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Tytuł:
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Improved diagnostic confidence in evaluating bone non-union using virtual monochromatic dual-energy CT.
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Autorzy:
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Donders JCE; Department of Orthopedic Surgery, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands. Electronic address: .
Wellenberg RHH; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Radiology, Isala, Zwolle, the Netherlands. Electronic address: .
Streekstra GJ; Department of Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands. Electronic address: .
Maas M; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, Amsterdam, the Netherlands. Electronic address: .
Kloen P; Department of Orthopedic Surgery, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands. Electronic address: .
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Źródło:
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European journal of radiology [Eur J Radiol] 2020 Nov; Vol. 132, pp. 109159. Date of Electronic Publication: 2020 Jul 01.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Limerick : Elsevier Science Ireland Ltd
Original Publication: Stuttgart ; New York : Thieme, [c1981-
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MeSH Terms:
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Radiographic Image Interpretation, Computer-Assisted*
Radiography, Dual-Energy Scanned Projection*
Humans ; Titanium ; Tomography, X-Ray Computed
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Contributed Indexing:
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Keywords: Artifacts; Diagnostic imaging; Dual-energy CT; Fracture fixation; Non-union; Tomography; X-Ray computed
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Substance Nomenclature:
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D1JT611TNE (Titanium)
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Entry Date(s):
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Date Created: 20201022 Date Completed: 20210414 Latest Revision: 20210414
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Update Code:
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20240105
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DOI:
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10.1016/j.ejrad.2020.109159
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PMID:
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33091864
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Purpose: The aim of this study was to determine whether virtual monochromatic dual-energy CT imaging improves the evaluation of suspected non-union of the appendicular skeleton treated with titanium or stainless steel intramedullary nails and plates.
Method: Forty-one patients with a clinical suspected non-union with hardware in place were included and scanned on a dual-source CT-scanner using 100/Sn150kVp. Images including titanium hardware were extracted at 130 keV. Images including stainless steel hardware were extracted at 150 keV. Monochromatic 70 keV images served as reference. Non-union confirmed during revision surgery was used as gold standard. A musculoskeletal radiologist and orthopedic trauma surgeon evaluated images on image quality, degree and location of consolidation, non-union type and diagnostic confidence.
Results: Likert scores with respect to image quality improved from 0.88 to 1.83 (p < 0.001) in high (130 and 150) keV images. High keV images reduced the number of false negative non-unions based on consolidation grade with 5% (p = 0.283). Agreement between observers regarding location of consolidation and non-union type did not improve in 130 and 150 keV images. Diagnostic confidence improved from 1.43 to 2.37 in high keV images compared to 70 keV images (p < 0.001). Overall diagnostic confidence was higher in intramedullary nails than plates (p < 0.05).
Conclusions: Use of virtual monochromatic 130 and 150 keV dual-energy CT compared to 70 keV images improves the evaluation of suspected non-union of the appendicular skeleton treated with titanium or stainless steel intramedullary nails and plates.
(Copyright © 2020. Published by Elsevier B.V.)
