Dual-Energy CT of Material Decomposition Analysis for Detection with Bone Marrow Edema in Patients with Vertebral Compression Fractures

Akisato, Kyouhei; Nishihara, Reisuke; Okazaki, H; Masuda, Takanori; Hironobe, Ayako; Ishizaki, Hiromi; Kondo, Shota; Yamaguchi, H.; Funama, Yoshinori

doi:10.1016/j.acra.2019.02.015

Cited by 25 publications

(20 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The strength of our study is pooling estimates of a larger number of studies (n = 17) and performing several subgroup analyses to explore pertinent factors that can optimize the diagnostic performance of DECT. Among the included studies, four techniques were available to obtain DECT images, as follows: (a) single-source consecutive scanning (33,34,39,44), (b) single-source fast kilovoltage switching (41,43), (c) dual-source DECT (29)(30)(31)(32)35,36,40,42,45), and (d) dual-layer DECT (37,38). Among these techniques, consecutive scanning has the advantage of high availability because of a more basic hardware requirement.…”

Section: Figurementioning

confidence: 99%

DECT in Detection of Vertebral Fracture–associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters

Sherbaf

Sair²,

Shakoor³

et al. 2021

Radiology

View full text Add to dashboard Cite

Background: Dual-energy CT (DECT) shows promising performance in detecting bone marrow edema (BME) associated with vertebral body fractures. However, the optimal technical and image interpretation parameters are not well described.Purpose: To conduct a systematic review and meta-analysis to determine the diagnostic performance of DECT in detecting BME associated with vertebral fractures (VFs), using different technical and image interpretation parameters, compared with MRI as the reference standard. Materials and Methods:A systematic literature search was performed on July 9, 2020, to identify studies evaluating DECT performance for in vivo detection of vertebral BME. A random-effects model was used to derive estimates of the diagnostic accuracy parameters of DECT. The impact of relevant covariates in technical, image interpretation, and study design parameters on the diagnostic performance of DECT was investigated using subgroup analyses.Results: Seventeen studies (with 742 of 2468 vertebrae with BME at MRI) met inclusion criteria. Pooled estimates of sensitivity, specificity, and area under the curve of DECT for vertebral body BME were 89% (95% CI: 84%, 92%), 96% (95% CI: 92%, 98%), and 96% (95% CI: 94%, 97%), respectively. Single-source consecutive scanning showed poor specificity (78%) compared with the dual-source technique (98%, P , .001). Specificity was higher using bone and soft-tissue kernels (98%) compared with using only soft-tissue kernels (90%, P = .001). Qualitative assessment had a better specificity (97%) versus quantitative assessment (90%) of DECT images (P = .01). Experienced readers showed considerably higher specificity (96%) compared with trainees (79%, P = .01). DECT sensitivity improved using a higher difference between low-and high-energy spectra (90% vs 83%, P = .04). Conclusion:Given its high specificity, the detection of vertebral bone marrow edema with dual-energy CT (DECT) associated with vertebral fracture may obviate confirmatory MRI in an emergency setting. Technical parameters, such as the dual-source technique, both bone and soft-tissue kernels, and qualitative assessment by experienced readers, can ensure the high specificity of DECT.

show abstract

Section: Figurementioning

confidence: 99%

DECT in Detection of Vertebral Fracture–associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters

Sherbaf

Sair²,

Shakoor³

et al. 2021

Radiology

View full text Add to dashboard Cite

show abstract

“…The utility of DECT in musculoskeletal imaging has been reported [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Although there are various applications of DECT, the detection of bone marrow oedema and bone contusion has recently been reported in the context of water-HAP images [ 7 , 24 ]. Water-HAP image is a reconstruction technique for visualising water density, but its reports are limited.…”

