Case–control study to estimate the performance of dual-energy computed tomography for anterior cruciate ligament tears in patients with history of knee trauma

Abstract

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.

Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

“…Glazebrook et al published a case-control study of 16 ACL rupture patients wherein they demonstrated DECT to have high accuracy and interobserver agreement for the detection of complete ACL tears [6]. In contrast to our study, their patient materials were chronic and subacute knee trauma patients.…”

“…The main aim in this study was to determine whether a complete rupture of the cruciate ligament can be detected with DECT. In other studies, also partial ruptures were reported [5,6]. However, as most of the ACL ruptures are complete [12], our limited patient material did not allow such patient allocation to subgroups to make a reasonable statistical analysis.…”

“…Johnson et al published that DECT with material decomposition for collagen can clearly differentiate the tendons of the wrist [4]. In Glazebrook's study, the DECT tendon-specific color map images did not perform as well as the mixed kVor DECT bone removal series in the identification of the ACL [6]. In our study, two radiologists judged what were subjectively the best, second best and least usable protocol (GSI 40-140 keV, bone removal or collagen-specific color mapping) to evaluate the cruciate ligament and popliteus tendon.…”

“…There are only a few previously published studies on the utilization of DECT in the evaluation of soft tissue injuries of the knee [5][6][7]. Glazebrook et al published a case-control study of 16 ACL rupture patients wherein they demonstrated DECT to have high accuracy and interobserver agreement for the detection of complete ACL tears [6].…”

“…These advantages include a higher soft tissue resolution in monochromatic gemstone spectral imaging (GSI) images compared to conventional polychromatic MDCT images and the ability to create material-specific color mapping and dual-energy bone removal [3,4]. However, there are only a few previously published studies on the utilization of DECT in the evaluation of soft tissue injuries of the knee [5][6][7].…”