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Fast kilovoltage (KV)-switching dual-energy computed tomography hydroxyapatite (HAP)-water decomposition technique for identifying bone marrow edema in vertebral compression fractures.

ABSTRACT: Background:Hydroxyapatite (HAP) is the main component of bone mineral. The utility of using HAP-water decomposition technique with fast kilovoltage (KV)-switching dual-energy computed tomography (DECT) to detect abnormal edema in vertebral compression fractures (VCFs) has not been widely reported. Methods:A total of 31 consecutive patients with 80 VCFs who underwent DECT and magnetic resonance imaging (MRI) of the spine were retrospectively enrolled in our study between October 2018 and January 2019. VCFs in MR examinations served as the standard of reference. Two radiologists blindly and independently evaluated color-coded overlay virtual nonhydroxyapatite (VNHAP) images for the presence of abnormal edema. The inter-reader agreement, specificity, sensitivity, accuracy, and predictive values of VNHAP images for edema detection were calculated. The diagnostic accuracy of two readers was compared using McNemar's test. Two additional radiologists performed a quantitative analysis on VNHAP images, receiver operating characteristic (ROC) curve analysis was conducted, and the threshold was calculated. Results:MRI depicted 45 edematous and 35 nonedematous VCFs. For visual analysis, the VNHAP technique showed a sensitivity of 93.3%, a specificity of 97.1%, a positive predictive value (PPV) of 97.7%, a negative predictive value (NPV) of 91.9%, and an accuracy of 95.0%. The inter-reader agreement was almost perfect (k=0.90). The diagnostic accuracy of the two readers showed no significant differences in the assessment of VNHAP images (P=1.00). Significant differences in CT numbers between vertebrae with and without bone marrow edema were found by quantitative analysis (P<0.01). The area under the curve (AUC) of the VNHAP images was estimated to be 0.917. The threshold of 1,003.2 mg/cm3 yielded a sensitivity of 88.9% and a specificity of 82.9% for the differentiation of fresh and old VCFs. Conclusions:Fast KV-switching DECT HAP-water decomposition technique had excellent diagnostic performance for identifying acute and chronic VCFs in visual and quantitative analyses.

SUBMITTER: Pan J

PROVIDER: S-EPMC7136727 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Fast kilovoltage (KV)-switching dual-energy computed tomography hydroxyapatite (HAP)-water decomposition technique for identifying bone marrow edema in vertebral compression fractures.

Pan Junhan J Yan Luyou L Gao Hui H He Yewen Y Zhong Zeya Z Li Ping P Zhang Yaxi Y Guo Ying Y Liao Liangying L Zhou Shuwei S Zhang Kun K

Quantitative imaging in medicine and surgery 20200301 3

<h4>Background</h4>Hydroxyapatite (HAP) is the main component of bone mineral. The utility of using HAP-water decomposition technique with fast kilovoltage (KV)-switching dual-energy computed tomography (DECT) to detect abnormal edema in vertebral compression fractures (VCFs) has not been widely reported.<h4>Methods</h4>A total of 31 consecutive patients with 80 VCFs who underwent DECT and magnetic resonance imaging (MRI) of the spine were retrospectively enrolled in our study between October 20 ...[more]

PMID: 32269921

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Project description:BACKGROUND:One factor related to disability in people with spinal deformity is decreased postural control and increased risk of falling. However, little is known about the effect of osteoporotic vertebral compression fractures (OVCFs) and their recovery on gait and stability. Walking characteristics of older adults with and without vertebral fractures have not yet been compared. AIMS:The purpose of the current study was to examine the spatiotemporal gait parameters and their variability in patients with an OVCF and healthy participants during treadmill walking at baseline and after 6 months of recovery. METHODS:Twelve female patients suffering a symptomatic OVCF were compared to 11 matched controls. Gait analysis was performed with a dual-belt instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment). Results of patients with an OVCF and healthy participants were compared. Furthermore, spatiotemporal gait parameters were assessed over 6 months following the fracture. RESULTS:Patients suffering from an OVCF appeared to walk with significantly shorter, faster and wider strides compared to their healthy counterparts. Although stride time and length improved over time, the majority of the parameters analysed remained unchanged after 6 months of conservative treatment. DISCUSSION:Since patients do not fully recover to their previous level of mobility after 6 months of conservative treatment for OVCF, it appears of high clinical importance to add balance and gait training to the treatment algorithm of OVCFs. CONCLUSIONS:Patients suffering from an OVCF walk with shorter, faster and wider strides compared to their healthy counterparts adopt a less stable body configuration in the anterior direction, potentially increasing their risk of forward falls if perturbed. Although stride time and stride length improve over time even reaching healthy levels again, patients significantly deviate from normal gait patterns (e.g. in stability and step width) after 6 months of conservative treatment.

Dataset Information

Fast kilovoltage (KV)-switching dual-energy computed tomography hydroxyapatite (HAP)-water decomposition technique for identifying bone marrow edema in vertebral compression fractures.

Publications

Fast kilovoltage (KV)-switching dual-energy computed tomography hydroxyapatite (HAP)-water decomposition technique for identifying bone marrow edema in vertebral compression fractures.

Similar Datasets

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