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Bone marrow edema in sacroiliitis : detection with dual-energy CT

Min Chen (UGent) , Nele Herregods (UGent) , Jacob Jaremko, Philippe Carron (UGent) , Dirk Elewaut (UGent) , Filip Van den Bosch (UGent) and Lennart Jans (UGent)
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Abstract
Objectives To evaluate the feasibility and diagnostic accuracy of dual-energy computed tomography (DECT) for the detection of bone marrow edema (BME) in patients suspected for sacroiliitis. Methods Patients aged 18-55 years with clinical suspicion for sacroiliitis were enrolled. All patients underwent DECT and 3.0 T MRI of the sacroiliac joints on the same day. Virtual non-calcium (VNCa) images were calculated from DECT images for demonstration of BME. VNCa images were scored by two readers independently using a binary system (0 = normal bone marrow, 1 = BME). Diagnostic performance was assessed with fluid-sensitive MRI as the reference standard. ROIs were placed on VNCa images, and CT numbers were displayed. Cutoff values for BME detection were determined based on ROC curves. Results Forty patients (16 men, 24 women, mean age 37.1 years +/- 9.6 years) were included. Overall inter-reader agreement for visual image reading of BME on VNCa images was good (kappa = 0.70). The sensitivity and specificity of BME detection by DECT were 65.4% and 94.2% on the quadrant level and 81.3% and 91.7% on the patient level. ROC analyses revealed AUCs of 0.90 and 0.87 for CT numbers in the ilium and sacrum, respectively. Cutoff values of - 44.4 HU (for iliac quadrants) and - 40.8 HU (for sacral quadrants) yielded sensitivities of 76.9% and 76.7% and specificities of 91.5% and 87.5%, respectively. Conclusions Inflammatory sacroiliac BME can be detected by VNCa images calculated from DECT, with a good interobserver agreement, moderate sensitivity, and high specificity.
Keywords
Radiography, dual-energy scanned projection, Tomography, X-ray computed, AXIAL SPONDYLOARTHRITIS, INFLAMMATION, PERFORMANCE, LESIONS

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MLA
Chen, Min, et al. “Bone Marrow Edema in Sacroiliitis : Detection with Dual-Energy CT.” EUROPEAN RADIOLOGY, 2020.
APA
Chen, M., Herregods, N., Jaremko, J., Carron, P., Elewaut, D., Van den Bosch, F., & Jans, L. (2020). Bone marrow edema in sacroiliitis : detection with dual-energy CT. EUROPEAN RADIOLOGY.
Chicago author-date
Chen, Min, Nele Herregods, Jacob Jaremko, Philippe Carron, Dirk Elewaut, Filip Van den Bosch, and Lennart Jans. 2020. “Bone Marrow Edema in Sacroiliitis : Detection with Dual-Energy CT.” EUROPEAN RADIOLOGY.
Chicago author-date (all authors)
Chen, Min, Nele Herregods, Jacob Jaremko, Philippe Carron, Dirk Elewaut, Filip Van den Bosch, and Lennart Jans. 2020. “Bone Marrow Edema in Sacroiliitis : Detection with Dual-Energy CT.” EUROPEAN RADIOLOGY.
Vancouver
1.
Chen M, Herregods N, Jaremko J, Carron P, Elewaut D, Van den Bosch F, et al. Bone marrow edema in sacroiliitis : detection with dual-energy CT. EUROPEAN RADIOLOGY. 2020;
IEEE
[1]
M. Chen et al., “Bone marrow edema in sacroiliitis : detection with dual-energy CT,” EUROPEAN RADIOLOGY, 2020.
@article{8647733,
  abstract     = {Objectives To evaluate the feasibility and diagnostic accuracy of dual-energy computed tomography (DECT) for the detection of bone marrow edema (BME) in patients suspected for sacroiliitis. Methods Patients aged 18-55 years with clinical suspicion for sacroiliitis were enrolled. All patients underwent DECT and 3.0 T MRI of the sacroiliac joints on the same day. Virtual non-calcium (VNCa) images were calculated from DECT images for demonstration of BME. VNCa images were scored by two readers independently using a binary system (0 = normal bone marrow, 1 = BME). Diagnostic performance was assessed with fluid-sensitive MRI as the reference standard. ROIs were placed on VNCa images, and CT numbers were displayed. Cutoff values for BME detection were determined based on ROC curves. Results Forty patients (16 men, 24 women, mean age 37.1 years +/- 9.6 years) were included. Overall inter-reader agreement for visual image reading of BME on VNCa images was good (kappa = 0.70). The sensitivity and specificity of BME detection by DECT were 65.4% and 94.2% on the quadrant level and 81.3% and 91.7% on the patient level. ROC analyses revealed AUCs of 0.90 and 0.87 for CT numbers in the ilium and sacrum, respectively. Cutoff values of - 44.4 HU (for iliac quadrants) and - 40.8 HU (for sacral quadrants) yielded sensitivities of 76.9% and 76.7% and specificities of 91.5% and 87.5%, respectively. Conclusions Inflammatory sacroiliac BME can be detected by VNCa images calculated from DECT, with a good interobserver agreement, moderate sensitivity, and high specificity.},
  author       = {Chen, Min and Herregods, Nele and Jaremko, Jacob and Carron, Philippe and Elewaut, Dirk and Van den Bosch, Filip and Jans, Lennart},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keywords     = {Radiography,dual-energy scanned projection,Tomography,X-ray computed,AXIAL SPONDYLOARTHRITIS,INFLAMMATION,PERFORMANCE,LESIONS},
  language     = {eng},
  pages        = {8},
  title        = {Bone marrow edema in sacroiliitis : detection with dual-energy CT},
  url          = {http://dx.doi.org/10.1007/s00330-020-06670-7},
  year         = {2020},
}

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