Imaging the Spine with Dual-Energy CT

Murray, Nicolas; Le, Megan; Ebrahimzadeh, Omid; Alharthy, Ahmed; Mohammed, Mohammed F.; Ouellette, Hugue A.; Khosa, Faisal

doi:10.1007/s40134-017-0236-6

Cited by 11 publications

(3 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mallinson and colleagues noted that a collagen postprocessing algorithm “[could] be used to enhance clarity of disc against the subtle grey scale of the adjacent thecal sac.” 31 Murray and colleagues used a collagen postprocessing algorithm to improve diagnostic suspicion of one case each of Schmorl node, disc extrusion, and disc dehydration of degenerative disc disease. 32 Another group applied a DECT collagen algorithm retrospectively to 13 patients and found DECT collagen had better interrater agreement than with standard CT for disc displacement, although no significant difference in sensitivity or specificity in the small cohort. 23 In a retrospective study, DECT differentiated vertebral metastases and Schmorl nodes, albeit using a water and bone based, rather than collagen based, material decomposition.…”

Section: Discussionmentioning

confidence: 99%

Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography

et al. 2022

Self Cite

View full text Add to dashboard Cite

Purpose: To assess value of dual energy computed tomography (DECT) collagen material decomposition algorithm when combined with standard computed tomography (CT) in detection of lumbar disc extrusion and sequestration. Materials and Methods: Retrospective analysis of all patients with acute low back pain who had a diagnosis of lumbar spine disc extrusion and/or sequestration on Magnetic Resonance Imaging (MRI) (reference standard), and had undergone non-contrast DECT of the lumbar spine within 60 days of the MRI. Age and sex-matched control patients (n = 42) were included. Patients were grouped into standard, grey-scale CT only group and standard CT + DECT tendon images group. Two double-blinded radiologists reviewed both groups for presence of extrusion or sequestration. They also rated their diagnostic confidence on Likert 5-point scale. McNemar Chi-square test was used to compare diagnostic accuracy, unpaired t-test to compare reviewers diagnostic confidence, and Cohen’s k (kappa) test for interobserver agreement. Results: The combined group showed higher overall sensitivity (96.6% vs 87.2%), specificity (99% vs 95.4%), and diagnostic accuracy (98.7% vs 94.5%) with a lower false positive rate (1.1% vs 4.6%). McNemar Chi-square test confirmed statistical significance ( P = .03 and P = .02 for Reviewers R1 and R2, respectively). The mean diagnostic confidence was also significantly higher on combined group (R1: 3.74 ± 1.1 vs 3.47 ± 1.15 ( P < .01) and R2: 3.91 ± 1.15 vs 3.72 ± 1.16 [mean ± SD] ( P = .02)). Conclusion: Utilizing MRI as a reference standard, DECT tendon application combined with standard CT increases the sensitivity, specificity, and accuracy of detection of lumbar spine disc extrusion and sequestration, when compared to standard CT alone.

show abstract

Section: Discussionmentioning

confidence: 99%

Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…For a correct diagnosis of an AARD, clinical and radiographic evaluation are essential. The possibility of having Dual Energy TC available today allows you to have well-detailed images of the occipito-cervical tract, with limited exposure to ionizing radiation (7,9,14). MRI will however be irreplaceable for the differential diagnosis for non-traumatic situations (13,15,20,21) We reached the diagnosis that led us to the correct treatment after 4 days from the emergency access of the child.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of a medulloblastoma mimicking an AARS (Atlanto axial rotatory subluxation). A case report.

Greggi¹,

Boriani²,

Scarale³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Atlanto-Axial Rotatory Subluxation is an acquired condition, usually occurring in pediatric patients, because of either trauma or pharyngitis or ear-nose-throat ( ENT) surgery or upper respiratory tract infection. Post-traumatic C1-C2 rotational subluxation in pediatric age is a very frequent event. It mimics benign torticollis but may result in permanent disability. The atlanto-axial rotatory displacement, as defined initially by Fielding and Hawkins in 1977, is classified into four types: Type 1 is the most common form in children. It is a simple rotatory displacement without an anterior shift. Type 2 is potentially more dangerous. It is a rotatory displacement with an anterior shift of 5 mm or less. Type 3 is rotatory displacement with an anterior shift greater than 5 mm. Finally, type 4 is rotatory displacement with a posterior shift. Type 3 and 4 deformities are rare, but neurological involvement or even instant death may follow [Fig. 4] (18). The condition requires prompt diagnosis by thorough examination to avoid any treatment delays. The difficulties for a timely and correct diagnosis and then the correct treatment are described. Case presentation: A 5 year old girl comes to the emergency room with cervical pain and stiffness.This painful state, as mum reports, has been lasted for about ten days, after a mild trauma. The radiographic picture demonstrates a rotary subluxation C1-C2, type 1 according to Fielding and Hawkins classificationThe treatment is head-halter traction with 2kg, and nonsteroidal anti-inflammatory drugs (NSAIDs) . After 2 days the x-ray picture improves, but the painful symptoms persist. An in-depth diagnostic MRI of the cervical spine and brain revealed a medulloblastoma which made an immediate and effective neurosurgical intervention necessary. Conclusions: the C1-C2 rotatory dislocation must always be evaluated with extreme care, without neglecting any clinical and anamnestic information for a correct and timely differential diagnosis. Remember that children show very clearly what they feel, always .

show abstract

“…Collagen maps can improve visualization and characterization of tendons in the hand and foot and some ligaments of the knee (127). It is an alternative technique for evaluation of disk degeneration, bulge, and herniation, seen as loss of disk attenuation (128).…”

Section: Calcium Decomposition Algorithms-calcium-mentioning

confidence: 99%

Update on Multienergy CT: Physics, Principles, and Applications

et al. 2020

View full text Add to dashboard Cite

Multienergy CT involves acquisition of two or more CT measurements with distinct energy spectra. Using the differential attenuation of tissues and materials at different x-ray energies, multienergy CT allows distinction of tissues and materials beyond that possible with conventional CT. Multienergy CT technologies can operate at the source or detector level. Dual-source, rapid tube-voltage switching, and dual-layer detector CT are the most commonly used multienergy CT technologies. Most of the currently available technologies typically use two energy levels, commonly referred to as dual-energy CT. With use of two or more energy bins, photoncounting detector CT can perform multienergy CT beyond current dual-energy CT technologies. Multienergy CT postprocessing can be performed in the projection or image domain using two-material or multimaterial decomposition. The most commonly used multienergy CT images are virtual monoenergetic images (VMIs), iodine maps, virtual noncontrast (VNC) images, and uric acid images. Low-energy VMIs are used to boost contrast signal and enhance lesion conspicuity. High-energy VMIs are used to decrease some artifacts. Iodine maps are used to evaluate perfusion, characterize lesions, and evaluate response to therapy. VNC images are used to characterize lesions and save radiation dose by eliminating true noncontrast images from multiphasic acquisitions. Uric acid images are used for characterization of renal calculi and gout.

show abstract

Imaging the Spine with Dual-Energy CT

Cited by 11 publications

References 63 publications

Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography

Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography

Unusual presentation of a medulloblastoma mimicking an AARS (Atlanto axial rotatory subluxation). A case report.

Update on Multienergy CT: Physics, Principles, and Applications

Contact Info

Product

Resources

About