Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study
Objectives 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. Methods Patients over 50 years of age with radiographically suspected vertebral compression fracture...
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| Veröffentlicht in: | European radiology 2019, Vol.29 (1), p.31-39 |
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| creator | Diekhoff, Torsten Engelhard, Nils Fuchs, Michael Pumberger, Matthias Putzier, Michael Mews, Jürgen Makowski, Marcus Hamm, Bernd Hermann, Kay-Geert A. |
| description | Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Key Points
• 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. |
| doi_str_mv | 10.1007/s00330-018-5568-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2060866705</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2154962724</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-2e0f3c6d26337163e30ae979ed73c43336efb291b4c5369d4e8d9d4154a0b0ae3</originalsourceid><addsrcrecordid>eNp1kU-L1jAQxoMo7uvqB_AiAS9eopOkTVtvsvgPFjyo55Cm026XNnlN0pV-HT-ps76rguAlQzK_eWYyD2NPJbyUAM2rDKA1CJCtqGvTiv0eO8hKKyGhre6zA3S6FU3XVWfsUc7XANDJqnnIzhS9tdC2B_bj8xymBUWOW_LIh80tAgOmaec-rset4MBLXOOU3PFq52NMvFwhdzljziuGwuPI-xiQry6l-J1HHHB1fA78BlPBPrnll1Iifo6Bj8n5stHtNXf8mGI-oi_zDbWe3RRiLrPnzvuNsJ3nsg37Y_ZgdEvGJ3fxnH199_bLxQdx-en9x4s3l8LrRhWhEEbtzaCM1o00GjU47JoOh0b7SmttcOxVJ_vK19p0Q4XtQKesKwc9ofqcvTjp0lTfNszFrnP2uCwuYNyyVWCgNaaBmtDn_6DXtL9A01lFgp1RjaqIkifK0zdzwtEe00xr2q0Ee2ugPRloyUB7a6DdqebZnfLWrzj8qfjtGAHqBGRKhQnT39b_V_0JYqGqkg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2154962724</pqid></control><display><type>article</type><title>Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Diekhoff, Torsten ; Engelhard, Nils ; Fuchs, Michael ; Pumberger, Matthias ; Putzier, Michael ; Mews, Jürgen ; Makowski, Marcus ; Hamm, Bernd ; Hermann, Kay-Geert A.</creator><creatorcontrib>Diekhoff, Torsten ; Engelhard, Nils ; Fuchs, Michael ; Pumberger, Matthias ; Putzier, Michael ; Mews, Jürgen ; Makowski, Marcus ; Hamm, Bernd ; Hermann, Kay-Geert A.</creatorcontrib><description>Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Key Points
• 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.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-018-5568-y</identifier><identifier>PMID: 29948088</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Algorithms ; Bone marrow ; Bone Marrow - diagnostic imaging ; Bone Marrow Diseases - diagnosis ; Bone Marrow Diseases - etiology ; Calcium ; Compression ; Compression tests ; Computation ; Computed tomography ; Contingency ; Diagnostic Radiology ; Diagnostic systems ; Edema ; Edema - diagnosis ; Edema - etiology ; Female ; Fractures ; Fractures, Compression - complications ; Fractures, Compression - diagnosis ; Humans ; Image acquisition ; Image quality ; Image reconstruction ; Imaging ; Internal Medicine ; Interventional Radiology ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - injuries ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical diagnosis ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Musculoskeletal ; Neuroradiology ; NMR ; Nuclear magnetic resonance ; Patients ; Prospective Studies ; Radiology ; Readers ; Reproducibility of Results ; ROC Curve ; Sensitivity ; Sensitivity analysis ; Spinal Fractures - complications ; Spinal Fractures - diagnosis ; Spine ; Spine (lumbar) ; Surgery ; Tomography, X-Ray Computed - methods ; Ultrasound ; Vertebrae</subject><ispartof>European radiology, 2019, Vol.29 (1), p.31-39</ispartof><rights>European Society of Radiology 2018</rights><rights>European Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-2e0f3c6d26337163e30ae979ed73c43336efb291b4c5369d4e8d9d4154a0b0ae3</citedby><cites>FETCH-LOGICAL-c372t-2e0f3c6d26337163e30ae979ed73c43336efb291b4c5369d4e8d9d4154a0b0ae3</cites><orcidid>0000-0003-3593-1449</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-018-5568-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-018-5568-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29948088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diekhoff, Torsten</creatorcontrib><creatorcontrib>Engelhard, Nils</creatorcontrib><creatorcontrib>Fuchs, Michael</creatorcontrib><creatorcontrib>Pumberger, Matthias</creatorcontrib><creatorcontrib>Putzier, Michael</creatorcontrib><creatorcontrib>Mews, Jürgen</creatorcontrib><creatorcontrib>Makowski, Marcus</creatorcontrib><creatorcontrib>Hamm, Bernd</creatorcontrib><creatorcontrib>Hermann, Kay-Geert A.</creatorcontrib><title>Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Key Points
