Fast kilovoltage (KV)-switching dual-energy CT virtual noncalcium technique using different reconstruction kernels for identifying acute and chronic vertebral compression fractures

Yan, Luyou; Zhong, Zhiheng; Gao, Hui; He, Yewen; Li, Ping; Shen, Haowei; Zhou, Shuwei; Guo, Ying; Liao, Liangying; Zhang, Kun

doi:10.1007/s11657-021-00948-z

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Additional research [25,26] indicated that DECT showed relatively high sensitivity (88.6%) and specificity (100%) in the diagnosis of osteoporotic vertebral compression fractures. It also demonstrated 81.8% sensitivity and 94.6% specificity in detecting subtle fractures and bone marrow edema in knee joints.…”

Section: Discussionmentioning

confidence: 99%

Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis – a highly sensitive and specific technique: An observational study

Chen,

Guo,

Zhao

et al. 2024

Medicine

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With the aging of the population in our society, osteoporosis (OP) has become one of the chronic diseases that seriously threaten the physical health of the elderly, leading to a heavy burden on healthcare. In recent years, with the continuous development of dual-energy CT (DECT) technology, quantitative measurements of DECT parameters, which is highly sensitive to OP, provides accurate results, is convenient and cost-effective, and is expected to be widely used in bone density testing. This study was aimed to explore the value of quantitative measurements of DECT parameters in diagnosing OP, in order to better guide clinical judgments and treatment. A total of 187 patients who underwent dual-energy X-ray and DECT examinations at Tianjin hospital between January 2022 and June 2023 were included as participants in this study. The bone mineral density (BMD) values of the lumbar spine (L1–L4) were determined using dual-energy X-ray absorptiometry. Simultaneously, CT scans of the lumbar spine (L1–L4) were conducted to measure the CT values of contrast media (CM), mixed-energy image CT values (regular CT value [rCT]), calcium concentration (CaD), as well as fat fraction (FF). Pearson correlation analysis was used to examine the relationship between the quantitative measurements of L1 to L4 vertebral bodies obtained from DECT and BMD. The values of CM, rCT, and CaD in the OP group were all lower than those in the non-OP group with statistical significance (P < .001). Conversely, the fat fraction parameter value in the OP group was significantly higher in contrast with the non-OP group (P = .004); there was a positive correlation between CM, rCT, CaD, and BMD values (R = 0.579, P < .001; R = 0.604, P < .001; R = 0.563, P < .001); CM, rCT, and CaD had high diagnostic value for OP, as evidenced by AUCs of 0.935 (95% CI: 0.900–0.971), 0.956 (95% CI: 0.925–0.987), and 0.926 (95% CI: 0.858–0.954), respectively, all with P values < .001. Quantitative measurement of DECT parameters showed a high sensitivity as well as a high specificity in the diagnosis of OP. It is also highly feasible and holds significant clinical diagnostic value, making it a suitable candidate for widespread application.

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Section: Discussionmentioning

confidence: 99%

Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis – a highly sensitive and specific technique: An observational study

Chen,

Guo,

Zhao

et al. 2024

Medicine

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“…Moreover, the results suggested that we should focus on the changes in HUs to exclude occult fractures in consideration of the high frequency of this phenomenon in Genant grade 0 VCFs. Yan et alfound that the quantitative analysis with the virtual noncalcium technique based on dual-energy CT performed well in identifying acute and old VCFs [ 3 ]. Our highest AUC is close to that of their study (0.839 vs. 0.851), indicating the need to improve the measurement method.…”

Section: Discussionmentioning

confidence: 99%

“…As the incidences of osteoporosis and traumatic accidents have increased, vertebral compression fractures (VCFs) have become a common disease in the daily diagnostic work of radiologists, imposing a substantial burden on society [ 1 , 2 ]. A fast and convenient method is necessary to distinguish incidental acute vertebral fracture from old fractures, as this would aid in treatment decision making-and the reduction of later complications [ 3 ]. Magnetic resonance imaging (MRI) is currently the gold standard for identifying acute and old fractures and can help diagnose specific types of fractures, such as occult VCFs.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and confounding factors of CT attenuation value differences in distinguishing acute and old vertebral compression fractures: a retrospective study

Liu

Wang

Zhao

et al. 2023

BMC Musculoskelet Disord

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Purpose To evaluate the influence of various factors on CT attenuation values (HUs) of acute and old fracture vertebra, and to determine the efficacy of HU differences (△HUs) in the differentiation of the two type of fractures. Materials and Methods A total of 113 acute and 71 old fracture vertebrae confirmed by MRI were included. Four HUs measured at the mid-sagittal, upper 1/3 axial, mid-axial, and lower 1/3 axial planes of each vertebra were obtained. The △HUs between fracture vertebra and its control counterpart was calculated. Receiver operating characteristic (ROC) curve analysis was used and the areas under the ROC curve (AUC) were calculated to evaluate the efficacy of HUs and △HUs. To evaluate the effect of height reduction, region, age and gender on HUs and △HUs, one-way analysis of variance, Pearson correlation analysis and t-test were used. Results The HUs and △HUs at the upper 1/3 axial plane achieved the highest AUCs of 0.801 and 0.839, respectively. The HUs decreased gradually from Thoracic to Lumbar in control group of acute fracture. While no significant differences were found in the HUs among the 3 localizations in both fracture groups (all P > 0.05). The HUs were negatively correlated with age in all groups. The HUs of male were significantly higher than female patients in all groups (all P < 0.05). While △HU was not significantly different between males and females (all P > 0.05). Conclusion The vertebral HUs at the upper 1/3 axial plane are more likely to identify acute fractures. △HUs were beneficial in eliminating interfering factors.

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AI-based prediction models for non-recognizable thoracolumbar compression fractures by X-ray inspection

Long

Cui

Liu

2023

Preprint

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Objective:The study evaluated the application value of an artificial intelligence-based classification model of vertebral fractures in lumbar X-ray images. Methods: Patients who received lateral lumbar radiographs and MRI in our unit from 2021 to 2022 were retrospectively selected. According to the MRI results, the included vertebrae were divided into three categories: fresh fracture, cold fracture, and normal vertebrae. A ResNet-18 classification model was constructed using delineated ROIs on the MRI images and the performance of the model was evaluated. Results: A total of 662 vertebrae from 272 patients were included in the study. The vertebrae were randomly divided into a training set (N=529) and an independent validation set (N=133). The performance of the model in discerning normal vertebrae, recent fractures, and chronic fractures was evaluated, showing accuracies of 0.91%, 0.42%, and 0.75%, respectively. The sensitivity measurements for these categories were 0.91%, 0.408%, and 0.72%, while the specificities were 0.796%, 0.892%, and 0.796%, respectively. Conclusion: This study demonstrated the feasibility of applying artificial intelligence to develop a tripartite classification model for lumbar X-ray images; however, additional refinements are required to enhance its efficacy..

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Fast kilovoltage (KV)-switching dual-energy CT virtual noncalcium technique using different reconstruction kernels for identifying acute and chronic vertebral compression fractures

Cited by 3 publications

References 30 publications

Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis – a highly sensitive and specific technique: An observational study

Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis – a highly sensitive and specific technique: An observational study

Efficacy and confounding factors of CT attenuation value differences in distinguishing acute and old vertebral compression fractures: a retrospective study

AI-based prediction models for non-recognizable thoracolumbar compression fractures by X-ray inspection

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