Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

Frank Oliver Henes; Michael Groth; Harald Kramer; Christian Schäfer; Marc Regier; Thorsten Derlin; Gerhard Adam; Peter Bannas

doi:10.1016/j.ejrad.2013.09.015

Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

Standard

Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT. / Henes, Frank Oliver; Groth, Michael; Kramer, Harald; Schäfer, Christian; Regier, Marc; Derlin, Thorsten; Adam, Gerhard ; Bannas, Peter.

in: EUR J RADIOL, Jahrgang 83, Nr. 1, 01.01.2014, S. 167-72.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Henes, FO, Groth, M, Kramer, H, Schäfer, C, Regier, M, Derlin, T, Adam, G & Bannas, P 2014, 'Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT', EUR J RADIOL, Jg. 83, Nr. 1, S. 167-72. https://doi.org/10.1016/j.ejrad.2013.09.015

APA

Henes, F. O., Groth, M., Kramer, H., Schäfer, C., Regier, M., Derlin, T., Adam, G., & Bannas, P. (2014). Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT. EUR J RADIOL, 83(1), 167-72. https://doi.org/10.1016/j.ejrad.2013.09.015

Vancouver

Henes FO, Groth M, Kramer H, Schäfer C, Regier M, Derlin T et al. Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT. EUR J RADIOL. 2014 Jan 1;83(1):167-72. https://doi.org/10.1016/j.ejrad.2013.09.015

Bibtex

@article{907c4dfeacb64986962b1de0a80692ff,

title = "Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT",

abstract = "OBJECTIVES: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures.METHODS: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland-Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT.RESULTS: HU measurements demonstrated a high interrater reliability (ICC=0.984). ROC curve analysis (AUC=0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone.CONCLUSIONS: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary.",

author = "Henes, {Frank Oliver} and Michael Groth and Harald Kramer and Christian Sch{\"a}fer and Marc Regier and Thorsten Derlin and Gerhard Adam and Peter Bannas",

year = "2014",

month = jan,

day = "1",

doi = "10.1016/j.ejrad.2013.09.015",

language = "English",

volume = "83",

pages = "167--72",

journal = "EUR J RADIOL",

issn = "0720-048X",

publisher = "Elsevier",

number = "1",

}

RIS

TY - JOUR

T1 - Detection of occult vertebral fractures by quantitative assessment of bone marrow attenuation values at MDCT

AU - Henes, Frank Oliver

AU - Groth, Michael

AU - Kramer, Harald

AU - Schäfer, Christian

AU - Regier, Marc

AU - Derlin, Thorsten

AU - Adam, Gerhard

AU - Bannas, Peter

PY - 2014/1/1

Y1 - 2014/1/1

N2 - OBJECTIVES: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures.METHODS: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland-Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT.RESULTS: HU measurements demonstrated a high interrater reliability (ICC=0.984). ROC curve analysis (AUC=0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone.CONCLUSIONS: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary.

AB - OBJECTIVES: To determine a cut-off value of Hounsfield attenuation units (HU) at multidetector computed tomography (MDCT) for valid and reliable detection of bone marrow oedema (BME) related to occult vertebral fractures.METHODS: 36 patients underwent both MDCT and Magnetic Resonance Imaging (MRI) for evaluation of vertebral fractures of the thoracolumbar spine and were included in this retrospective study. Two readers independently assessed HU values at MDCT in a total of 196 vertebrae. Reliability was assessed by intraclass correlation coefficient and Bland-Altman analysis. For each patient we determined the vertebra with the lowest HU value and calculated the HU-difference to each other vertebral body. HU-differences were subjected to receiver operating characteristic (ROC) curve analysis to determine the diagnostic accuracy for detection of BME as determined by MRI, which served as the reference standard. Results of HU-measurements were compared with standard visual evaluation of MDCT.RESULTS: HU measurements demonstrated a high interrater reliability (ICC=0.984). ROC curve analysis (AUC=0.978) exhibited an ideal cut-off value of 29.6 HU for detection of BME associated with vertebral fractures with an accuracy of 97.4% as compared to 93.4% accuracy of visual evaluation. Particularly, HU-measurements increased the sensitivity for detection of vertebral fractures from 78.0% to 92.7% due to the detection of 7 of 9 occult fractures that were missed by visual evaluation alone.CONCLUSIONS: Assessing bone marrow density by HU measurements using the cut-off of 29.6 HU is a valid and reliable tool for detection of BME related to occult vertebral fractures in MDCT. The introduced technique may allow more accurate treatment decisions and may make further diagnostic work-up with MRI unnecessary.

U2 - 10.1016/j.ejrad.2013.09.015

DO - 10.1016/j.ejrad.2013.09.015

M3 - SCORING: Journal article

C2 - 24144447

VL - 83

SP - 167

EP - 172

JO - EUR J RADIOL

JF - EUR J RADIOL

SN - 0720-048X

IS - 1

ER -