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Levi R, Garoli F, Battaglia M, Rizzo DAA, Mollura M, Savini G, Riva M, Tomei M, Ortolina A, Fornari M, Rohatgi S, Angelotti G, Savevski V, Mazziotti G, Barbieri R, Grimaldi M, Politi LS. CT-based radiomics can identify physiological modifications of bone structure related to subjects' age and sex. LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01641-6. [PMID: 37147473 DOI: 10.1007/s11547-023-01641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/26/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE Radiomics of vertebral bone structure is a promising technique for identification of osteoporosis. We aimed at assessing the accuracy of machine learning in identifying physiological changes related to subjects' sex and age through analysis of radiomics features from CT images of lumbar vertebrae, and define its generalizability across different scanners. MATERIALS AND METHODS We annotated spherical volumes-of-interest (VOIs) in the center of the vertebral body for each lumbar vertebra in 233 subjects who had undergone lumbar CT for back pain on 3 different scanners, and we evaluated radiomics features from each VOI. Subjects with history of bone metabolism disorders, cancer, and vertebral fractures were excluded. We performed machine learning classification and regression models to identify subjects' sex and age respectively, and we computed a voting model which combined predictions. RESULTS The model was trained on 173 subjects and tested on an internal validation dataset of 60. Radiomics was able to identify subjects' sex within single CT scanner (ROC AUC: up to 0.9714), with lower performance on the combined dataset of the 3 scanners (ROC AUC: 0.5545). Higher consistency among different scanners was found in identification of subjects' age (R2 0.568 on all scanners, MAD 7.232 years), with highest results on a single CT scanner (R2 0.667, MAD 3.296 years). CONCLUSION Radiomics features are able to extract biometric data from lumbar trabecular bone, and determine bone modifications related to subjects' sex and age with great accuracy. However, acquisition from different CT scanners reduces the accuracy of the analysis.
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Affiliation(s)
- Riccardo Levi
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Federico Garoli
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Massimiliano Battaglia
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Dario A A Rizzo
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Maximilliano Mollura
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, 20133, Milan, Italy
| | - Giovanni Savini
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Marco Riva
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Massimo Tomei
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Alessandro Ortolina
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Maurizio Fornari
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Saurabh Rohatgi
- Department of Neuroradiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Giovanni Angelotti
- Artificial Intelligence Center, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Victor Savevski
- Artificial Intelligence Center, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Metabolic Bone Diseases and Osteoporosis Section, Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Riccardo Barbieri
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, 20133, Milan, Italy
| | - Marco Grimaldi
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy
| | - Letterio S Politi
- Department of Biomedical Sciences, Humanitas University, Via R. Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
- Department of Neuroradiology, IRCCS Humanitas Research Hospital, 20090, Rozzano, Italy.
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Abdellatif W, Nugent JP, Alballa F, Murray N, Jalal S, Ali IT, Nicolaou S. Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography. Can Assoc Radiol J 2023; 74:110-118. [PMID: 35948996 DOI: 10.1177/08465371221118886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose: To assess value of dual energy computed tomography (DECT) collagen material decomposition algorithm when combined with standard computed tomography (CT) in detection of lumbar disc extrusion and sequestration. Materials and Methods: Retrospective analysis of all patients with acute low back pain who had a diagnosis of lumbar spine disc extrusion and/or sequestration on Magnetic Resonance Imaging (MRI) (reference standard), and had undergone non-contrast DECT of the lumbar spine within 60 days of the MRI. Age and sex-matched control patients (n = 42) were included. Patients were grouped into standard, grey-scale CT only group and standard CT + DECT tendon images group. Two double-blinded radiologists reviewed both groups for presence of extrusion or sequestration. They also rated their diagnostic confidence on Likert 5-point scale. McNemar Chi-square test was used to compare diagnostic accuracy, unpaired t-test to compare reviewers diagnostic confidence, and Cohen's k (kappa) test for interobserver agreement. Results: The combined group showed higher overall sensitivity (96.6% vs 87.2%), specificity (99% vs 95.4%), and diagnostic accuracy (98.7% vs 94.5%) with a lower false positive rate (1.1% vs 4.6%). McNemar Chi-square test confirmed statistical significance (P = .03 and P = .02 for Reviewers R1 and R2, respectively). The mean diagnostic confidence was also significantly higher on combined group (R1: 3.74 ± 1.1 vs 3.47 ± 1.15 (P < .01) and R2: 3.91 ± 1.15 vs 3.72 ± 1.16 [mean ± SD] (P = .02)). Conclusion: Utilizing MRI as a reference standard, DECT tendon application combined with standard CT increases the sensitivity, specificity, and accuracy of detection of lumbar spine disc extrusion and sequestration, when compared to standard CT alone.
