Additive values of pelvic tomosynthesis in comparison to pelvic radiography alone for the diagnosis of sacroiliitis in p
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SCIENTIFIC ARTICLE
Additive values of pelvic tomosynthesis in comparison to pelvic radiography alone for the diagnosis of sacroiliitis in patients with suspected axial spondyloarthritis Euddeum Shim 1 & Taeho Ha 1 & Baek Hyun Kim 1 & Suk-Joo Hong 2 & Chang Ho Kang 3 & Sookyung Jeon 4 & Jaehyung Cha 5 Received: 4 August 2020 / Revised: 21 September 2020 / Accepted: 21 September 2020 # ISS 2020
Abstract Objectives To compare inter-reader agreement and diagnostic confidence in detecting sacroiliitis by the modified New York criteria (mNY) on digital radiography (DR) versus digital pelvic tomosynthesis assisted DR (DR+DPT), and to evaluate changes in the presence of axial spondyloarthritis (axSpA) according to the Assessment of Spondyloarthritis International Society (ASAS) criteria. Methods One hundred and thirty-eight patients who underwent both DR and DPT with suspicious axSpA in our rheumatologic clinic were included from February 2017 to February 2018. Three radiologists independently graded sacroiliitis and confidence level on DR first and then re-graded them on DPT in a paired manner. Agreement, confidence, and diagnostic accuracy were evaluated for readers. Changes in the presence of disease by mNY and ASAS criteria were assessed between DR alone and DR+ DPT. Results On DR alone, 73 patients were assessed with radiographic sacroiliitis, and 85 were classified into axSpA by the ASAS criteria; however, 78 and 85, respectively, were classified on DR+DPT. With the assistance of DPT, 17 and 12 patients changed to the disease positivity according to the mNY and ASAS criteria, respectively; the negative results changed to positive in 11 and six patients, respectively. For all readers, agreement improved with DPT (0.79 to 0.89). DR+DPT achieved higher diagnostic accuracy (AUC, P < 0.05).
Euddeum Shim and Taeho Ha contributed equally to this work. * Baek Hyun Kim [email protected] Euddeum Shim [email protected] Taeho Ha [email protected]
1
Department of Radiology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
2
Department of Radiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
3
Department of Radiology, Korea University Anam Hospital, 126-1 Anam-dong 5-ga, Seongbuk-gu, Seoul 02856, Republic of Korea
4
Mammogrpahy and Radiography Application Specialist, GE Healthcare Korea, 15F, Seoul Square, 416 Hangang-daero, Jung-gu, Seoul 04637, Republic of Korea
5
Medical Science Research Center, Korea Unversity Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
Suk-Joo Hong [email protected] Chang Ho Kang [email protected] Sookyung Jeon [email protected] Jaehyung Cha [email protected]
Skeletal Radiol
Conclusion The combination of DR and DPT achieved a higher diagnostic performance than that of DR alone, with better agreement. On DR+DPT, the diagnoses of 9.0% of patients with suspicious axSpA (12 of 134) were changed to the status of disease by the ASAS cr
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