Open AccessVirtual Noncalcium Dual-Energy CT: Detection of Lumbar Disk Herniation in Comparison with Standard Gray-scale CT
Author(s) -
Christian Booz,
Jochen Nöske,
Simon S. Martin,
Moritz H. Albrecht,
Ibrahim Yel,
Lukas Lenga,
Tatjana GruberRouh,
Katrin Eichler,
Tommaso D’Angelo,
Thomas J. Vogl,
Julian L. Wichmann
Publication year - 2019
Publication title -
radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.118
H-Index - 295
eISSN - 1527-1315
pISSN - 0033-8419
DOI - 10.1148/radiol.2018181286
Subject(s) - medicine , lumbar , intervertebral disk , radiology , nuclear medicine , tomography , dual energy , bone mineral , osteoporosis
Purpose To assess the diagnostic performance of dual-energy CT with reconstruction of virtual noncalcium (VNCa) images for the detection of lumbar disk herniation compared with standard CT image reconstruction. Materials and Methods For this retrospective study, 41 patients (243 intervertebral disks; overall mean age, 68 years; 24 women [mean age, 68 years] and 17 men [mean age, 68 years]) underwent clinically indicated third-generation, dual-source, dual-energy CT and 3.0-T MRI within 2 weeks between March 2017 and January 2018. Six radiologists, blinded to clinical and MRI information, independently evaluated conventional gray-scale dual-energy CT series for the presence and degree of lumbar disk herniation and spinal nerve root impingement. After 8 weeks, readers reevaluated examinations by using color-coded VNCa reconstructions. MRI evaluated by two separate experienced readers, blinded to clinical and dual-energy CT information, served as the standard of reference. Sensitivity and specificity were the primary metrics of diagnostic performance. Results A total of 112 herniated lumbar disks were depicted at MRI. VNCa showed higher overall sensitivity (612 of 672 [91%] vs 534 of 672 [80%]) and specificity (723 of 786 [92%] vs 665 of 786 [85%]) for detecting lumbar disk herniation compared with standard CT (all comparisons, P < .001). Interreader agreement was excellent for VNCa and substantial for standard CT (κ = 0.82 vs 0.67; P < .001). VNCa achieved superior diagnostic confidence, image quality, and noise scores compared with standard CT (all comparisons, P < .001). Conclusion Color-coded dual-energy CT virtual noncalcium reconstructions show substantially higher diagnostic performance and confidence for depicting lumbar disk herniation compared with standard CT. © RSNA, 2018.