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Diagnostic accuracy of dual-energy CT for detection of bone marrow lesions in the subacutely injured knee with MRI as reference method
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.ORCID iD: 0000-0002-7077-5667
Karolinska Inst, Sweden.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV). Karolinska Inst, Sweden.ORCID iD: 0000-0002-9446-6981
2019 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, article id UNSP 0284185119877343Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background Dual-energy computer tomography (DECT) can detect post-traumatic bone marrow lesions. Prospective studies of the knee with large numbers of participants and intra-observer agreement assessment are limited. Purpose To investigate the diagnostic accuracy of DECT in detecting bone marrow lesions as well as estimating the bone marrow lesion volume in patients with suspected anterior cruciate ligament trauma with magnetic resonance imaging (MRI) as reference standard. Material and Methods Forty-eight consecutive patients with suspected anterior cruciate ligament injury were imaged bilaterally with DECT within a mean of 25 days (range 4-55 days) following injury and MRI within seven days of DECT. Two readers analyzed DECT virtual non-calcium-blinded images. Consensus MRI was reference standard. Intra- and inter-observer agreement were determined using weighted kappa statistics. Sensitivity, specificity, and negative and positive predictive values were calculated. Bone marrow lesion volumes were measured; for comparison, intra-class correlation coefficient was used. Results The 48 patients (26 men, 22 women; mean age 23 years, age range 15-37 years) were imaged bilaterally yielding 52 knees with bone marrow lesions, of which 44 were in the femur and 41 were in the tibia. Intra- and inter-observer agreement to detect bone marrow lesions was moderate and fair to moderate (kappa 0.54-0.66, 95% confidence interval [CI] 0.39-0.80 and 0.37-0.41, 95% CI 0.20-0.57) and overall sensitivity and specificity were 70.1% and 69.1%, respectively. Positive and negative predictive values were 72.9% and 66.1%, respectively. Bone marrow lesion volumes showed excellent intra- and inter-observer agreement (0.83-0.91, 95% CI 0.74-0.94 and 0.76-0.78, 95% CI 0.57-0.87). Conclusion The diagnostic performance of DECT to detect bone marrow lesions in the subacutely injured knee was moderate with intra- and inter-observer agreement ranging from moderate to substantial and fair to moderate. Bone marrow lesion volume correlation was excellent.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2019. article id UNSP 0284185119877343
Keywords [en]
Knee; dual-energy computed tomography; trauma; bone marrow lesion
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-161616DOI: 10.1177/0284185119877343ISI: 000491671400001PubMedID: 31581782OAI: oai:DiVA.org:liu-161616DiVA, id: diva2:1367916
Note

Funding Agencies|Swedish Medical Research CouncilSwedish Medical Research Council (SMRC) [VR 2015-03687]; Division of Radiological Sciences, Department of Medical and Health Sciences, Faculty of Health Sciences, Link_oping University

Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2020-04-27

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Björkman, Ann-Sofi

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Björkman, Ann-SofiLindblom, MariaPersson, Anders
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Division of Community MedicineFaculty of Medicine and Health SciencesDepartment of Radiology in LinköpingDepartment of Medical and Health SciencesDivision of Radiological SciencesCenter for Medical Image Science and Visualization (CMIV)
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Acta Radiologica
Radiology, Nuclear Medicine and Medical Imaging

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