Added value of color-coded virtual non-calcium dual-energy CT in the detection of acute knee fractures in non-radiology inexpert readers.

Abstract

PURPOSE:

To evaluated the added value of dual-energy CT (DECT) virtual non-calcium (VNCa) protocol on conventional CT in the detection of acute knee fractures in non-radiology inexpert readers.

METHOD:

One hundred fifty-six patients (mean age, 51.97 years; age range, 17-86 years) with knee trauma, who underwent DECT and MRI within 3 days between April 2017 and October 2018, were retrospectively analyzed. Three readers (intern, 1st-year general surgery resident, 1st-year emergency medicine resident) independently analyzed CT alone and then with the additional color-coded DECT VNCa for fractures. A board-certified radiologist, analyzed CT and MRI series to define the reference standard. Sensitivity, specificity, and AUC were compared between the two reading sessions.

RESULTS:

Fifty-seven patients had acute fractures and 99 had no fractures. Thirteen of 57 fractures were nondisplaced. The additional use of VNCa images significantly increased the mean AUC (reader 1: 0.813 vs. 0.919; reader 2: 0.842 vs. 0.930; reader 3: 0.837 vs. 0.921; P < 0.05). When only nondisplaced fractures included, the mean AUC was more increased in the combined analysis of CT and DECT VNCa (reader 1: 0.521 vs. 0.916; reader 2: 0.542 vs. 0.926; reader 3: 0.575 vs. 0.926; P <  .01). Sensitivity increased by 15 %-20 % in total fracture group and by 69 %-77 % in nondisplaced fracture group over that with CT alone when both CT and DECT VNCa were used. Specificity did not differ significantly.

CONCLUSIONS:

The additional use of color-coded DECT VNCa protocol to conventional CT improved diagnostic performance in detecting acute knee fractures for inexperienced non-radiology readers.

• Authors: Su Jeong Yang, Ji Young Jeon, Sheen-Woo Lee, Yu Mi Jeong
• Journal: European journal of radiology (Eur J Radiol) Vol. 129 Pg. 109112 (Aug 2020) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 32526668 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier B.V. All rights reserved.

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Clinical Competence (statistics & numerical data)
• Color
• Female
• Fractures, Bone (diagnostic imaging)
• Humans
• Knee (diagnostic imaging)
• Knee Injuries (diagnostic imaging)
• Male
• Middle Aged
• Radiography, Dual-Energy Scanned Projection
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)
• Young Adult