Improved accuracy of bone marrow edema detection in patients with hip pain using dual-energy computed tomography: Optimization of blended material density images combining water-calcium and water-hydroxyapatite

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-07-08 DOI:10.1016/j.ejrad.2025.112293

Kosuke Yoshii , Takanori Masuda , Shinichi Tanaka , Yuki Sanda , Shunsuke Takahara

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引用次数: 0

Abstract

Rationale and Objectives

This study aimed to optimize newly developed blended material density (MD) images, compare them with conventional water-calcium (Ca) and water-hydroxyapatite (HAP) images, and identify the most suitable MD images for detecting bone marrow edema (BME).

Materials and Methods

We retrospectively analyzed the data of 24 patients (47 hips) who underwent dual-energy computed tomography (DECT) and magnetic resonance imaging (MRI) within one week of experiencing hip pain between April 2022 and March 2024. DECT was performed using a single-source fast-kV switching system and two material decomposition algorithms to generate 9 blended MD images by adjusting the mixing ratios of water-Ca and water-HAP (water-9Ca:1HAP to water-1Ca:9HAP). The optimal blended MD image was identified using the area under the curve (AUC) from the receiver operating characteristic (ROC) analysis. Radiologists and orthopedic surgeons visually assessed the concordance between the three types of MD images and MRI findings using a five-point scale.

Results

Among the 24 patients, 19 (79.2 %) were diagnosed with BME through MRI. Among the blended MD images, water-2Ca:8HAP demonstrated the highest diagnostic accuracy (AUC: 0.980), significantly outperforming water-Ca (AUC: 0.909, P <0.01) and water-HAP (AUC: 0.898, P = 0.01). At a cut-off value of 969 mg/cm³, water-2Ca:8HAP achieved a sensitivity of 100.0 % and specificity of 91.8 %. Visual assessments further confirmed the highest concordance with MRI findings (both P < 0.01).

Conclusion

The blended MD image using water-2Ca:8HAP demonstrated superior diagnostic performance compared to conventional images, offering a promising tool for improved BME detection.

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双能计算机断层扫描提高髋关节疼痛患者骨髓水肿检测的准确性：水钙和水羟基磷灰石混合材料密度图像的优化

本研究旨在优化新开发的混合材料密度（MD）图像，并将其与传统的水钙（Ca）和水羟基磷灰石（HAP）图像进行比较，以确定最适合骨髓水肿（BME）检测的MD图像。材料与方法我们回顾性分析了24例（47髋）患者的数据，这些患者在2022年4月至2024年3月期间经历髋关节疼痛的一周内接受了双能计算机断层扫描（DECT）和磁共振成像（MRI）。通过调整水- ca和水- hap的混合比例（water-9Ca:1HAP to water-1Ca:9HAP），使用单源快速kv开关系统和两种材料分解算法进行DECT，生成9幅混合MD图像。利用受试者工作特征（ROC）分析的曲线下面积（AUC）识别出最优的混合MD图像。放射科医生和骨科医生使用五分制视觉评估三种类型的MD图像和MRI结果之间的一致性。结果24例患者中，有19例（79.2%）经MRI诊断为BME。在混合MD图像中，water-2Ca:8HAP的诊断准确率最高（AUC: 0.980），显著优于water-Ca （AUC: 0.909, P <0.01）和water-HAP （AUC: 0.898, P = 0.01）。在截断值为969 mg/cm3时，water-2Ca:8HAP的灵敏度为100.0%，特异性为91.8%。视觉评估进一步证实了与MRI结果的高度一致性(P和lt；0.01)。结论水- 2ca:8HAP混合MD图像与常规图像相比具有更好的诊断性能，为改进BME的检测提供了一种有前途的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.