Christian Booz1, Jochen Nöske1, Lukas Lenga1, Simon S Martin1, Ibrahim Yel1, Katrin Eichler2, Tatjana Gruber-Rouh2, Nicole Huizinga3, Moritz H Albrecht1, Thomas J Vogl2, Julian L Wichmann4,5. 1. Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. 2. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany. 3. Interdisciplinary Center for Neuroscience, Goethe-University of Frankfurt, Frankfurt am Main, Germany. 4. Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. docwichmann@gmail.com. 5. Smart Reporting GmbH, Munich, Germany. docwichmann@gmail.com.
Abstract
OBJECTIVES: To evaluate the diagnostic accuracy of dual-energy computed tomography (CT) virtual non-calcium (VNCa) reconstructions for the depiction of traumatic knee bone marrow edema. METHODS: Fifty-seven patients (mean age, 50 years; range, 20-82 years) with acute knee trauma further divided into 30 women and 27 men, who had undergone third-generation dual-source dual-energy CT and 3-T magnetic resonance imaging (MRI) within 7 days between January 2017 and May 2018, were retrospectively analyzed. Six radiologists, blinded to clinical and MRI information, independently analyzed conventional grayscale dual-energy CT series for fractures; after 8 weeks, readers evaluated color-coded VNCa reconstructions for the presence of bone marrow edema in six femoral and six tibial regions. Quantitative analysis of CT numbers on VNCa reconstructions was performed by a seventh radiologist. Two additional radiologists, blinded to clinical and CT information, analyzed MRI series in consensus to define the reference standard. Sensitivity, specificity, and the area under the curve (AUC) were the primary metrics of diagnostic accuracy. RESULTS: MRI revealed 197 areas with bone marrow edema (91/342 femoral, 106/342 tibial). In the qualitative analysis, VNCa showed high overall sensitivity (1108/1182 [94%]) and specificity (2789/2922 [95%]) for depicting bone marrow edema. The AUC was 0.96 (femur) and 0.97 (tibia). A cutoff value of - 51 Hounsfield units (HU) provided high sensitivity (102/106 [96%]) and specificity (229/236 [97%]) for differentiating tibial bone marrow edema. CONCLUSIONS: In both quantitative and qualitative analyses, dual-energy CT VNCa reconstructions yielded excellent diagnostic accuracy for depicting traumatic knee bone marrow edema compared with MRI. KEY POINTS: • Dual-energy CT (DECT) virtual non-calcium (VNCa) reconstructions are highly accurate in depicting bone marrow edema of the femur and tibia. • Diagnostic confidence, image noise, and image quality were rated as equivalent in VNCa reconstructions and MRI (magnetic resonance imaging) series. • VNCa images may serve as an alternative imaging approach to MRI.
OBJECTIVES: To evaluate the diagnostic accuracy of dual-energy computed tomography (CT) virtual non-calcium (VNCa) reconstructions for the depiction of traumatic knee bone marrow edema. METHODS: Fifty-seven patients (mean age, 50 years; range, 20-82 years) with acute knee trauma further divided into 30 women and 27 men, who had undergone third-generation dual-source dual-energy CT and 3-T magnetic resonance imaging (MRI) within 7 days between January 2017 and May 2018, were retrospectively analyzed. Six radiologists, blinded to clinical and MRI information, independently analyzed conventional grayscale dual-energy CT series for fractures; after 8 weeks, readers evaluated color-coded VNCa reconstructions for the presence of bone marrow edema in six femoral and six tibial regions. Quantitative analysis of CT numbers on VNCa reconstructions was performed by a seventh radiologist. Two additional radiologists, blinded to clinical and CT information, analyzed MRI series in consensus to define the reference standard. Sensitivity, specificity, and the area under the curve (AUC) were the primary metrics of diagnostic accuracy. RESULTS: MRI revealed 197 areas with bone marrow edema (91/342 femoral, 106/342 tibial). In the qualitative analysis, VNCa showed high overall sensitivity (1108/1182 [94%]) and specificity (2789/2922 [95%]) for depicting bone marrow edema. The AUC was 0.96 (femur) and 0.97 (tibia). A cutoff value of - 51 Hounsfield units (HU) provided high sensitivity (102/106 [96%]) and specificity (229/236 [97%]) for differentiating tibial bone marrow edema. CONCLUSIONS: In both quantitative and qualitative analyses, dual-energy CT VNCa reconstructions yielded excellent diagnostic accuracy for depicting traumatic knee bone marrow edema compared with MRI. KEY POINTS: • Dual-energy CT (DECT) virtual non-calcium (VNCa) reconstructions are highly accurate in depicting bone marrow edema of the femur and tibia. • Diagnostic confidence, image noise, and image quality were rated as equivalent in VNCa reconstructions and MRI (magnetic resonance imaging) series. • VNCa images may serve as an alternative imaging approach to MRI.
