Assessment of thoracic disk herniation by using virtual noncalcium dual-energy CT in comparison with standard grayscale CT

  • Objectives: To determine the diagnostic accuracy of dual-energy CT (DECT) virtual noncalcium (VNCa) reconstructions for assessing thoracic disk herniation compared to standard grayscale CT. Methods: In this retrospective study, 87 patients (1131 intervertebral disks; mean age, 66 years; 47 women) who underwent third-generation dual-source DECT and 3.0-T MRI within 3 weeks between November 2016 and April 2020 were included. Five blinded radiologists analyzed standard DECT and color-coded VNCa images after a time interval of 8 weeks for the presence and degree of thoracic disk herniation and spinal nerve root impingement. Consensus reading of independently evaluated MRI series served as the reference standard, assessed by two separate experienced readers. Additionally, image ratings were carried out by using 5-point Likert scales. Results: MRI revealed a total of 133 herniated thoracic disks. Color-coded VNCa images yielded higher overall sensitivity (624/665 [94%; 95% CI, 0.89–0.96] vs 485/665 [73%; 95% CI, 0.67–0.80]), specificity (4775/4990 [96%; 95% CI, 0.90–0.98] vs 4066/4990 [82%; 95% CI, 0.79–0.84]), and accuracy (5399/5655 [96%; 95% CI, 0.93–0.98] vs 4551/5655 [81%; 95% CI, 0.74–0.86]) for the assessment of thoracic disk herniation compared to standard CT (all p < .001). Interrater agreement was excellent for VNCa and fair for standard CT (ϰ = 0.82 vs 0.37; p < .001). In addition, VNCa imaging achieved higher scores regarding diagnostic confidence, image quality, and noise compared to standard CT (all p < .001). Conclusions: Color-coded VNCa imaging yielded substantially higher diagnostic accuracy and confidence for assessing thoracic disk herniation compared to standard CT.
Author:Vitali KochORCiDGND, Ibrahim YelORCiDGND, Leon David GrünewaldORCiDGND, Sebastian Beckers, Iris BurckORCiDGND, Lukas Fabian LengaORCiDGND, Simon S. MartinORCiDGND, Christoph MaderORCiDGND, Julian WichmannORCiDGND, Moritz Hans Ernst AlbrechtORCiDGND, Katrin EichlerGND, Tatjana Gruber-RouhORCiDGND, Tommaso D’AngeloORCiD, Silvio MazziottiORCiD, Giorgio Ascenti, Thomas J. VoglORCiDGND, Christian BoozORCiDGND
Parent Title (English):European radiology
Place of publication:Berlin ; Heidelberg
Document Type:Article
Date of Publication (online):2021/06/02
Date of first Publication:2021/06/02
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/07/12
Tag:Image processing; Intervertebral disc displacement; Spine; Tomography; X-ray computed; computer-assisted
Page Number:11
First Page:9221
Last Page:9231
Open Access funding enabled and organized by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0