• 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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Algorithms</subject><subject>Bone marrow</subject><subject>Bone Marrow - diagnostic imaging</subject><subject>Bone Marrow Diseases - diagnosis</subject><subject>Bone Marrow Diseases - etiology</subject><subject>Calcium</subject><subject>Compression</subject><subject>Compression tests</subject><subject>Computation</subject><subject>Computed tomography</subject><subject>Contingency</subject><subject>Diagnostic Radiology</subject><subject>Diagnostic systems</subject><subject>Edema</subject><subject>Edema - diagnosis</subject><subject>Edema - etiology</subject><subject>Female</subject><subject>Fractures</subject><subject>Fractures, Compression - complications</subject><subject>Fractures, Compression - diagnosis</subject><subject>Humans</subject><subject>Image acquisition</subject><subject>Image quality</subject><subject>Image reconstruction</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - injuries</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Musculoskeletal</subject><subject>Neuroradiology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Radiology</subject><subject>Readers</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Sensitivity</subject><subject>Sensitivity analysis</subject><subject>Spinal Fractures - complications</subject><subject>Spinal Fractures - diagnosis</subject><subject>Spine</subject><subject>Spine (lumbar)</subject><subject>Surgery</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ultrasound</subject><subject>Vertebrae</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU-L1jAQxoMo7uvqB_AiAS9eopOkTVtvsvgPFjyo55Cm026XNnlN0pV-HT-ps76rguAlQzK_eWYyD2NPJbyUAM2rDKA1CJCtqGvTiv0eO8hKKyGhre6zA3S6FU3XVWfsUc7XANDJqnnIzhS9tdC2B_bj8xymBUWOW_LIh80tAgOmaec-rset4MBLXOOU3PFq52NMvFwhdzljziuGwuPI-xiQry6l-J1HHHB1fA78BlPBPrnll1Iifo6Bj8n5stHtNXf8mGI-oi_zDbWe3RRiLrPnzvuNsJ3nsg37Y_ZgdEvGJ3fxnH199_bLxQdx-en9x4s3l8LrRhWhEEbtzaCM1o00GjU47JoOh0b7SmttcOxVJ_vK19p0Q4XtQKesKwc9ofqcvTjp0lTfNszFrnP2uCwuYNyyVWCgNaaBmtDn_6DXtL9A01lFgp1RjaqIkifK0zdzwtEe00xr2q0Ee2ugPRloyUB7a6DdqebZnfLWrzj8qfjtGAHqBGRKhQnT39b_V_0JYqGqkg</recordid><startdate>2019</startdate><enddate>2019</enddate><creator>Diekhoff, Torsten</creator><creator>Engelhard, Nils</creator><creator>Fuchs, Michael</creator><creator>Pumberger, Matthias</creator><creator>Putzier, Michael</creator><creator>Mews, Jürgen</creator><creator>Makowski, Marcus</creator><creator>Hamm, Bernd</creator><creator>Hermann, Kay-Geert A.</creator><general>Springer Berlin Heidelberg</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>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</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>FR3</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>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3593-1449</orcidid></search><sort><creationdate>2019</creationdate><title>Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study</title><author>Diekhoff, Torsten ; Engelhard, Nils ; Fuchs, Michael ; Pumberger, Matthias ; Putzier, Michael ; Mews, Jürgen ; Makowski, Marcus ; Hamm, Bernd ; Hermann, Kay-Geert A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-2e0f3c6d26337163e30ae979ed73c43336efb291b4c5369d4e8d9d4154a0b0ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Algorithms</topic><topic>Bone marrow</topic><topic>Bone Marrow - diagnostic imaging</topic><topic>Bone Marrow Diseases - diagnosis</topic><topic>Bone Marrow Diseases - etiology</topic><topic>Calcium</topic><topic>Compression</topic><topic>Compression tests</topic><topic>Computation</topic><topic>Computed