Authors: Paul I Mallinson; Tyler M Coupal; Patrick D McLaughlin; Savvas Nicolaou; Peter L Munk; Hugue A Ouellette Journal: Radiology Date: 2016-12 Impact factor: 11.105
Authors: Moritz H Albrecht; Jesko Trommer; Julian L Wichmann; Jan-Erik Scholtz; Simon S Martin; Thomas Lehnert; Thomas J Vogl; Boris Bodelle Journal: Invest Radiol Date: 2016-09 Impact factor: 6.016
Authors: Patrice W J Vincken; Bert P M Ter Braak; Arian R van Erkel; Emile G Coerkamp; Walter M C Mallens; Johan L Bloem Journal: Eur Radiol Date: 2005-04-20 Impact factor: 5.315
Authors: Aleksander Kosmala; Andreas Max Weng; Anke Heidemeier; Bernhard Krauss; Stefan Knop; Thorsten Alexander Bley; Bernhard Petritsch Journal: Radiology Date: 2017-08-11 Impact factor: 11.105
Authors: Claudia Frellesen; Mehrnoush Azadegan; Simon S Martin; Katharina Otani; Tommaso DʼAngelo; Christian Booz; Katrin Eichler; Bita Panahi; Moritz Kaup; Ralf W Bauer; Thomas J Vogl; Julian L Wichmann Journal: Invest Radiol Date: 2018-07 Impact factor: 6.016
Authors: Giovanni Foti; William Mantovani; Niccolò Faccioli; Giacomo Crivellari; Luigi Romano; Claudio Zorzi; Giovanni Carbognin Journal: Radiol Med Date: 2020-08-25 Impact factor: 3.469
Authors: Tommaso D'Angelo; Moritz H Albrecht; Danilo Caudo; Silvio Mazziotti; Thomas J Vogl; Julian L Wichmann; Simon Martin; Ibrahim Yel; Giorgio Ascenti; Vitali Koch; Giuseppe Cicero; Alfredo Blandino; Christian Booz Journal: Eur Radiol Exp Date: 2021-09-03
Authors: Vitali Koch; Ibrahim Yel; Leon D Grünewald; Sebastian Beckers; Iris Burck; Lukas Lenga; Simon S Martin; Christoph Mader; Julian L Wichmann; Moritz H Albrecht; Katrin Eichler; Tatjana Gruber-Rouh; Tommaso D'Angelo; Silvio Mazziotti; Giorgio Ascenti; Thomas J Vogl; Christian Booz Journal: Eur Radiol Date: 2021-06-02 Impact factor: 5.315
Authors: Marco Cavallaro; Tommaso D'Angelo; Moritz H Albrecht; Ibrahim Yel; Simon S Martin; Julian L Wichmann; Lukas Lenga; Silvio Mazziotti; Alfredo Blandino; Giorgio Ascenti; Marcello Longo; Thomas J Vogl; Christian Booz Journal: Eur Radiol Date: 2021-07-02 Impact factor: 5.315