Vertebral disk morphology of the lumbar spine: a retrospective analysis of collagen-sensitive mapping using dual-energy
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SCIENTIFIC ARTICLE
Vertebral disk morphology of the lumbar spine: a retrospective analysis of collagen-sensitive mapping using dual-energy computed tomography Friederike Schömig 1 Friedemann Göhler 2
&
Matthias Pumberger 1 & Yannick Palmowski 1 & Ann-Kathrin Ditges 2 & Torsten Diekhoff 2 &
Received: 12 October 2020 / Revised: 24 November 2020 / Accepted: 25 November 2020 # The Author(s) 2020
Abstract Objectives To investigate the diagnostic accuracy of collagen-sensitive maps derived from dual-energy computed tomography (DECT) for the detection of lumbar disk pathologies in a feasibility setting. Materials and methods We retrospectively reviewed magnetic resonance imaging (MRI), computed tomography (CT), and DECT datasets acquired in patients who underwent periradicular therapy of the lumbar spine from June to December 2019. Three readers scored DECT collagen maps, conventional CT, and MRI for presence, type, and extent of disk pathology. Contingency table analyses were performed to determine diagnostic accuracy using MRI as standard of reference. Interrater agreement within and between imaging modalities was evaluated by computing intraclass correlation coefficients (ICCs) and Cohen’s kappa. Correlation between sum scores of anteroposterior disk displacement was determined by calculation of a paired t test. Results In 21 disks in 13 patients, DECT had a sensitivity of 0.87 (0.60–0.98) and specificity of 1.00 (0.54–1.00) for the detection of disk pathology. Intermodality agreement for anteroposterior disk displacement was excellent for DECT (ICC 0.963 [0.909– 0.985]) and superior to CT (ICC 0.876 [0.691–0.95]). For anteroposterior disk displacement, DECT also showed greater withinmodality interrater agreement (ICC 0.820 [0.666–0.916]) compared with CT (ICC 0.624 [0.39–0.808]). Conclusion Our data suggest that collagen-sensitive imaging has an added benefit, allowing more accurate evaluation of the extent of disk displacement with higher interrater reliability. Thus, DECT could provide useful diagnostic information in patients undergoing CT for other indications or with contraindications to MRI. Keywords Vertebral disk . Pathology . Tomography . X-ray computed . Spine . Collagen * Friederike Schömig [email protected] Matthias Pumberger [email protected] Yannick Palmowski [email protected] Ann-Kathrin Ditges [email protected] Torsten Diekhoff [email protected] Friedemann Göhler [email protected] 1
Center for Musculoskeletal Surgery, Charité – University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
2
Department of Radiology, Charité – University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
Introduction Affecting 3–5% of the population, lumbar radiculopathy is one of the most common symptoms caused by degenerative spinal disease [1]. Patients present with pain or sensory loss in a dermatomal pattern, possibly in conjunction with motor function loss in a myotomal pattern. In most cases, the underlying cause is irritation o
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