Achilles Tendinopathy and Partial Tear Diagnosis Using Dual-Energy Computed Tomography Collagen Material Decomposition Application

Mallinson, Paul I.; Stevens, Christopher J; Reisinger, Clemens; Nicolaou, Savvas; Munk, Peter L.; Ouellette, Hugue A.

doi:10.1097/rct.0b013e318287efa0

Cited by 28 publications

(9 citation statements)

References 13 publications

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“…Tendinopathy also has been diagnosed in the Achilles tendon. 33 Similar positive results have been reported in large ligamentous structures, such as the anterior cruciate ligament, and initial case reports also show positive results in the diagnosis of complete tears of small ligamentous structures in the extremities, such as plantar plate injury of the foot. 34 In an animal study, Fickert and colleagues 35 compared the diagnostic accuracy of DECT and MR imaging in the detection of arthroscopically induced total and partial tears of the anterior cruciate ligament (ACL) in 20 porcine hind legs.…”

Section: Tendons and Ligamentssupporting

confidence: 51%

Dual-Energy Computed Tomography

McLaughlin

Mallinson

Lourenco

et al. 2015

Radiologic Clinics of North America

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Section: Tendons and Ligamentssupporting

confidence: 51%

Dual-Energy Computed Tomography

McLaughlin

Mallinson

Lourenco

et al. 2015

Radiologic Clinics of North America

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“…Peltola et al reported high SE (79%) and SP (100%) when using it to detect anterior cruciate ligament tears [27]. Mallinson et al diagnosed Achilles tendinopathy with a technique similar to the one we used [12]. Kumar et al detected and quantified myocardial fibrosis [20].…”

Section: Discussionmentioning

confidence: 99%

“…Special postprocessing tools allow detection of bone marrow edema using the so-called virtual non-calcium technique [11]. When a three-material decomposition algorithm is applied, DECT also allows visualization of collagenous structures such as tendons and ligaments [12, 13]. In this study, we applied this technique to the vertebral disk.…”

Section: Introductionmentioning

confidence: 99%

Disk injury in patients with vertebral fractures—a prospective diagnostic accuracy study using dual-energy computed tomography

et al. 2019

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Objectives Using magnetic resonance imaging (MRI) as the standard of reference, we aimed to evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) in assessing disk injuries in patients aged more than 50 years with vertebral fractures. Methods This prospective study was approved by the local ethics committee (EA1/372/14), and all patients gave written informed consent. Patients with suspected fractures underwent spinal DECTs and MRIs. Three readers scored DECT collagen maps for the presence or absence of disk injuries and also scored MR images according to the Sander classification (0–3). Only disks at risk (target disks) were included in the analysis. Sensitivity and specificity were calculated. Fleiss’s κ was used to evaluate interrater agreement. Attenuation, in Hounsfield units, was compared between affected and unaffected disks in DECT. Results Analyzing 295 disks in 67 patients, DECT was both sensitive (0.85) and specific (0.75). Sensitivity varied with the severity of disk damage, as assessed using the Sander scale (grade 1, 0.80; 2, 0.85; and 3, 0.98). Fleiss’s κ was 0.41 for MRI and 0.51 for DECT. In the DECT collagen maps, attenuation was lower in injured disks compared to that in normal disks (80.3 ± 35.2 vs. 97.9 ± 41.0, p < 0.001). Conclusions Compared to conventional CT, DECT collagen maps can yield more diagnostic information, allowing identification of disk injuries in elderly patients with vertebral fractures. Key Points • Dual-energy computed tomography allows vertebral disk injuries to be detected in elderly patients with vertebral fractures. • Dual-energy computed tomography yields more diagnostic information about vertebral disks compared to conventional CT. • Dual-energy computed tomography can be used as an alternative imaging modality for patients unwilling or unable to undergo MRI. Electronic supplementary material The online version of this article (10.1007/s00330-018-5963-4) contains supplementary material, which is available to authorized users.

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“…8,37 The disruption of larger collagen-based structures such as the triceps tendon and cruciate ligaments was demonstrated. 38,39 In theory, if the collagen algorithm is optimized, even partial tears, which are also difficult to identify on MRI, could become more conspicuous.…”

Section: Collagen Imagesmentioning

confidence: 99%

Top-Ten Tips for Dual-Energy CT in MSK Radiology

Walstra

Hickle

Duggan

et al. 2019

Semin Musculoskelet Radiol

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Dual-energy computed tomography (DECT) has the potential to detect musculoskeletal pathology with greater sensitivity than conventional CT alone at no additional radiation dose to the patient. It therefore has the potential to reduce the need for further diagnostic imaging or procedures (e.g., joint aspirations in the case of gout or magnetic resonance imaging to confirm undisplaced fractures).DECT is a well-established technique for the detection of gout arthropathy. Multiple newer applications have shown clinical potential including bone marrow edema detection and metal artifact reduction. Collagen analysis, bone marrow lesion detection, and iodine mapping in CT arthrography are areas of possible future application and development.This article outlines 10 tips on the use of DECT imaging of the musculoskeletal system, explaining the technique and indications with practical suggestions to help guide the radiologist.

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Achilles Tendinopathy and Partial Tear Diagnosis Using Dual-Energy Computed Tomography Collagen Material Decomposition Application

Cited by 28 publications

References 13 publications

Dual-Energy Computed Tomography

Dual-Energy Computed Tomography

Disk injury in patients with vertebral fractures—a prospective diagnostic accuracy study using dual-energy computed tomography

Top-Ten Tips for Dual-Energy CT in MSK Radiology

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