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Affiliation(s)
- Waleed Abdellatif
- Department of Radiology, 12334UT Southwestern Medical Center, Dallas, TX, USA
| | - James P Nugent
- Department of Radiology, 8167University of British Columbia/Vancouver General Hospital, Vancouver, BC, Canada
| | - Faisal Alballa
- Department of Radiology, 37852King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nicolas Murray
- Department of Radiology, 8167University of British Columbia/Vancouver General Hospital, Vancouver, BC, Canada
| | - Sabeena Jalal
- Department of Radiology, 8167Vancouver General Hospital, Vancouver, BC, Canada
| | - Ismail T Ali
- Department of Radiology, 8167University of British Columbia/Vancouver General Hospital, Vancouver, BC, Canada
| | - Savvas Nicolaou
- Department of Radiology, 8167Vancouver General Hospital, Vancouver, BC, Canada
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Abbassi M, Jain A, Shin D, Arasa CA, Li B, Anderson SW, LeBedis CA. Quantification of bone marrow edema using dual-energy CT at fracture sites in trauma. Emerg Radiol 2022; 29:691-696. [PMID: 35503393 DOI: 10.1007/s10140-022-02046-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of our study was to analyze the change in water and fat density within the bone marrow using the GE Revolution dual-energy computed tomography (DECT) platform using two-material decomposition analyses at extremity, spine, and pelvic fracture sites compared to normal bone marrow at equivalent anatomic sites in adult patients who sustained blunt trauma. METHODS This retrospective study included 26 consecutive adults who sustained blunt torso trauma and an acute fracture of the thoracolumbar vertebral body, pelvis, or upper and lower extremities with a total of 32 fractures evaluated. Two-material decomposition images were analyzed for quantitative analysis. Statistical analysis was performed using the paired t-test and Shapiro-Wilk test for normality. RESULTS There were statistically significant differences in the water and fat densities in the bone marrow at the site of an extremity, vertebral body, or pelvic fracture when compared to the normal anatomic equivalent (p < 0.01). CONCLUSION In this preliminary study, DECT basis material images, using water (calcium) and fat (calcium) decomposition illustrated significant differences in water and fat content between fracture sites and normal bone in a variety of anatomical sites.
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Affiliation(s)
- Mashya Abbassi
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA.
