TY  - JOUR
A1  - Koch, Vitali
A1  - Albrecht, Moritz Hans Ernst
A1  - Grünewald, Leon David
A1  - Yel, Ibrahim
A1  - Eichler, Katrin
A1  - Gruber-Rouh, Tatjana
A1  - Hammerstingl, Renate Maria
A1  - Burck, Iris
A1  - Wichmann, Julian
A1  - Alizadeh, Leona Soraja
A1  - Vogl, Thomas J.
A1  - Lenga, Lukas
A1  - Mader, Christoph
A1  - Martin, Simon
A1  - Mazziotti, Silvio
A1  - D’Angelo, Tommaso
A1  - Booz, Christian
T1  - Diagnostic accuracy of color-coded virtual noncalcium reconstructions derived from portal venous phase dual-energy CT in the assessment of lumbar disk herniation
T2  - European radiology
N2  - Objectives: To investigate the diagnostic accuracy of color-coded contrast-enhanced dual-energy CT virtual noncalcium (VNCa) reconstructions for the assessment of lumbar disk herniation compared to unenhanced VNCa imaging.
Methods: A total of 91 patients were retrospectively evaluated (65 years ± 16; 43 women) who had undergone third-generation dual-source dual-energy CT and 3.0-T MRI within an examination interval up to 3 weeks between November 2019 and December 2020. Eight weeks after assessing unenhanced color-coded VNCa reconstructions for the presence and degree of lumbar disk herniation, corresponding contrast-enhanced portal venous phase color-coded VNCa reconstructions were independently analyzed by the same five radiologists. MRI series were additionally analyzed by one highly experienced musculoskeletal radiologist and served as reference standard.
Results: MRI depicted 210 herniated lumbar disks in 91 patients. VNCa reconstructions derived from contrast-enhanced CT scans showed similar high overall sensitivity (93% vs 95%), specificity (94% vs 95%), and accuracy (94% vs 95%) for the assessment of lumbar disk herniation compared to unenhanced VNCa images (all p > .05). Interrater agreement in VNCa imaging was excellent for both, unenhanced and contrast-enhanced CT (κ = 0.84 vs κ = 0.86; p > .05). Moreover, ratings for diagnostic confidence, image quality, and noise differed not significantly between unenhanced and contrast-enhanced VNCa series (all p > .05).
Conclusions: Color-coded VNCa reconstructions derived from contrast-enhanced dual-energy CT yield similar diagnostic accuracy for the depiction of lumbar disk herniation compared to unenhanced VNCa imaging and therefore may improve opportunistic retrospective lumbar disk herniation assessment, particularly in case of staging CT examinations.
Key Points
• Color-coded dual-source dual-energy CT virtual noncalcium (VNCa) reconstructions derived from portal venous phase yield similar high diagnostic accuracy for the assessment of lumbar disk herniation compared to unenhanced VNCa CT series (94% vs 95%) with MRI serving as a standard of reference.
• Diagnostic confidence, image quality, and noise levels differ not significantly between unenhanced and contrast-enhanced portal venous phase VNCa dual-energy CT series.
• Dual-source dual-energy CT might have the potential to improve opportunistic retrospective lumbar disk herniation assessment in CT examinations performed for other indications through reconstruction of VNCa images.
KW  - Herniated disk
KW  - Computed tomography, X-ray
KW  - Spine
KW  - Contrast agent
KW  - Virtual noncalcium reconstructions
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69613
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-696138
SN  - 1432-1084
SN  - 1613-3757
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 32
IS  - 4
SP  - 2168
EP  - 2177
PB  - Springer
CY  - Berlin ; Heidelberg
ER  -