Evaluation of Femoral Head Avascular Necrosis With Virtual Noncalcium Dual-Energy Computed Tomography.

IF 1 4区 医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Muhsin Ozgun Ozturk, Mecit Kantarcı, Sonay Aydin, Volkan Kızılgöz, Nizamettin Kockara, Volkan Gur
{"title":"Evaluation of Femoral Head Avascular Necrosis With Virtual Noncalcium Dual-Energy Computed Tomography.","authors":"Muhsin Ozgun Ozturk, Mecit Kantarcı, Sonay Aydin, Volkan Kızılgöz, Nizamettin Kockara, Volkan Gur","doi":"10.1097/RCT.0000000000001655","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to investigate the effectiveness of the dual-energy computed tomography (DECT) virtual noncalcium (VNCa) technique in avascular necrosis (AVN) for detecting bone marrow edema (BME) and staging.</p><p><strong>Methods: </strong>This prospective study included adult patients diagnosed with unilateral or bilateral femoral head AVN between January 2023 and December 2023, who had magnetic resonance imaging (MRI) and DECT. Two participants were excluded from the study due to undergoing surgical procedures during the period between the scans. Two reviewers, blinded to MRI images and clinical data, visually examined color-coded VNCa pictures to assess BME using a binary classification (0 = normal bone marrow, 1 = BME). Same 2 reviewers also used color-coded and nonmapped images to stage AVN in accordance to the \"Association for Research on Osseous Circulation\" (ARCO) staging system. Interobserver agreements for the visual evaluation and staging were calculated with κ coefficient. Following a visual assessment of BME and the staging of AVN, same 2 reviewers conducted CT density measurements on regions of BME regions utilizing DECT noncalcium images. An independent third investigator (reference standard) utilized MRI, x-ray, and clinical data to confirm the definitive diagnosis and staging of AVN. A P value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Fifty patients (28 men, 22 women, mean age: 44.2 ± 13.1 years, range: 25-75 years) were included in the final analysis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the VNCa technique in detecting BME were 96.0%, 94.4%, 97.9%, 89.4%, and 95.6%, respectively, for reviewer 1; and 96.0%, 88.9%, 96.0%, 88.9%, and 94.1%, respectively, for reviewer 2. Interobserver agreement was almost perfect ( κ = 0.84). Both reviewer 1 and reviewer 2 accurately classified 92.7% of the AVNs. The density measurements showed a statistically significant difference ( P = 0.001) between the edema regions and the normal marrow regions. No statistically significant difference was observed in the density measurements of edema regions at different stages ( P = 0.13).</p><p><strong>Conclusions: </strong>DECT VNCa technique exhibits excellent performance in detecting BME in hip AVN cases, as well as accurately determining the stage of AVN.</p>","PeriodicalId":15402,"journal":{"name":"Journal of Computer Assisted Tomography","volume":" ","pages":"133-139"},"PeriodicalIF":1.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Computer Assisted Tomography","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RCT.0000000000001655","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Our aim was to investigate the effectiveness of the dual-energy computed tomography (DECT) virtual noncalcium (VNCa) technique in avascular necrosis (AVN) for detecting bone marrow edema (BME) and staging.

Methods: This prospective study included adult patients diagnosed with unilateral or bilateral femoral head AVN between January 2023 and December 2023, who had magnetic resonance imaging (MRI) and DECT. Two participants were excluded from the study due to undergoing surgical procedures during the period between the scans. Two reviewers, blinded to MRI images and clinical data, visually examined color-coded VNCa pictures to assess BME using a binary classification (0 = normal bone marrow, 1 = BME). Same 2 reviewers also used color-coded and nonmapped images to stage AVN in accordance to the "Association for Research on Osseous Circulation" (ARCO) staging system. Interobserver agreements for the visual evaluation and staging were calculated with κ coefficient. Following a visual assessment of BME and the staging of AVN, same 2 reviewers conducted CT density measurements on regions of BME regions utilizing DECT noncalcium images. An independent third investigator (reference standard) utilized MRI, x-ray, and clinical data to confirm the definitive diagnosis and staging of AVN. A P value less than 0.05 was considered statistically significant.

Results: Fifty patients (28 men, 22 women, mean age: 44.2 ± 13.1 years, range: 25-75 years) were included in the final analysis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the VNCa technique in detecting BME were 96.0%, 94.4%, 97.9%, 89.4%, and 95.6%, respectively, for reviewer 1; and 96.0%, 88.9%, 96.0%, 88.9%, and 94.1%, respectively, for reviewer 2. Interobserver agreement was almost perfect ( κ = 0.84). Both reviewer 1 and reviewer 2 accurately classified 92.7% of the AVNs. The density measurements showed a statistically significant difference ( P = 0.001) between the edema regions and the normal marrow regions. No statistically significant difference was observed in the density measurements of edema regions at different stages ( P = 0.13).

Conclusions: DECT VNCa technique exhibits excellent performance in detecting BME in hip AVN cases, as well as accurately determining the stage of AVN.

利用虚拟非钙双能量计算机断层扫描评估股骨头血管性坏死。
目的:我们的目的是研究双能计算机断层扫描(DECT)虚拟无钙(VNCa)技术在血管性坏死(AVN)中检测骨髓水肿(BME)和分期的有效性:这项前瞻性研究纳入了2023年1月至2023年12月期间确诊为单侧或双侧股骨头坏死的成年患者,他们都接受了磁共振成像(MRI)和DECT检查。有两名患者因在两次扫描之间接受手术治疗而被排除在研究之外。两名对核磁共振成像图像和临床数据视而不见的审查员目测了彩色编码的 VNCa 图像,采用二元分类法(0 = 骨髓正常,1 = BME)评估 BME。同两名审稿人还根据 "骨循环研究协会"(ARCO)的分期系统,使用彩色编码和非映射图像对 AVN 进行分期。用κ系数计算了视觉评估和分期的观察者间一致性。在对 BME 进行视觉评估和对 AVN 进行分期后,同两名审查员利用 DECT 非钙图像对 BME 区域进行 CT 密度测定。独立的第三位研究者(参考标准)利用核磁共振成像、X 光和临床数据确认 AVN 的明确诊断和分期。P值小于0.05被认为具有统计学意义:最终分析包括 50 名患者(28 名男性,22 名女性,平均年龄:44.2 ± 13.1 岁,范围:25-75 岁)。VNCa 技术检测 BME 的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为:审查员 1 96.0%、94.4%、97.9%、89.4% 和 95.6%;审查员 2 96.0%、88.9%、96.0%、88.9% 和 94.1%。观察者之间的一致性几乎完美(κ = 0.84)。评审员 1 和评审员 2 对 92.7% 的 AVN 进行了准确分类。密度测量结果显示,水肿区域与正常骨髓区域之间存在显著统计学差异(P = 0.001)。不同阶段水肿区域的密度测量结果差异无统计学意义(P = 0.13):结论:DECT VNCa 技术在检测髋关节 AVN 病例中的 BME 方面表现出色,并能准确判断 AVN 的分期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
0.00%
发文量
230
审稿时长
4-8 weeks
期刊介绍: The mission of Journal of Computer Assisted Tomography is to showcase the latest clinical and research developments in CT, MR, and closely related diagnostic techniques. We encourage submission of both original research and review articles that have immediate or promissory clinical applications. Topics of special interest include: 1) functional MR and CT of the brain and body; 2) advanced/innovative MRI techniques (diffusion, perfusion, rapid scanning); and 3) advanced/innovative CT techniques (perfusion, multi-energy, dose-reduction, and processing).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信