ACL disruption in the subacute or chronic setting with reliable identification by musculoskeletal radiologists.</description><subject>Adult</subject><subject>Anterior Cruciate Ligament - diagnostic imaging</subject><subject>Anterior Cruciate Ligament Injuries</subject><subject>Case-Control Studies</subject><subject>CT imaging</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Knee Injuries - diagnostic imaging</subject><subject>Lacerations - diagnostic imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nuclear Medicine</subject><subject>Orthopedics</subject><subject>Pathology</subject><subject>Radiography, Dual-Energy Scanned Projection - methods</subject><subject>Radiology</subject><subject>Reproducibility of Results</subject><subject>Rupture, Spontaneous - diagnostic imaging</subject><subject>Scientific Article</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Young Adult</subject><issn>0364-2348</issn><issn>1432-2161</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kkuO1DAQhiMEYpqBA7BBltiwyeCyHTtZjlq8pJHYwNoyTqXbQ2IH2xHKbu7ABTgbJ8FRD0-BvLBV_uqvKtVfVY-BXgCl6nmilDWypsBrUK2o-Z1qB4KzmoGEu9WOcilqxkV7Vj1I6ZpSUKqR96szJjhXooNd9XVvEn67-WKDzzGMJOWlX0kOBFN2k8lI8hHJjHEIcTLeIgkD6Rcz1ugxHlZiwzQvGfuSM4VDNPNxJYUlxmeMrjxsXKzbhEZ3MBP6TDKamIjzZDbZlUAin10-kqNLOcR1K_DRYykczTKZh9W9wYwJH93e59X7ly_e7V_XV29fvdlfXtVW8C7XwJmlXHAw2HZGUKu6hhsJDQUQopWsb5vWNn3TMi4tlwabBjvKbE9LuFX8vHp20p1j-LSU6fXkksVxNB7DkjSIjimqFIOCPv0LvQ5L9KW7jQIBDZP8F3UwI2rnh1AGspuovlQcSl9dKwt18Q-qnB4nV5aCgyvxPxLglGBjSCnioOdYFhVXDVRvrtAnV-jiCr25Qm-tPLltePkwYf8z44cNCsBOQCpf_oDxt4n-q_odWf_DNQ</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Glazebrook, Katrina N.</creator><creator>Brewerton, Lee J.</creator><creator>Leng, Shuai</creator><creator>Carter, Rickey E.</creator><creator>Rhee, Peter C.</creator><creator>Murthy, Naveen S.</creator><creator>Howe, B. Mathew</creator><creator>Ringler, Michael D.</creator><creator>Dahm, Diane L.</creator><creator>Stuart, Michael J.</creator><creator>McCollough, Cynthia H.</creator><creator>Fletcher, J. G.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20140301</creationdate><title>Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma</title><author>Glazebrook, Katrina N. ; Brewerton, Lee J. ; Leng, Shuai ; Carter, Rickey E. ; Rhee, Peter C. ; Murthy, Naveen S. ; Howe, B. Mathew ; Ringler, Michael D. ; Dahm, Diane L. ; Stuart, Michael J. ; McCollough, Cynthia H. ; Fletcher, J. G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-132c03431ae89a40c7953a61501144862d858c5d58236c36ae55e902cd08c5873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Anterior Cruciate Ligament - diagnostic imaging</topic><topic>Anterior Cruciate Ligament Injuries</topic><topic>Case-Control Studies</topic><topic>CT imaging</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Knee Injuries - diagnostic imaging</topic><topic>Lacerations - diagnostic imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nuclear Medicine</topic><topic>Orthopedics</topic><topic>Pathology</topic><topic>Radiography, Dual-Energy Scanned Projection - methods</topic><topic>Radiology</topic><topic>Reproducibility of Results</topic><topic>Rupture, Spontaneous - diagnostic imaging</topic><topic>Scientific Article</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glazebrook, Katrina N.</creatorcontrib><creatorcontrib>Brewerton, Lee J.</creatorcontrib><creatorcontrib>Leng, Shuai</creatorcontrib><creatorcontrib>Carter, Rickey E.</creatorcontrib><creatorcontrib>Rhee, Peter C.</creatorcontrib><creatorcontrib>Murthy, Naveen S.</creatorcontrib><creatorcontrib>Howe, B. Mathew</creatorcontrib><creatorcontrib>Ringler, Michael D.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>McCollough, Cynthia H.</creatorcontrib><creatorcontrib>Fletcher, J. 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Mathew</au><au>Ringler, Michael D.</au><au>Dahm, Diane L.</au><au>Stuart, Michael J.</au><au>McCollough, Cynthia H.</au><au>Fletcher, J. G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma</atitle><jtitle>Skeletal radiology</jtitle><stitle>Skeletal Radiol</stitle><addtitle>Skeletal Radiol</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>43</volume><issue>3</issue><spage>297</spage><epage>305</epage><pages>297-305</pages><issn>0364-2348</issn><eissn>1432-2161</eissn><abstract>Objective
Computed tomography (CT) is used to assess for fracture after knee trauma, but identification of ligamentous injuries may also be beneficial. Our purpose is to assess the potential of dual-energy computed tomography (DECT) for the detection of complete anterior cruciate ligament (ACL) disruption.
Methods
Sixteen patients with unilateral traumatic ACL disruption (average of 58 days following trauma) confirmed by MRI, and 11 control patients without trauma, underwent DECT of both knees. For each knee, axial, sagittal, and oblique sagittal images (with DECT bone removal, single-energy (SE) bone removal, and DECT tendon-specific color mapping) were reconstructed. Four musculoskeletal radiologists randomly evaluated the 324 DECT reconstructed series (54 knees with 6 displays) separately, to assess for ACL disruption using a five-point scale (1 = definitely not torn, to 5 = definitely torn). ROC analysis was used to compare performance across readers and displays.
Results
Sagittal oblique displays (mixed kV soft tissue, SE bone removal, and DECT bone removal) demonstrated higher areas under the curve for ACL disruption (AUC = 0.95, 0.93 and 0.95 respectively) without significant differences in performance between readers (
p
> 0.23). Inter-reader agreement was also better for these display methods (ICC range 0.62–0.69) compared with other techniques (ICC range 0.41–0.57). Mean sensitivity for ACL disruption was worst for DECT tendon-specific color map and axial images (24 % and 63 % respectively).
Conclusion
DECT knee images with oblique sagittal reconstructions using either mixed kV or bone removal displays (either DECT or SE) depict ACL disruption in the subacute or chronic setting with reliable identification by musculoskeletal radiologists.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24337491</pmid><doi>10.1007/s00256-013-1784-3</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0364-2348 |
| ispartof | Skeletal radiology, 2014-03, Vol.43 (3), p.297-305 |
| issn | 0364-2348 1432-2161 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1492707721 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Anterior Cruciate Ligament - diagnostic imaging Anterior Cruciate Ligament Injuries Case-Control Studies CT imaging Female Humans Imaging Knee Injuries - diagnostic imaging Lacerations - diagnostic imaging Male Medicine Medicine & Public Health Middle Aged Nuclear Medicine Orthopedics Pathology Radiography, Dual-Energy Scanned Projection - methods Radiology Reproducibility of Results Rupture, Spontaneous - diagnostic imaging Scientific Article Sensitivity and Specificity Tomography, X-Ray Computed - methods Young Adult |
| title | Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma |
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