Prospective validation of a rapid CT-based bone mineral density screening method using colored spinal images.
Prospective validation of a rapid CT-based bone mineral density screening method using colored spinal images.
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使用彩色脊柱图像对基于 CT 的快速骨矿物质密度筛查方法进行前瞻性验证。
DOI：
10.1007/s00261-020-02791-1
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Smith,AndrewD
中科院分区：
文献类型：
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作者：
Varney,Elliot;AbouElkassem,Asser;Khan,Majid;Parker,Ellen;Nichols,Todd;Joyner,David;Lirette,SethT;Howard-Claudio,Candace;Smith,AndrewD
目的前瞻性地验证一种利用腹部彩色CT图像准确、快速地区分正常和异常脊柱骨密度的方法。方法对196例50岁无症状的 ≥ 患者行常规腹部平扫。用软件对CT图像进行处理，生成矢状位彩色图像，绿色表示骨密度正常，红色表示骨密度异常(低骨密度或骨质疏松)。四位放射科医生使用灰度级图像的视觉评估、平均椎体衰减的定量测量和彩色图像的视觉评估来评估矢状位图像上的L1/L2骨密度。以体模定量CT测量L1/L2的平均BMD值为参考标准。计算平均判读准确率和判读时间。结果L1/L2的平均衰减与平均骨密度高度相关(r= 0.96/0.91，p<； 均为0.001)。在4位读者中，对于正常和异常骨密度的视觉评估，S的平均准确率和平均时间分别为66%和6.0%，S的平均准确率和平均时间分别为88%和15.2%，S的平均准确率和平均时间分别为92%和2.1%(P<； 0.001和P<； 0.001)。使用灰度图像的视觉评估一致性较差(ICC：0.31)，定量测量椎体平均密度的一致性较好(ICC：0.73)，使用彩色图像的视觉评估的一致性较好(ICC：0.90)。结论彩色腹部CT图像检测异常骨密度具有较高的准确性、快速和良好的观察者间一致性。
PurposeTo prospectively validate a method to accurately and rapidly differentiate normal from abnormal spinal bone mineral density (BMD) using colored abdominal CT images.MethodsFor this prospective observational study, 196 asymptomatic women ≥ 50 years of age presenting for screening mammograms underwent routine nonenhanced CT imaging of the abdomen. The CT images were processed with software designed to generate sagittal colored images with green vertebral trabecular bone indicating normal BMD and red indicating abnormal BMD (low BMD or osteoporosis). Four radiologists evaluated L1/L2 BMD on sagittal images using visual assessment of grayscale images, quantitative measurements of mean vertebral attenuation, and visual assessment of colored images. Mean BMD values at L1/L2 using quantitative CT with a phantom served as the reference standard. The average accuracy and time of interpretation were calculated. Inter-observer agreement was assessed using intraclass correlation coefficient (ICC).ResultsMean attenuation at L1/L2 was highly correlated with mean BMD (r= 0.96/0.91,p< 0.001 for both). The average accuracy and mean time to assess BMD among four readers for differentiating normal from abnormal BMD was 66% and 6.0 s using visual assessment of grayscale images, 88% and 15.2 s using quantitative measurements of mean vertebral attenuation, and 92% and 2.1 s using visual assessment of colored images (p< 0.001 andp< 0.001, respectively). Inter-observer agreement was poor using visual assessment of grayscale images (ICC:0.31), good using quantitative measurements of mean vertebral attenuation (ICC:0.73), and excellent using visual assessment of colored images (ICC:0.90).ConclusionDetection of abnormal BMD using colored abdominal CT images was highly accurate, rapid, and had excellent inter-observer agreement.