| | - Ashwin Jain
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
| | - Donghoon Shin
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
| | - Carlota Andreu Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
| | - Baojun Li
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
| | - Stephan W Anderson
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
| | - Christina A LeBedis
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, 3rdFloor, FGH Building, Boston, MA, 02118, USA
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Vara G, Ceccarelli L, Ponti F, Miceli M, Golfieri R, Facchini G. Reduction of Metal Artifacts Caused by Titanium Peduncular Screws in the Spine by Means of Monoenergetic Images and the Metal Artifact Reduction Software in Dual-Energy Computed Tomography. J Med Phys 2022; 47:152-158. [PMID: 36212200 PMCID: PMC9543003 DOI: 10.4103/jmp.jmp_121_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/04/2022] Open
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Impact of Dual-Energy CT in the Emergency Department: Increased Radiologist Confidence, Reduced Need for Follow-Up Imaging, and Projected Cost Benefit. AJR Am J Roentgenol 2020; 215:1528-1538. [DOI: 10.2214/ajr.19.22357] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Jeong SY, Jeon SJ, Seol M, Ahn TH, Juhng SK. Diagnostic performance of dual-energy computed tomography for detection of acute spinal fractures. Skeletal Radiol 2020; 49:1589-1595. [PMID: 32382979 DOI: 10.1007/s00256-020-03450-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the diagnostic performance of dual-energy computed tomography (DECT) with the color-coded virtual non-calcium (VNC) technique for detecting acute fractures in patients after acute spine trauma, especially in an emergency clinical setting. MATERIALS AND METHODS Our retrospective study included 31 patients presented to emergency department with suspected spine trauma. All patients underwent both DECT (80 kVp and 140 kVp) and MRI. Post-processing was performed using color-coded VNC technique. Two independent radiologists visually assessed color-coded VNC images in a random order, and one of the two readers re-assessed the images in 4 weeks after the initial assessment. They were allowed to read only color-coded VNC images and asked to determine the presence of acute fracture. To determine the standard reference point, the other two experienced radiologists made consensus readings on both grayscale CT and MRI. Sensitivity, specificity, PPV, NPV, and accuracy analyses were determined. Both intra- and inter-observer agreements were also calculated. RESULTS A total of 217 vertebral bodies (65 thoracic and 152 lumbar vertebrae) were included in our study. Sensitivity was 83.3% and 76.7% for first and second readers, respectively. Specificity of 99.5% and 98.9%, PPV of 96.1% and 96.3%, NPV of 97.3% and 96.3%, and accuracy of 97.2% and 95.8%, respectively, were noted. Both intra-observer and inter-observer agreements indicated excellent agreement (κ = 0.86 and κ = 0.84, respectively). CONCLUSION In spite of the relatively low sensitivity, DECT-based detection of acute spinal fractures showed good specificity, positive predictive value, negative predictive value, accuracy, and inter-/intra-observer agreements.
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Affiliation(s)
- Soo-Yeon Jeong
- Department of Radiology, Wonkwang University School of Medicine, 895 Muwang-Ro, Iksan, Jeonbuk, 54538, Republic of Korea
| | - Se-Jeong Jeon
- Department of Radiology, Wonkwang University School of Medicine, 895 Muwang-Ro, Iksan, Jeonbuk, 54538, Republic of Korea
| | - Myungjin Seol
- Department of Radiology, Wonkwang University School of Medicine, 895 Muwang-Ro, Iksan, Jeonbuk, 54538, Republic of Korea
| | - Tae-Hoon Ahn
- Department of Radiology, Wonkwang University School of Medicine, 895 Muwang-Ro, Iksan, Jeonbuk, 54538, Republic of Korea
| | - Seon Kwan Juhng
- Department of Radiology, Wonkwang University School of Medicine, 895 Muwang-Ro, Iksan, Jeonbuk, 54538, Republic of Korea.
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Rajiah P, Parakh A, Kay F, Baruah D, Kambadakone AR, Leng S. Update on Multienergy CT: Physics, Principles, and Applications. Radiographics 2020; 40:1284-1308. [DOI: 10.1148/rg.2020200038] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Prabhakar Rajiah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Anushri Parakh
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Fernando Kay
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Dhiraj Baruah
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Avinash R. Kambadakone
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
| | - Shuai Leng
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (P.R., S.L.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.P., A.R.K.); Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (F.K.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (D.B.)
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Shinohara Y, Sasaki F, Ohmura T, Itoh T, Endo T, Kinoshita T. Evaluation of lumbar intervertebral disc degeneration using dual energy CT virtual non-calcium imaging. Eur J Radiol 2020; 124:108817. [DOI: 10.1016/j.ejrad.2020.108817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/27/2019] [Accepted: 01/02/2020] [Indexed: 01/08/2023]
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Dual-Energy CT in Musculoskeletal Imaging: What Is the Role Beyond Gout? AJR Am J Roentgenol 2019; 213:493-505. [DOI: 10.2214/ajr.19.21095] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Wong WD, Shah S, Murray N, Walstra F, Khosa F, Nicolaou S. Advanced Musculoskeletal Applications of Dual-Energy Computed Tomography. Radiol Clin North Am 2018; 56:587-600. [DOI: 10.1016/j.rcl.2018.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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