Comparison of Two Dual Energy Quantitative CT Methods to Measure the Volume Fraction of Water, Fat and Mineral Bone to Characterize the Bone Marrow Composition

Dual-energy computed tomography (DECT) has the potential to detect musculoskeletal pathology with greater sensitivity than conventional CT alone at no additional radiation dose to the patient. It therefore has the potential to reduce the need for further diagnostic imaging or procedures (e.g., joint aspirations in the case of gout or magnetic resonance imaging to confirm undisplaced fractures).DECT is a well-established technique for the detection of gout arthropathy. Multiple newer applications have shown clinical potential including bone marrow edema detection and metal artifact reduction. Collagen analysis, bone marrow lesion detection, and iodine mapping in CT arthrography are areas of possible future application and development.This article outlines 10 tips on the use of DECT imaging of the musculoskeletal system, explaining the technique and indications with practical suggestions to help guide the radiologist.

Download Full-text

Detection of Bone Marrow Edema in Patients with Osteoid Osteoma Using Three-Material Decomposition with Dual-Layer Spectral CT

Diagnostics ◽

10.3390/diagnostics11060953 ◽

2021 ◽

Vol 11 (6) ◽

pp. 953

Author(s):

Florian T. Gassert ◽

Johannes Hammel ◽

Felix C. Hofmann ◽

Jan Neumann ◽

Claudio E. von Schacky ◽

...

Keyword(s):

Bone Marrow ◽

Osteoid Osteoma ◽

Bone Marrow Edema ◽

Volume Fraction ◽

Imaging Findings ◽

Spectral Ct ◽

Material Decomposition ◽

Negative Imaging ◽

Interreader Agreement ◽

Marrow Edema

The aim of this study is to assess whether perifocal bone marrow edema (BME) in patients with osteoid osteoma (OO) can be accurately detected on dual-layer spectral CT (DLCT) with three-material decomposition. To that end, 18 patients with OO (25.33 ± 12.44 years; 7 females) were pairwise-matched with 18 patients (26.72 ± 9.65 years; 9 females) admitted for suspected pathologies other than OO in the same anatomic location but negative imaging findings. All patients were examined with DLCT and MRI. DLCT data was decomposed into hydroxyapatite and water- and fat-equivalent volume fraction maps. Two radiologists assessed DLCT-based volume fraction maps for the presence of perifocal BME, using a Likert scale (1 = no edema; 2 = likely no edema; 3 = likely edema; 4 = edema). Accuracy, sensitivity, and specificity for the detection of BME on DLCT were analyzed using MR findings as standard of reference. For the detection of BME in patients with OO, DLCT showed a sensitivity of 0.92, a specificity of 0.94, and an accuracy of 0.92 for both radiologists. Interreader agreement for the assessment of BME with DLCT was substantial (weighted κ = 0.78; 95% CI, 0.59, 0.94). DLCT with material-specific volume fraction maps allowed accurate detection of BME in patients with OO. This may spare patients additional examinations and facilitate the diagnosis of OO.

Download Full-text