Giovanni Foti1, Niccolò Faccioli2, Ronaldo Silva3, Eugenio Oliboni4, Claudio Zorzi5, Giovanni Carbognin4. 1. Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, Italy. gfoti81@yahoo.it. 2. Department of Radiology, Verona University Hospital, Verona, Italy. 3. Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy. 4. Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 10, 37024, Negrar, Italy. 5. Department of Orthopedic Surgery, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy.
Abstract
OBJECTIVES: To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) in identifying bone marrow edema (BME) around the hip joint in non-traumatic patients. METHODS: This prospective IRB-approved study was conducted between January 2019 and October 2019 and included 59 consecutive patients (18 males, 41 females; mean age 61.5 years, range 32-82) who were assessed by DECT and magnetic resonance imaging (MRI) within a 5-day period. Diagnostic accuracy values for diagnosing BME on a per-patient and on a per-partition-basis analysis were calculated for DECT images by two readers (R1 and R2, with 15 and 10 years of experience, respectively), using MRI as reference for diagnosis. Inter-observer agreements were calculated with k-statistics. A p value of < 0.05 was considered as statistically significant. RESULTS: MRI depicted BME in 44/59 patients (74.58%), with the involvement of 83/708 (11.72%) partitions. The sensitivity, specificity, and accuracy of R1 and R2 were 95.45% (42/44), 86.67% (13/15), and 93.22% (55/59) for R1, and 86.36% (38/44), 80.00% (12/15), and 84.75% (50/59) for R2. For both readers, the BME detection rate was higher in patients with severe edema (100%) in comparison to patients with mild edema (91.30% and 73.91%). In the partition-basis analysis, sensitivity, specificity, and accuracy ranges were 33.3 to 100%, 91.84 to 100%, and 88.14 to 100%, respectively. The inter-observer agreement for patients' analysis was substantial (k = 0.7065), whereas for partition analysis ranged from fair (k = 0.2976) to near-perfect (k = 1.000). CONCLUSION: DECT can accurately identify BME around the hip joint, in comparison to MRI. KEY POINTS: • DECT can accurately identify bone marrow edema around the hip joint in a cohort of non-traumatic patients. • The detection of bone marrow edema by means of DECT may help the radiologist to identify associated findings, including avascular necrosis of the femoral head and insufficiency or stress fractures. • In cases of patients suffering from groin pain with bone marrow edema identified by DECT, the concurrent reading of high-resolution conventional CT images may increase the confidence of diagnosis and/or reduce the reading time.
OBJECTIVES: To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) in identifying bone marrow edema (BME) around the hip joint in non-traumaticpatients. METHODS: This prospective IRB-approved study was conducted between January 2019 and October 2019 and included 59 consecutive patients (18 males, 41 females; mean age 61.5 years, range 32-82) who were assessed by DECT and magnetic resonance imaging (MRI) within a 5-day period. Diagnostic accuracy values for diagnosing BME on a per-patient and on a per-partition-basis analysis were calculated for DECT images by two readers (R1 and R2, with 15 and 10 years of experience, respectively), using MRI as reference for diagnosis. Inter-observer agreements were calculated with k-statistics. A p value of < 0.05 was considered as statistically significant. RESULTS: MRI depicted BME in 44/59 patients (74.58%), with the involvement of 83/708 (11.72%) partitions. The sensitivity, specificity, and accuracy of R1 and R2 were 95.45% (42/44), 86.67% (13/15), and 93.22% (55/59) for R1, and 86.36% (38/44), 80.00% (12/15), and 84.75% (50/59) for R2. For both readers, the BME detection rate was higher in patients with severe edema (100%) in comparison to patients with mild edema (91.30% and 73.91%). In the partition-basis analysis, sensitivity, specificity, and accuracy ranges were 33.3 to 100%, 91.84 to 100%, and 88.14 to 100%, respectively. The inter-observer agreement for patients' analysis was substantial (k = 0.7065), whereas for partition analysis ranged from fair (k = 0.2976) to near-perfect (k = 1.000). CONCLUSION: DECT can accurately identify BME around the hip joint, in comparison to MRI. KEY POINTS: • DECT can accurately identify bone marrow edema around the hip joint in a cohort of non-traumaticpatients. • The detection of bone marrow edema by means of DECT may help the radiologist to identify associated findings, including avascular necrosis of the femoral head and insufficiency or stress fractures. • In cases of patients suffering from groin pain with bone marrow edema identified by DECT, the concurrent reading of high-resolution conventional CT images may increase the confidence of diagnosis and/or reduce the reading time.
Entities:
Keywords:
Bone marrow; Hip joint; Magnetic resonance imaging; Multidetector computed tomography
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