Section: Discussionmentioning

confidence: 99%

Improved Diagnostic Accuracy of Bone Metastasis Detection by Water-HAP Associated to Non-Contrast CT

et al. 2020

View full text Add to dashboard Cite

We examined whether water-hydroxyapatite (HAP) images improve the diagnostic accuracy of bone metastasis compared with non-contrast CT alone. We retrospectively evaluated dual-energy computed tomography (DECT) images of 83 cancer patients (bone metastasis, 31; without bone metastasis, 52) from May 2018 to June 2019. Initially, two evaluators examined for bone metastasis on conventional CT images. In the second session, both CT and CT images plus water-HAP images on DECT. The confidence of bone metastasis was scored from 1 (benign) to 5 (malignant). The sensitivity, specificity, positive predictive values, and negative predictive values for both modalities were calculated based on true positive and negative findings. The intra-observer area under curve (AUC) for detecting bone metastasis was compared by receiver operating characteristic analysis. Kappa coefficient calculated the inter-observer agreement. In conventional CT images, sensitivity, specificity, positive predictive value, and negative predictive value of raters 1 and 2 for the identification of bone metastases were 0.742 and 0.710, 0.981 and 0.981, 0.958 and 0.957, and 0.864 and 0.850, respectively. In water-HAP, they were 1.00 and 1.00, 0.981 and 1.00, 0.969 and 1.00, and 1.00 and 1.00, respectively. In CT, AUCs were 0.861 and 0.845 in each observer. On water-HAP images, AUCs were 0.990 and 1.00. Kappa coefficient was 0.964 for CT and 0.976 for water-HAP images. The combination of CT and water-HAP images significantly increased diagnostic accuracy for detecting bone metastasis. Water-HAP images on DECT may enable accurate initial staging, reduced radiation exposure, and cost.

show abstract

Section: Spine and Dentalmentioning

confidence: 99%

“…77 Additional studies published after this meta-analysis assessing edema in vertebral compression fractures with VNCa demonstrated very similar sensitivities (between 85% and 98%) and specificities (between 92% and 99%), with an area under the receiver-operating characteristic curve ranging from 0.88 to 0.97. [78][79][80][81] In addition to detecting marrow edema, VNCa color map overlay images have been found to have higher overall sensitivity and specificity (91% and 92%, respectively) than standard CT for detecting lumbar disk herniation, using MRI as a reference standard 82 (Figure 6). In patients with vertebral fractures, color overlay collagen maps created using three-material decomposition techniques were found to be both sensitive (0.85) and specific (0.75) for disk injuries, with sensitivity varying from 0.80 to 0.98 depending on severity of disk injury.…”

Section: Bone Marrow and Disk Assessmentmentioning

confidence: 99%

A Review of the Applications of Dual-Energy CT in Acute Neuroimaging

et al. 2020

View full text Add to dashboard Cite

Dual-energy computed tomography (CT) is a promising tool with increasing availability and multiple emerging and established clinical applications in neuroradiology. With its ability to allow characterization of materials based on their differential attenuation when imaged at two different energy levels, dual-energy CT can help identify the composition of brain, neck, and spinal components. Virtual monoenergetic imaging allows a range of simulated single energy-level reconstructions to be created with postprocessing. Low-energy reconstructions can aid identification of edema, ischemia, and subtle lesions due to increased soft tissue contrast as well as increasing contrast-to-noise ratios on angiographic imaging. Higher energy reconstructions can reduce image artifact from dental amalgam, aneurysm clips and coils, spinal hardware, dense contrast, and dense bones. Differentiating iodine from hemorrhage may help guide management of patients after thrombectomy and aid diagnosis of enhancing tumors within parenchymal hemorrhages. Iodine quantification may predict hematoma expansion in aneurysmal bleeds and outcomes in traumatic brain injury. Calcium and bone subtraction can be used to distinguish hemorrhage from brain parenchymal mineralization as well as improving visualization of extra-axial lesions and vessels adjacent to dense plaque or skull. This article reviews the basics of dual-energy CT and highlights many of its clinical applications in the evaluation of acute neurological presentations.

show abstract

Dual-Energy CT of Material Decomposition Analysis for Detection with Bone Marrow Edema in Patients with Vertebral Compression Fractures

Cited by 25 publications

References 22 publications

DECT in Detection of Vertebral Fracture–associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters

DECT in Detection of Vertebral Fracture–associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters

Improved Diagnostic Accuracy of Bone Metastasis Detection by Water-HAP Associated to Non-Contrast CT

A Review of the Applications of Dual-Energy CT in Acute Neuroimaging

Contact Info

Product

Resources

About