tomography</topic><topic>Contingency</topic><topic>Diagnostic Radiology</topic><topic>Diagnostic systems</topic><topic>Edema</topic><topic>Edema - diagnosis</topic><topic>Edema - etiology</topic><topic>Female</topic><topic>Fractures</topic><topic>Fractures, Compression - complications</topic><topic>Fractures, Compression - diagnosis</topic><topic>Humans</topic><topic>Image acquisition</topic><topic>Image quality</topic><topic>Image reconstruction</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - injuries</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Musculoskeletal</topic><topic>Neuroradiology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Radiology</topic><topic>Readers</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Sensitivity</topic><topic>Sensitivity analysis</topic><topic>Spinal Fractures - complications</topic><topic>Spinal Fractures - diagnosis</topic><topic>Spine</topic><topic>Spine (lumbar)</topic><topic>Surgery</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ultrasound</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Diekhoff, Torsten</creatorcontrib><creatorcontrib>Engelhard, Nils</creatorcontrib><creatorcontrib>Fuchs, Michael</creatorcontrib><creatorcontrib>Pumberger, Matthias</creatorcontrib><creatorcontrib>Putzier, Michael</creatorcontrib><creatorcontrib>Mews, Jürgen</creatorcontrib><creatorcontrib>Makowski, Marcus</creatorcontrib><creatorcontrib>Hamm, Bernd</creatorcontrib><creatorcontrib>Hermann, Kay-Geert A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diekhoff, Torsten</au><au>Engelhard, Nils</au><au>Fuchs, Michael</au><au>Pumberger, Matthias</au><au>Putzier, Michael</au><au>Mews, Jürgen</au><au>Makowski, Marcus</au><au>Hamm, Bernd</au><au>Hermann, Kay-Geert A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2019</date><risdate>2019</risdate><volume>29</volume><issue>1</issue><spage>31</spage><epage>39</epage><pages>31-39</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Key Points
• 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29948088</pmid><doi>10.1007/s00330-018-5568-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3593-1449</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2019, Vol.29 (1), p.31-39 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2060866705 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Algorithms Bone marrow Bone Marrow - diagnostic imaging Bone Marrow Diseases - diagnosis Bone Marrow Diseases - etiology Calcium Compression Compression tests Computation Computed tomography Contingency Diagnostic Radiology Diagnostic systems Edema Edema - diagnosis Edema - etiology Female Fractures Fractures, Compression - complications Fractures, Compression - diagnosis Humans Image acquisition Image quality Image reconstruction Imaging Internal Medicine Interventional Radiology Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - injuries Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical diagnosis Medical imaging Medicine Medicine & Public Health Middle Aged Musculoskeletal Neuroradiology NMR Nuclear magnetic resonance Patients Prospective Studies Radiology Readers Reproducibility of Results ROC Curve Sensitivity Sensitivity analysis Spinal Fractures - complications Spinal Fractures - diagnosis Spine Spine (lumbar) Surgery Tomography, X-Ray Computed - methods Ultrasound Vertebrae |
| title | Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: a prospective diagnostic accuracy study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T21%3A38%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Single-source%20dual-energy%20computed%20tomography%20for%20the%20assessment%20of%20bone%20marrow%20oedema%20in%20vertebral%20compression%20fractures:%20a%20prospective%20diagnostic%20accuracy%20study&rft.jtitle=European%20radiology&rft.au=Diekhoff,%20Torsten&rft.date=2019&rft.volume=29&rft.issue=1&rft.spage=31&rft.epage=39&rft.pages=31-39&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-018-5568-y&rft_dat=%3Cproquest_cross%3E2154962724%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2154962724&rft_id=info:pmid/29948088&rfr_iscdi=true |