Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography

Waleed Abdellatif, James P. Nugent, Faisal Alballa, Nicolas Murray, Sabeena Jalal, Ismail T. Ali, Savvas Nicolaou

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalCanadian Association of Radiologists Journal
DOIs
StateAccepted/In press - 2022

Keywords

  • collagen material decomposition
  • disk extrusion
  • dual energy computed tomography
  • emergency radiology
  • lumbar spine
  • sequestration

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Dual Energy Computed Tomography Collagen Material Decomposition for Detection of Lumbar Spine Disc Extrusion and Sequestration: A Comparative Study With Greyscale Computed Tomography'. Together they form a unique fingerprint.

Cite this